The First Week of Treatment is Hard. Here’s What Can Help.
You’re a few hours into treatment—or maybe a few days in—when you begin to wonder if you’ve made a mistake. The anxiety you expected to subside has only gotten more intense. “You’re not sick enough for this,” it says. “You can handle this on your own.” Part of you is already scanning for the exit.
This can happen even if you felt ready to begin eating disorder treatment. Even if you walked in with real motivation and a sense of hope. However disorienting it might be to experience, a spike of panic at hour twelve or an overwhelming urge to leave at the end of day three are not signs that treatment is wrong for you. Research tells us that the eating disorder voice tends to get loudest when it feels most threatened, and entering treatment is about as threatening as it gets.
Read on to learn why the first days can feel so destabilizing, and what to do when the urge to leave feels the strongest.
Why Starting Treatment Can Feel So Hard
Embarking on the path of eating disorder recovery represents a huge leap of faith. Recovery means choosing the unknown over what’s familiar, moving toward outcomes you can’t fully control or predict. That’s a huge ask, especially in the early stages of treatment.
Your eating disorder caused real harm—you know that. But it may have also offered you clear rules, a sense of structure, and a way to manage unpleasant feelings, sometimes for a long time. The moment you step into treatment and begin disrupting those patterns, your brain responds the way it would to any significant threat: with alarm, with resistance, with an intense pull back to what feels familiar, protective, necessary…even when that’s also what’s been hurting you.
It’s also worth understanding what’s happening neurobiologically. Eating disorders are serious, complex mental health conditions that can fundamentally affect how your brain functions. Malnutrition affects the brain directly. It can impair cognitive functioning, emotional regulation, and the ability to sit with uncertainty without immediately wanting to escape it. When you’re living with an eating disorder, it can become harder to imagine a different future for yourself, access hope and curiosity, or trust that a life beyond the illness is possible. Your brain may be working against you because the eating disorder itself has changed how it functions.
That’s why even when part of you genuinely wants to recover, another part might not be convinced—and has no problem letting you know that (the alarm bells it’s setting off are hard to ignore). An eating disorder’s patterns can still feel safer than the uncertainty of letting them go, even if you intellectually understand the risks and damage associated with them. In early treatment, that push-and-pull is more the rule than the exception, however frustrating it might be.
Add to this all the other logistical newness treatment asks you to take on at once: new people, new routines, new schedules, new settings, new skills, new meal plans. It makes complete sense that your nervous system is struggling. Yes, it’s all there to support you, but the sheer volume of change is a lot for anyone to absorb, let alone a person absorbing it in a body and brain that are already depleted.
What the First Days Can Feel Like
At some point in those first hours or days, your distress may start to crystallize into something that feels increasingly like a reasonable decision: “I should leave.” Most people who make it through the initial stretch of treatment describe wanting to walk out at some point. However, that urge rarely reflects whether treatment is right for you. Eating disorders are skilled at sounding rational, especially under pressure. The thought telling you to go home is usually the illness grasping at reasons to stay in control.
It’s also normal to feel a kind of grief for the routines and coping mechanisms you’re being asked to leave behind, even when those things have caused harm. Perhaps you’re struggling to imagine yourself as separate from your illness, which can make you question the value of treatment or second-guess your desire to recover at all. These are documented features of eating disorders, and there’s nothing wrong with you for feeling this way.
Challenging an eating disorder is demanding work. It takes enormous energy to show up and stay present when your eating disorder desperately wants you to retreat. Feeling worn out, panicked, sad, or angry—or any emotion that feels bigger than the moment warrants—is all valid, and all part of the process. It’s also temporary.
Ways to Stay Grounded and Commit to Treatment
The distress you’re feeling doesn’t have to be a deal breaker. You’re not expected to white-knuckle your way through early treatment. Here are some things that can help when the urge to leave feels loudest:
Shrink your time horizon.
You don’t have to think about next week, or even tomorrow. Just focus on the next thing in front of you: your next session, the next ten minutes, or the next three slow breaths. Healing happens one foothold at a time.
Name and validate what you’re feeling.
Even if just to yourself. “I’m overwhelmed. I’m scared. I’m angry that I’m here.” Let go of what treatment is “supposed to” feel like. All emotions, even if they don’t feel fully justified to you, have a place in recovery. Putting words to your experience won’t fix everything, but it is a way to start reclaiming some power from your eating disorder.
Come back to something that matters to you.
In the middle of a hard hour, identify one concrete reason why you’re in treatment. “I want more energy. I want more space in my head. I want to travel. I want my hobbies back.” Write it down or tell someone on your team so they can reflect it back to you when doubts get loud. Early treatment can make your world feel small and intense; this gives you something bigger to hold onto.
Tell your care team how you’re actually doing.
This can be harder than it sounds. Eating disorders thrive in secrecy and shame, so you may be used to minimizing your distress. You don’t have to perform okayness or prepare a perfectly packaged insight. Your team understands why the first weeks are so challenging, and they’re here to help. You can simply say: “I’m having a hard time” or “Part of me wants to quit.” It might feel awkward or exposing at first, but you’re allowed to be honest here, and it gets easier the more you do it.
Remind yourself that this feeling will pass.
Early treatment can feel overwhelming, but distress comes in waves. When anxiety spikes and you feel the urge to quit, pause and tell yourself: “This feeling won’t last forever. I can get through this moment.” Notice what’s happening in your body: racing thoughts, tension, or any other sensations. Acknowledge it without trying to force it away. Then bring your focus to your breath, your next step, or the simple fact that you’re still here. Staying present, however briefly or reluctantly, is an act of courage. With time and support from your treatment team, you’ll get stronger at sitting with these feelings and letting them pass without letting them control your choices.
The Emily Program is Here for You
Our admissions team works hard to make sure every client knows what to expect before their first day of treatment. But we understand that no amount of preparation can fully capture the reality of that first week when you’re living it firsthand.
If your heart is racing or your mind is calculating how to leave, please know: the struggle you’re feeling right now is not a sign that you made the wrong choice. It’s not evidence that treatment isn’t working, or that you aren’t “ready” to heal. It’s one of the most human, most predictable parts of the process. Our teams are here exactly for that part, not just the work ahead.
If you or someone you love is considering treatment, or if you’re already in it and struggling to hold on, we’re here. Call us at Call: 888-364-5977 or complete our online form.
Founded in 1993, The Emily Program is nationally recognized for our compassionate and personalized approach to eating disorder awareness, treatment, and lifetime recovery. We understand the tangled complexities of eating disorders, often from personal experiences. We know that you’re not defined by your eating disorder, and our team of experts—including therapists, dietitians, and medical staff—focuses on treating the whole person. We provide an integrative approach for people of all ages and genders who struggle with eating disorders and related mental health and body image issues. The Emily Program care teams bring decades of experience managing the unique medical and psychiatric complications of eating disorders. With convenient locations in GA, MN, NC, OH, PA, and WA or within a virtual environment, The Emily Program is here to help you no matter where you live. For more information, please visit emilyprogram.com.