Applied Optimization in Eating Disorder Recovery

In Part 2 of this series we considered what happens when you have an optimization problem (let’s say recovery) with multiple competing objectives (let’s say getting healthy whilst having a body weight that is acceptable to you). In this final part of the series, we consider some troubleshooting options to help recovery stay on track despite the complexities of competing objectives that change as you do.

As we saw in Part 2, as soon as you have more than one objective, you have more than one optimal solution: Specifically, you have a whole curve populated with optimal solutions. It often doesn’t feel this way when you’re doing something difficult where you’re having to balance multiple aims. The most immediate reasons why you don’t see the curve are usually fear and misinformation. Hiding the curve from you is what fear does best because fearing something means, in optimization terms, trying to minimize the hell out of it. This means that you radically reduce the number of available optimization options.

This fear is probably responsible for the fact that the majority of people who have anorexia don’t get fully better, i.e. never even get to the optimal curve. And even if it doesn’t prevent you from reaching the optimal curve, fear might well persuade you, once you’re on it, that you’re not on a curve—i.e. inhabiting one of a family of equally good points—but at a unique optimal point that must not be deviated from. You might have got to a weight where you are truly capable of full health but are terrified about gaining or losing even a kilo or two, in case that ruins everything. This sense of having no options, no freedom of movement, will reliably endanger any potentia fully recovered state through paradoxical fear of its endangerment. It’s worth remembering that misinformation comes in many forms, including dressed up in medical clothing. For example, one form of life-wrecking misinformation is the notion that a BMI of 20 to 25 is healthy and that this is all any of us should aim for or consider acceptable, whatever our genetics or our life circumstances.

This biomedical model of body weight can be contrasted with the standard “lay” view and the anorexic view. Cost perceptions can be altered by direct efforts at attitude change, as well as by therapeutic efforts to come closer to the “normal” curve. And of course, as pre-recovery gives way to recovery and recovery proceeds, the anorexic view begins to change—in some respects becoming better aligned with the “standard” view but also developing an unforgiving pattern of perceived costs for each new phase of progress. In a context where the perceived costs of each incremental increase in body weight can feel unbearably high, one function of professional support can be to smooth out the spikes in your cost function.

In the end, it’s crucial to remember that when several objectives are in tension, there is never a single optimal answer. All of your optimal options are trade-offs, and you get to choose which you like best.

Read the full details here.