Eating disorder recovery can be messy, one writer learns : NPR

When Mallary Tenore Tarpley was 11 years old, her mother died from breast cancer. Her father, who was reeling from his wife’s death and at a loss to guide his daughter through puberty, gave Tarpley a subscription to a teen magazine.

Instead of finding helpful advice about her changing body, Tarpley saw models with big hair and emaciated figures. In a school health class, Tarpley and her classmates were lectured about their food choices, so she began eliminating what she saw as “unhealthy” foods. Then she reduced portion sizes, reasoning, in her grief, that if she stayed small she could keep her mother close. That quickly spiraled into severely restricting her food intake.

“I found that calorie counts gave me some semblance of control in the aftermath of my mother’s death; I couldn’t control what happened to her body, but I could regulate what I put in mine,” she writes.

In her new book, SLIP: Life in the Middle of Eating Disorder Recovery, which combines memoir and research, Tarpley, now 40, writes about living with an eating disorder and the insights she’s gained as an adult.

Mallay Tenore Tarpley is the author of SLIP: Life in the Middle of Eating Disorder Recovery
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Tarpley was admitted to the hospital at 13 and diagnosed with anorexia nervosa. She spent most of her teens in and out of residential treatment facilities, and what followed were difficult years in pursuit of recovery.

Only a few years ago, there was a movement away from diet culture toward body acceptance, but now diet-culture is roaring back. Instead of the low-fat foods and heroin-chic of the 1990s, everyone seems to be using GLP-1s and #skinnytok, a social media hashtag promoting eating disorders, had millions of views before it was banned by TikTok in June. It’s a troubling trend because many people who develop eating disorders never fully recover.

This has been true for Tarpley, who says that she remains somewhere between acute sickness and complete recovery. In her book, she writes about living in this “middle place.” She examines how shifting from an all-or-nothing recovery approach of her teens and early 20s to one where setbacks are expected and accepted has allowed her to live a full life while continuing to strive for progress.

Tarpley spoke with NPR about her new book.

This interview has been edited for clarity and length.

You spent many years striving for full recovery. What was that like for you to realize that you might not ever arrive at complete recovery?

I left treatment when I was 16 and really did feel like I wanted to be fully recovered. I wanted, in some ways, to be the poster child for that because I’d spent so many of my teenage years just wanting to be the perfect anorexic. But I never really knew what full recovery looked like. As a perfectionist, I thought I need to eat perfectly. I need to exercise just the right amount. I can’t have any disordered thoughts around my food or body. I did that in my junior and senior year [of high school], and felt like, OK, I’ve got this. I’m fully recovered. I stopped seeing my therapist, got off my medications, thinking I’m done with the disorder.

I ended up relapsing in college and fell into the cycle of binge eating and restricting. I was telling everyone I was fully recovered, even though I wasn’t because I felt ashamed to admit that I was anything but fully recovered. I kept my behaviors pretty secretive.

Then [as a journalist], I started to do some work around restorative narratives, which is this genre that is really looking at how people in communities make meaningful pathways forward in the aftermath of trauma and illness. As I began to slowly reframe my thinking, it enabled me to embrace the imperfections, and it made recovery feel more attainable.

How did this shift in thinking allow you to thrive even though you were still contending with your eating disorder?

It really helped me to think about normalizing slips more. So to think, OK, I had a slip, rather than letting this turn into a slide, or rather than keeping it secretive, I am going to tell somebody. I started to go back to therapy. Around this time I was also meeting my now husband and was beginning to realize that if I want to be in a meaningful relationship with him, it would have to be rooted in honesty. I began to be more open about these moments where I found myself slipping, and I would try to deal with it in that moment.

There was more immediacy to it, which helped me to think about forward momentum through the middle place. One of the biggest misconceptions is that the middle place is about settling for stagnancy, and it’s really not. It’s about being able to get up and keep moving forward.

Do you think the thought of never fully recovering might feel discouraging for some people?

I do think full recovery can be possible for some. So many of the people I interviewed [for the book] said that they inhabit this [middle] place, and that to be able to own that narrative and to give words to it was really helpful. It enables me to give myself grace and to not be so hard on myself.

We know people with eating disorders often share the same temperament traits, and one of those traits is perfectionism. There’s a lot of black-and-white thinking, and that can really be detrimental because it feels like, well, if full recovery is perfection, I’m never going to get there, so why even try? In some ways, that push for full recovery can actually leave some people feeling defeated.

You write in the book about how “full recovery” hasn’t actually been defined by the medical community. Do you think it should be?

It can be very confusing for people with lived experience to even know what it means because the field itself hasn’t even come to a consensus definition. There are almost as many definitions of full recovery as there are studies about it. Individually, it can be helpful for us to define recovery on our own terms because certainly it’s not one size fits all. It plays out differently for each of us.

I do think that it can be helpful from a research perspective to have some parameters around what full recovery means because otherwise it makes it really hard to compare data across studies.

Being in the middle place, what challenge does that present to you as a parent to a 9-year-old daughter and 7-year-old son?

There are moments when I feel like there’s a little bit of a fake-it-till-you-make-it situation where I will talk with my kids about their bodies, and I will be thinking negatively about my own. I’m talking with them about how strong they are, and how their bodies help them move through the world, and how I want them to feel like they can take up space in the world, and yet I find that I still have trouble doing that myself. So there’s kind of this mix of hope and hypocrisy.

How do you talk to your kids about content that promotes eating disorders on social media?

When we’re driving in the car, we hear these ads about weight loss. We were streaming Disney+, and there was an ad that came on for GLP-1s. I used to very quickly grab the remote or turn down the volume in the car, but I’ve started to use that as an opportunity to talk with them.

I tell them, you’re going to see so many of these messages, but I want you to know that they don’t have to apply to you. I want you to realize that you don’t have to try to change the way your body looks just to try to fit what society tells you your body should look like. I’m trying to do what I can to protect them now, but I know as they get older, that’s only going to be harder.

Alicia Garceau is an Indianapolis-based journalist. She writes about health, caregiving and identity and publishes the Substack newsletter The Wonder Years.