What does it really mean to be fully recovered from an eating disorder?

For decades, the conversation has been clouded by vague definitions, conflicting philosophies, and the fear that “recovery” might not even be possible. In this powerful conversation, I sit down with Carolyn Costin, a renowned therapist, author, and pioneer in the eating disorder field, to dig into what recovery actually looks like, why she believes full recovery is possible, and how to strengthen the “healthy self” rather than fight against the eating disorder voice.

Carolyn Costin MA, MEd., MFT, CEDS, FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker. Recovered from anorexia in her twenties, as a young therapist Carolyn recognized her calling after successfully treating her first eating disorder client. Carolyn was first to publicly take the position that people with eating disorders can become fully recovered.

“When you are recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on the scale.” - Carolyn Costin

“We are not born with an eating disorder. We were born with this core healthy soul self in there.” - Carolyn Costin

“Instead of getting rid of the eating disorder self, I help strengthen people’s healthy self.” - Carolyn Costin

“When someone has had an eating disorder, I want to be cautious for a while, but I know so many people now being in this for so long who are recovered and shit’s happened in their life… and not slipped back.” - Carolyn Costin

“I don’t weigh myself. It’s like a feminist statement.” - Carolyn Costin

“We have to be careful… but my experience is people who are recovered actually navigate it better because we’ve already been through all that and it’s like we have a bit of a shield up for it.” - Carolyn Costin

Visit Carolyn’s website - www.CarolynCostinInstitute.com

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Have you ever wondered where the line really is between disordered eating and a true eating disorder? It’s not always as clear as we’d like to think. In fact, so much of what we consider “normal” in diet culture—tracking every bite, stressing over body image, or skipping meals in the name of health—can feel harmless at first… until it slowly starts taking over more and more of your life.

If you’ve ever asked yourself, “Is this just disordered eating, or is it something more?”, this conversation is for you.

“You don’t have to have a diagnosable or a life-threatening eating disorder in order to qualify to get help.” - Rachelle Heinemann

“Think of it like an iceberg. Disordered eating is the part you can see… but an eating disorder is the entire iceberg—this massive, dangerous thing that’s hidden.” - Rachelle Heinemann

“With disordered eating, the rules are upsetting if you can’t follow them. With an eating disorder, the rules feel like commands, and breaking them feels like a moral failure.” - Rachelle Heinemann

“To me, one of the most important pieces to keep an eye out for is how your relationship with food is impacting your life—your work, your friendships, even your ability to leave the house.” - Rachelle Heinemann

“No matter if you have a full-blown eating disorder or you struggle with yo-yo dieting, there is help out of it. You don’t have to wait.” - Rachelle Heinemann

Bergen Mental Health Group Inc. is hiring! If you think you’d be a great fit, check it out!

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LEAVE A REVIEW + help someone who may need this podcast by sharing this episode.

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You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

While we’re on summer break, we’re bringing back some of the most impactful episodes that deserve a second listen—and this one is just too good to pass up. This is our last re-release for the summer. We will be back with new episodes on September 9th, so be sure to tune back in.

In this episode, we’re going deep into the neurobiology of eating disorders with Dr. Jeffrey DeSarbo, a renowned psychiatrist and medical director of ED-180, one of the largest private eating disorder treatment centers in the U.S.

If you’ve ever wondered why eating disorder recovery can feel so hard, or what’s really going on in the brain beneath the behaviors, this episode will open your eyes and deepen your understanding. Dr. DeSarbo explains the science in a way that’s relatable, clear, and deeply compassionate. From the neurological impacts of restriction, binging, and purging to the effects of compulsive exercise and body image distress, we’re unpacking it all.

This conversation is a must-listen for clinicians, individuals in recovery, and anyone curious about the “why” behind the “what.”

In this episode, we’re talking about:

• Dr. Jeffrey De Sarbo’s unique path from finance to psychiatry, and how he became a leading expert in eating disorder neurobiology.

• Why eating disorders are “half medical, half psychiatric”—and how this complexity makes them uniquely challenging and important to understand.

• What neurobiology really means, and how our brains function through electrochemical energy.

• The role of genetics and epigenetics in eating disorders, and why some people are more biologically predisposed than others.

• How brain scans show measurable differences in individuals with eating disorders, especially in how different regions of the brain communicate.

• Why “just eat” or “just stop” is a myth, and how deeply biological factors resist simplistic solutions.

• How behaviors like binging can physically change the brain, creating patterns that mimic addiction and drive compulsion.

• What restriction does to the brain, including loss of gray and white matter and cognitive impairment, even when someone appears high-functioning.

• The dangerous effects of purging, from electrolyte imbalances to cardiac issues, and why “feeling fine” doesn’t mean you’re medically safe.

• The neurobiology of compulsive exercise, and how stress hormones and overtraining harm the brain’s ability to function and recover.

• Why body image distress is not just emotional but neurological, with altered blood flow patterns and measurable differences in perception.

• How neurobiology informs the recovery process, and why rewiring the brain is both essential and entirely possible—with time, persistence, and support.

"Eating disorders are not a choice. It’s something that happens." - Dr. DeSarbo

"Oftentimes, when we work with our eating disorder patients, they have 10,000 plus hours of eating disorder thought processes—so they become experts." - Dr. DeSarbo

"Restriction with anorexia nervosa is giving you a compromised brain." - Dr. DeSarbo

"You're invincible until you are not—and then it is too late." - Rachelle Heinemann

"What percentage of your free thoughts, when you're not busy actively doing something, do you spend thinking about or worrying about food, weight, body image, calories, exercise?" - Dr. DeSarbo

ED180

The Brain and Neurobiology of Eating Disorders

Translating ED

Nora Volkaw

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You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com