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xiiEATING DISORDERS ANONYMOUSWhile this volume is not intended to be a supplement to Alcoholics Anonymous, we highly recommend thatthe reader become familiar with the original text.2 Muchguidance and inspiration can be found there. Note that thechapters in both books are arranged similarly to accommodate easy cross-reference.The solution we outline here is based on our personalexperiences of having and recovering from our eating disorders. For members of EDA, this typically means gainingperspective (Step One), gaining hope (Step Two), preparingto make changes (Steps Three and Four), becoming accountable (Step Five), surrendering to a new approach without fearof self-recrimination or judgment (Steps Six and Seven), recognizing and repairing damage done (Steps Eight and Nine),maintaining integrity and trust (Step Ten), and building afoundation for, and then expanding on, a purpose-driven life(Step Eleven). As a result of working these Steps, we experience a transformation that enables us to gain—and maintain—a healthy perspective. This enables us to break free,and stay free, from eating-disordered thoughts and behaviors. Most EDA members recognize this transformation as aspiritual awakening,3 yet the transcendent experience of fullrecovery is not limited to those of us who adopt a spiritualor religious faith. In Step Twelve, we share our experience,Early members of EDA successfully used the AA “Big Book” and the AA“Twelve and Twelve,” translating the words “alcohol” and “drinking” to “acting out” and the word “alcoholic” to “eating disordered.” Sponsors may, ofcourse, still do so. An online, English version of the 4th edition of the AA “BigBook,” Alcoholics Anonymous, is available here: http://www.aa.org/pages/en US/alcoholics-anonymous, and an online, English version of the AA text, TwelveSteps and Twelve Traditions, is available here: http://www.aa.org/pages/en US/twelve-steps-and-twelve-traditions.3The term “spiritual awakening” can refer to an event—a vital spiritual experience—or to a gradual change. Those of us who are atheists also experiencea transformation, enabling us to place service before selfishness.2

PREFACExiiistrength, and hope. We apply the principles of the programto all we do: this way of looking at life and our place in itworks under all conditions.EDA has no opinion on the current scientific, medical, and humanistic debate about whether an eating disorder is an addiction or whether an addiction is a disease. Wewant no one to be distracted by academic arguments aboutlabels. The founders of AA made a serious effort to clarifythe complexity of the various manifestations and forms ofalcoholism: theirs was not a “one-size-fits-all” definition,and neither is ours. Our stories show a great diversity intype and severity. Some of our members conceive of theireating disorders as an addiction and a disease, while othersdo not. In the end, we find it matters very little what labelswe apply, if any at all; our solution is not contingent uponany specific conception of what an eating disorder may ormay not be.Some medical professionals have been critical ofTwelve-Step groups for denigrating the value of medicaltreatment. They are concerned that viewing an eating disorder as an addiction or disease absolves the individual ofresponsibility for addressing their condition, prevents themfrom recognizing that their condition is treatable, createsa culture in which patients believe they are unable to fullyrecover, and requires a cult-like dependence on a spiritualpower as a marker of recovery.We certainly hope that anyone with a genuine understanding of the Twelve-Step programs of AA and EDA willimmediately recognize the flaws in these objections. Forthose who are less familiar with these programs, we addressthese points one by one.

xivEATING DISORDERS ANONYMOUSFirst, EDA members typically work closely with medical professionals. EDA recognizes that many people need,and greatly benefit from, the support of the medical community. Most EDA members are eager to help newcomersfind and leverage whatever support is available.Next, in all Twelve-Step programs, the individual isultimately held accountable for their behavior. Rather thanusing “the condition” as an excuse for failing to exerciseone’s own agency to recover, all Twelve-Step programs require members to recognize that they alone must make thedecision to change; they alone must take action for the decision to be effective. Those who object to the Twelve-Stepapproach on the basis that it is a “culture of powerlessness”should recognize that the first step is but an admission ofperspective gained; the rest of the steps are all about gainingthe power needed to build and sustain recovery.Those who object to Twelve-Step programs on the basis that they foster dependence on a spiritual entity shouldunderstand that for most EDA members, spiritual dependence produces independence from fear, self-pity, despair,myriad forms of obsession, and freedom from mortal peril.For others, working the Twelve Steps need not entail reliance on any spiritual source at all. The choice of how towork the Steps is up to the individual. “God” in EDA literature can mean the Deity, a deity, a spiritual entity ofone’s own understanding (a Higher Power), or a non-spiritual conception (a higher purpose). Reliance on any one ofthese conceptions confers a perspective that transcends ourimmediate physical, social, and emotional circumstancesand allows us to “keep calm and carry on” with what really matters. All Twelve-Step groups encourage members to“take what you can use and leave the rest.” This is not astatement to be found in any cult.

PREFACExvFinally, while AA maintains a position that can be described as “once an alcoholic, always an alcoholic,” EDA’sstance is that people can and often do recover fully fromtheir eating disorders. In EDA, we recognize that our responses to life are conditioned by how we have reacted inthe past. And while life-long patterns can be changed, it ishard work. EDA provides support for those who are readyto engage in the work of recovery.In early recovery, we learn to take small risks to buildtrust with ourselves and others. We soon discover that thistakes time and patience, so we do our best to follow theguidance we hear in EDA meetings: Eat when hungry, stop when moderately full.Consistent nutrition is essential for recovery. Recovery is about feelings, not food, but we can’treason or build trust when bingeing, purging, orstarving. Get basic needs met first. If hungry, eat. If angry,find a safe outlet. If lonely, reach out. If tired,sleep. If ashamed, talk about it. Ask others for input, then make your own decisions. When anxious or troubled, do something thatfocuses attention on your physical senses, getoutside, pray, or meditate. Then deal with theproblem head-on. Get open with others. Honesty restores integrity. Develop willingness to look at things differently.Recovery is not rigid.

xviEATING DISORDERS ANONYMOUS Go to Twelve-Step meetings, read the literature,and work the Steps with a sponsor. Be proactive and plan your recovery.Following such suggestions, and relying on others’experience, strength and hope, we may do well for days,weeks, or months—only to find ourselves right back intired, old habits that don’t serve us or anyone else. Indeed,a “normal” recovery often involves what can seem like a distressingly long period of back-and-forth, as we learn moreabout what changes are truly required. But mistakes thatlead us back to old behaviors should not be feared: theycan be powerful tools for building a solid foundation if weare consistently open and honest about our expectations,resentments, fears, self-pity, shame, guilt, confusion, frustration, and despair—all the messy emotions that drove usinto our eating disorders in the first place. This then opensus up to the difficult process of changing the thoughts thatunderlie these emotions. To maintain progress, we need asmuch support as we can get.We in EDA don’t find it helpful to count numbers ofany sort: we don’t weigh or measure anything, includingdays or years of freedom. Instead, we recognize what we call“milestones of recovery,” which are self-defined markers onour journey. Even on our worst days, it is essential to recognize that we are doing things that are right and good, andsupportive of our success. In meetings, we encourage everyone to claim as many milestones as they can. As we resolveour underlying thinking problems and become more positive and proactive, our recovery grows stronger and moreflexible. By practicing the habits of thought and behaviorwe learn through working the Twelve Steps, we find we can

PREFACExviirely on them to bring us durable peace and freedom: weneed never return to our old patterns.We still have normal life challenges, of course, and weexperience emotions just as deeply as before—though thereare differences. In full recovery, many of our most powerfulemotions are positive: love, joy, delight, satisfaction, and asense of wholeness and happiness. When we experience distressing emotions, we no longer seek escape; we know whatto do and generally do it automatically. When troubled,we take stock, seek to understand where our thinking hasgone awry, make amends where needed, and immediatelyturn our attention to how we can use our experience toserve some good purpose. Full recovery is resilient. We areable to do all sorts of things that used to “trigger” obsessive thinking and eating-disordered behavior. We can goanywhere and do anything that normal people do, withoutre-engaging our eating disorders: we are restored to sanity.Our EDA groups include members who are religious,spiritual, agnostic, and atheist. Though our ideas aboutGod, Higher Power, and higher purpose may be very different, this creates no great friction among us. We are alliedin our common struggle to establish reliance on somethinggreater than ourselves. Rather than debating theologicaldifferences, we grow in tolerance and humility as we shareour experience, strength, and hope with each other. Wecherish the diversity of our ideas and our stories, for theseoffer fresh hope to the newcomer.We respect each individual’s journey. We encouragemembers who have a strong faith in God to continue toseek God with all their hearts. We support members whoseek to grow along different spiritual lines, and we respectmembers who seek peace in service to the greater good. InEDA, we celebrate everyone in recovery.

xviiiEATING DISORDERS ANONYMOUSWe acknowledge that EDA has no monopoly on recovery. Many people recover from an eating disorder without any intervention, while others benefit from medical,social, and psychological support. We appreciate and respect that a combination of support is often desperatelyneeded by those who find themselves as profoundly helpless in their eating disorders as we once were.We know our solution—the program of EDA—relieved us of our eating disorders. Our main purpose inwriting this text is to share our accumulated experience,strength, and hope so that others might also find relief. Wehope that you, the reader, will find guidance you can use inthe following pages. And we wish that everyone might behappy, joyous, and free.

DOCTORS’ OPINIONSEDA members encourage everyone seeking recovery froman eating disorder to work with qualified medical professionals. For the most severely afflicted, a trained and experienced team—usually including a physician, a psychiatrist, a psychologist, and a registered dietician—can meanthe difference between life and death. Even in relativelymild cases, caring and trained professionals can be essentialto sustained change.We think everyone engaged in eating disorders recovery will be interested in what medical professionals themselves have to say about the process and about our organization. It is a great honor to offer the following letters ofsupport from three such individuals who have dedicatedtheir time, talent, and energy to helping people with eatingdisorders develop strong foundations for recovery.Our first letter is from Dr. Ray Lemberg, PhD. Dr.Lemberg is a clinical psychologist in practice in Arizonasince 1977. He received his doctorate from the Universityof Maryland and is a pioneer in the field of eating disorders,having formed the first psychiatric inpatient program inArizona in 1980. Dr. Lemberg has made over one hundredpresentations on this subject; is Associate Editor of: EatingDisorders, The Journal of Treatment and Prevention; is theauthor of forty-five papers and publications; and editor ofthree books on eating disorders, the most recent, co-editedwith Leigh Cohn: Current Findings on Males with EatingDisorders (NY/London, Routledge Press, 2014).xix

xxEATING DISORDERS ANONYMOUSDr. Ray Lemberg’s OpinionTo Whom It May Concern:When the “Big Book” of Alcoholics Anonymous waspublished in 1939 no one could have dreamed of itsmonumental impact. AA is now over 2,000,000 membersstrong. Eating Disorders Anonymous (EDA), which wasfounded in 2000 in Phoenix, Arizona, is modeled on thesame Twelve-Step philosophy, respecting and preservingthe major tenets of AA. The Twelve-Step model has beenpowerful in promoting recovery through support and fellowship as well as by demonstrating the success of thosewho were able to escape the grip of obsessive thought andcompulsive behavior.Years ago, Dr. Scott Peck, psychiatrist, wrote the bestselling book, The Road Less Traveled, which had a significant impact at that time. Dr. Peck conveyed that the pursuit of happiness was misguided, as happiness is a fleetingemotion. Instead, fulfillment in life is achieved, in part,by delaying gratification and overcoming obstacles that inhibit growth and transformation.The EDA philosophy has many parallels to these teachings. A major contribution by EDA is an aim to broadenthe understanding and conceptualization of a “HigherPower.” In essence, finding meaning in life is often dependent on finding purpose outside and beyond self-preservation and self-interest.Typically, the process of recovery is arduous and characterized by backward and forward movement that ultimately is necessary for creating a fundamental life change. Itinvolves internalizing the belief that each person’s journeyis uniquely individual, and that personal transformation ispossible. It also involves the sense of belonging to a fellowship that empowers a person with the strength of knowingthat he/she is not going it alone.

DOCTORS’ OPINIONSxxiWithin the EDA text that follows, it is proposed thatthe concept of a Higher Power can be embodied by theidea of a higher purpose. This allows those who do notembrace religious convictions to empower themselves witha higher level of life’s meaning, and enables them to evolveinto more complete and resilient people. Recovery is muchless about one’s relationship with food and much moreabout one’s relationship with oneself, others, and a higherpurpose.In this context, for some people the concept of faith isin a Higher Power, for others it is in a higher purpose. Bothembrace a deep commitment and reliance on believing thatsomeone or something is of much greater importance thanself.The work that follows is innovative, significant, andgroundbreaking.Raymond Lemberg, PhDClinical PsychologistOur second letter is from psychologist Dr. SumerAeed, whose guidance was critical in EDA’s identificationof balance and perspective as goals of recovery. Dr. Aeedholds a doctoral degree in Educational Psychology/Counseling Emphasis, a master’s degree in Counseling Psychology, and a BA in International Relations. She has workedfor over twenty years in the counseling, consultation, andeducation fields helping individuals and families createhealthier relationships. As the founder of What’s Your StoryExperiences—experiential workshops that support transformation and healing—Dr. Aeed guides individuals to explore the power of their unique stories. An adjunct facultymember at Northern Arizona University, she has developedprevention programs for youth, serves on several boardswith a focus on healing and prevention work, and writes

xxiiEATING DISORDERS ANONYMOUSarticles in the field of mental health for numerous magazines and websites. Dr. Aeed’s work helped EDA embracethe idea that consciously taking care of our own basic needsis essential to establishing relationships of trust. This ideais central to EDA’s message of recovery, and we are gratefulfor her contribution.Dr. Sumer Aeed’s OpinionTo Whom It May Concern:Our identity is forged by our story; that story determines our emotions, behaviors, relationships, possibilities,and truth. People conquer their eating disorders in manydifferent ways. Yet we often seek “the” answer, or “the”story, rather than looking for our own. Thankfully, thereis a way out.As a psychologist and educator with twenty years ofexperience working with eating concerns across the spectrum, I am passionate about individuals having access to abroad base of tools and solutions on their road to recovery.I have not only witnessed the devastation that eating disorders can play out in people’s lives, I have seen the stories ofhope and new beginnings that can be forged from the pain.Research shows us that eating disorders stem from biopsycho-social-spiritual roots, and my experience is thata resilient recovery allows for tools in all of those areas.Through the power of the group, the power of shared stories, and the power of others speaking into our lives, wecan co-author our recovery stories, borrowing pieces fromeach other’s chapters and weaving them into our own.What I often see in my clients are patterns in which theygo 100 mph, get inspired, dig in and fall back down, seethe breakthrough, and then end in yet another breakdown.They decide it’s all a waste of time and then think, I can’t

DOCTORS’ OPINIONSkeep living like this. They are determined to find “the” answer and get it exactly right, while ensuring they don’t riskor let go of anything. They are stuck in not being willingto change the questions they ask, which are still all aboutbody, food, and control. This is all that they know and allthat they trust, even though it is gradually killing them dayby day. They watch others recover and feel hopeless, sometimes wondering if people “in recovery” are all just lying.Then they see hope in their eyes and peace as they sit sideby side, realizing they aren’t lying, and wanting what theyhave. Clients then become willing to listen—even when itdoes not make sense and challenges all that they are doing—desperate to find some other way to live and wearyof the despair, disgust, and shame weighing them down.Although my experience stems from the varied storiesthat people struggling with eating challenges bring to their“table,” aspects of the following might sound familiar tomany readers. The more things spin out of control inside,the harder you work to keep the outside looking “fine”—not realizing there is any other way to live, certain everyonefeels this way, while at the same time afraid you are aloneand broken in some unspeakable, unfixable way. Otherssee possibilities that you are not yet ready to claim; you letgo of old ways of thinking and create new habits; you getto the “end” and then start all over again. You hide, youare seen, and you feel certain you would be the one personthat the tools would not work for. You have slow chaptersof great effort with seemingly little benefit—journaling,meditating, yelling at the fridge, not wanting to look inthe mirror. You face the devastation of the eating disorder,still not able to tell the truth. You live with your body cutoff from the head down, refusing to connect in any way tothis horrible thing you are stuck in, with which you must“do life.” You push your body past any logical or healthylimits, seeing what you are doing, and still not being ablexxiii

xxivEATING DISORDERS ANONYMOUSto stop. You feel like someone else’s foot is on the accelerator, racing y

1 EDA’s program of recovery is adapted from the first 164 pages of Alcoholics Anonymous, the “Big Book,” with permission from Alcoholics Anonymous World Services, Inc. Permission to reprint and adapt this material does not mean that AA has reviewed or approved this or any other EDA material. AA