Note: I first explored this idea in a personal essay, then pitched it as a reported piece. After I signed a contract, I continued to work on this piece, but unfortunately the publication pulled it, citing fear of litigation. Since I was unsuccessful pitching elsewhere, I wanted to publish it here.
From my own experience, I didn’t leave with a positive impression and was curious if others had similar thoughts. During the course of my reporting, what I found was very polarizing– some found recovery in the rooms while for others their health dangerously declined. In speaking with so many sources who trusted me with their stories (thank you), I want to be sure I present all sides.
Names of participants have been changed to protect privacy.
This topic is so nuanced that I could write an entire book about it. But here is a start.
Leah just wanted to lose some weight for the summer. Soon she found herself in a church basement reciting the Serenity Prayer and pledging her weighed-to-the-ounce food to a stranger. Every morning she called a sponsor for fifteen minutes. She also pledged to do her Tools every day: attend meetings three times a week, buy the required books and read two pages each night, make 15-minute phone calls each day to at least three Fellows, 30 minutes of Quiet Time a day, and pray twice a day to a Higher Power.
At first, it worked. She lost the weight. But she also lost her period, her hair thinned, and her mental health took a toll.
Leah joined Food Addicts in Recovery Anonymous (FA), an eating support group based on the 12 Steps more known for Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Formed in Massachusetts in the 1980s, FA officially now has over 6,000 members across the globe. They believe in “no flour, no sugar, and no alcohol or mood-altering drugs.” Members eat three meals a day that must be weighed and measured, with no snacking (or tasting) in between. Their website states there is no weigh-in at meetings, though Sponsees report their weight once a month or week to their sponsor.
FA sprung from Overeaters Anonymous (OA) which began in 1960 in Los Angeles and now has approximately 54,000 members in 80 countries. They define themselves as a “Fellowship of individuals who, through shared experience, strength, and hope, are recovering from compulsive overeating.”
Kori says OA tremendously helped her. In her meetings, there’s no weighing and they have a three-pronged approach to recovery: physical, emotional, spiritual.
“Many come in wanting to be thinner, like myself, but that was the least valuable part of it,” Kori says. She’s been in Program for almost three decades and in it, she found best friends and her mental health improved. “It taught me to be open and I think without that, I wouldn’t have my husband or children.”
Some are more skeptical. Jennifer Medina MS RDN CDN CDE, co-owner of New York based Brown and Medina Nutrition, doesn’t recommend OA at all. “People with eating disorders are very impressionable and vulnerable,” she says. The food plans are “very rigid” and she’d heard of someone who had to take a food scale to a restaurant. (She has known of some people finding success in an offshoot of OA called Foot Steps.)
Pat went to OA at the request of her eating disorder specialist therapist who herself had found success in the program. Pat was open to it, though resistant about treatment in general. What was found in OA was not helpful to her specifically.
“I was in it ten years ago so maybe the language has changed, but I found it to be very fatphobic,” Pat says. She left the rooms and eventually found her way to an in-patient treatment center covered by her parent’s health insurance. There, they used a 12-step model focusing on alcohol, not food, that she found beneficial.
“It’s important to remember that AA was designed primarily for men,” says Dr. Marianne Miller PhD LMFT, an eating disorder therapist & binge eating coach based in San Diego. “OA is mostly women, and they live in a sexist society with families and work environments that can be unsafe for them. The 12 steps in OA closely mirror the 12 steps in AA, and sexism, racism, systemic oppression, homophobia, transphobia, etc., isn’t taken into account.”
But FA and OA aren’t the only games in town. Food Addicts Anonymous (FAA) is an organization that believes that “food addiction is a biochemical disorder that occurs at a cellular level and therefore cannot be cured by willpower or by therapy alone.” Its website offers 26 promises for those who remain abstinent– everything from happiness to clear thinking to better relationships. Their testimonial page includes before and afters that center around weight loss as markers of success.
There are more still. Compulsive Eaters Anonymous: Honesty, Open-Mindedness, Willingness (CEA-HOW) is a group for “anyone suffering from compulsive eating, anorexia and bulimia” that started in 1979 in Phoenix, Arizona by Fred S. and Helaine. Their meal plan is “still rigid” according to some members, but you can have measured skim milk in your coffee, as long as you take it out from your allotted protein at breakfast. If you’re still hungry after Meal Time, sugar-free products are allowed.
CEA-HOW member and sponsor Keisha’s been in Program for seven years and loves it. “I changed my whole life from the inside out,” she says. It helped her accomplish things in life when she stopped obsessing over food. She lost weight and met her Sponsor-designated “goal weight” within months without exercise, and has been at her “maintenance weight” for years now.
“I’d still like to lose ten pounds, but I’m happy either way,” Keisha says.
Like the other 12-step eating programs, there is no sugar or flour ever allowed, and alcohol is forbidden too because of its sugar content. Birthday cakes, of course, are banned. “I’ll have a Jell-O,” Keisha says, “to celebrate a special occasion.”
CEA-HOW declined to comment but directs newcomers to their website. Their site poses questions that many struggling with eating disorders can identify with: secretive eating habits, obsession with body image, hyper control or lack thereof with eating.
But Is It A Diet?
For some, these 12-step groups work for the long haul. Rosana, a current sponsor in FA, has been in Program for over ten years. She came from decades of dieting and weight-loss clinics that injected her each week; none of them worked. All were expensive. Programs like FA work to help people overcome the addictive nature of eating in the craving cycle, she says, of flour and sugar by never eating it. But… is it a diet?
“This is not a diet. It is a recovery program,” Rosana says. “It’s a nutritious, healthy diet. I mean, a Food Plan. There’s so much negativity saying the word diet.”
The Plan has fruits, vegetables, grain, and meat, and even accommodates people who are vegan. Rosana’s happy to stay in Program for the foreseeable future because, she says, she gets to stay in the “same size body” year after year.
“It’s freedom,” she says. “It's given me back so many benefits that I don't want to go back. Why would I want to go back to misery and be in bondage with food?”
She encourages newcomers to attend three meetings to see if it is a good fit. However she realizes Program isn’t for everyone.
Some professionals state that any restriction (or “red light” foods) can set someone up for disordered eating. One source commented that OA used to use something called a Grey Sheet, a list of approved foods. When I called the OA office, they said they hadn’t used it in over 20 years.
“We don’t tell people what they can and cannot eat,” they say. There’s no weighing of food or bodies. They say it’s really individualized and up to each Sponsor. However, Sponsors are not trained in any official capacity. They’ve worked The Steps and their own Sponsor decides if they’re ready to take on Sponsees, and track their progress. OA states they do not restrict what members can eat, but they still forbid certain ‘trigger’ foods.
Though not officially endorsed, there’s another 12-step eating group that sprung from this called Grey Sheeters Anonymous (GSA). It boasts 1,300 members in countries like Israel and Iceland, with 185 people reaching Abstinence of 90 days to 1 year. But what happens after those 90 days? For some, it was not a sustainable way to live.
Yet another 12-step eating group is Eating Disorders Anonymous (EDA) which, according to their website, helps people recover from eating disorders without dieting. “Diets and weight management techniques do not solve our thinking problems,” the site states. “EDA endorses sound nutrition and discourages any form of rigidity around food.” No phone number is listed on their site, and when emailed, they declined to officially comment.
“Our public relations policy is based on attraction, rather than promotion; we need to maintain personal anonymity at the level of press, radio, film, and web,” they state in an email. “Because of this tradition we don't really have a PR arm or representative so-to-speak. We are a volunteer based organization and all volunteers are members of EDA. It is up to a particular individual what they want to share about their recovery. I would encourage you to visit our website and even attend an open meeting to learn more about our program.”
Winona knew people who had success with AA, so when her mom suggested she try EDA, she went to the rooms to listen. “It was the first time I said out loud that I had an eating disorder and other people's lives were as chaotic as mine around food,” she says. With so much stigma and shame around eating disorders, Winona didn’t tell many people.
Ultimately, she didn’t find EDA helpful. “You have to admit you’re powerless over food, but I think we have to be neutral and get our power back.” Though she was in Program for about six months, she didn’t get a Sponsor. She eventually found her way into a treatment program, but afterwards felt there wasn’t much support or community. “It’s hard to share your experience without triggering someone, or to see someone still struggling.”
Dr. Joann Hendelman PhD MA BSN RN FAED FAPA CEDS-S, Clinical Director of National Alliance for Eating Disorders and The Alliance Psychological Services based in Florida, says these groups are too black and white and place too much of an emphasis on weighing food and numbers.
“OA, FA, and FAA are too tied to right/wrong foods, which only promotes more focus on food and eating,” Hendelman says. “It is important to move away from good/bad foods and measuring foods to get back to doing life, and to understand how food has been a coping mechanism they have used and to learn new workable coping mechanisms rather than using food.”
Hendelman also discourages people with eating disorders from seeking help in these settings, as they frown on seeing therapists. “My understanding is that Sponsors are people who have been with the program for a period of time and have understanding and command of the 12 Steps. I am unaware of further qualifications and definitely do not feel they should be treating eating disorders.”
Accessibility
With the plethora of diets, pills, supplements, and gimmicks out there, the diet industry is now worth $72 billion, even with proof that diets fail 95% of the time. Much of this restriction and obsession over calories and exercise, along with our very appearance-obsessed culture, can lead to eating disorders and body image issues. (Just look at the recent Ozempic articles.) A Harvard School of Public Health Report found that $64.7 billion dollars account for eating disorders including hospitalization, emergency visits, treatment and lost productivity. In fact, 28.8 million Americans will have an eating disorder in their lifetime.
But millions are left to fend for themselves. Eating disorder treatment centers are challenging to access, from the limited beds available to insurance denying coverage to stigma and misdiagnoses— many quietly struggle. Some find the structure, peer support, community, and accountability of 12-step groups helpful. It might seem like the only option.
The 12-step world is free or low-cost, sustained only by member contributions of about $3 per meeting. If you can’t pay, members say, no one will ask you for money. Programs like FA offer several meeting options: 33 by phone, 128 in-person, and 424 video call meetings each week across multiple time zones and languages. A phone list gives access to people dealing with similar issues and, in a text-message-loving world, Fellows actually pick up the phone and engage in live conversations. For people who are struggling, this seems like a pretty immediate solution.
“Treatment with an anti-diet dietitian or a therapist who specializes in disordered eating can be quite costly– it's understandable people would be drawn to these programs especially if AA/NA has resonated with them,” says Kathleen Meehan, MS RD, a non-diet dietician based in Los Angeles.
It Works If You Work It (Forever)
Some have been in and out of Program for years. Each time they leave, they “pack on the pounds” and are even more confused about what to eat when they’re “off the wagon.” One former member says, “I know I need to get back to it. It’s painful with or without Program but at least in Program I’m in a smaller size.”
Others tried it out but knew it wouldn’t work long term. Jenna quickly lost the weight she wanted but it cramped her social life. “I couldn’t go out,” she says. “I’m in my twenties! What was I supposed to do, just sit at home?”
Dining out at restaurants, and even dating, were discouraged at first to protect one’s Abstinence. Once Abstinence is obtained (ninety days of “no breaks”), calling ahead to a restaurant and bringing measuring cups or a food scale is strongly advised, as is adhering closely to the allowed foods. Some Sponsors discourage the temptation altogether and simply eat at home for their Meal Times.
Nolan has been in FA for over ten years, after 22 years in AA. Once he found recovery from alcohol, he “put on weight” and soon found himself in an FA meeting. He learned a lot about himself when he joined, including why he ate. He wants others to find hope too.
But he is aware of the “very strict and rigid” members: foods that have to be separated into different containers so they don’t touch; no grapes; no salt or pepper; no eating five minutes after Meal Time.
“I stay away from those people,” he says. Because of this inflexibility around food, what some in Program call “hard line” sponsoring, he created a website called Compassionate Food Recovery which seeks to connect people with a more balanced approach while still adhering to most of the rules of FA.
“It saved my life,” Nolan says.
Forbidden Yoga
For Leah, at first FA worked too. As a diabetic bulimic, she found it helped improve her physical and mental health. She had a support group and made friends who she still talks to today, her blood sugar was under control, and she stopped bingeing and purging. And, well, she lost the weight she wanted. But soon there were unexpected pitfalls.
It wasn’t just the foods she had to measure. It was also the Braggs Liquid Aminos (a soy sauce alternative) and the nutritional yeast (used as a seasoning). Sparkling water and tea were considered too tempting— a slippery slope to losing Abstinence. Even her vitamins had to be reported to her Sponsor.
“You have to brainwash yourself into extreme dependency on other people,” Leah says.
Once she got to her “lowest weight” she became depressed and wanted to do hot yoga to see if it would help. Her sponsor deemed it “too aggressive” even though Leah had previously enjoyed competitive sports and working out. Instead, she mostly lounged around, as exercise was discouraged while striving for perfect Abstinence.
Her Sponsor even went so far as to encourage Leah to question her faith, she says. “I felt like I needed her to be happy with me in order to stay well. It was like being in a cult, and everyone in it reinforced the idea that all of this was necessary to get well, that being at Goal Weight was essential to happiness. I felt like my only options were to be on a strict weighed plan or else be totally out of control.”
She wasn’t alone. Marla had unexpected health issues during her time in FA. She was perimenopausal when she first joined, but her periods stopped quickly soon after.
Dallas-based non-diet Registered Dietitian Christyna Johnson MS RDN LD states her clients experienced this too when in Program. “This interrupted their ability to manage other aspects of their chronic illnesses or negatively impacted their health markers due to altered lab levels and nutrition status,” Johnson says. “If someone is maintaining their weight below what their body deems appropriate, this can contribute to oligomenorrhea or amenorrhea.”
In addition to the physical health problems, Marla also experienced mental health issues. “I went into a major Complex-PTSD flare-up and I hit my head with my fist hard and often,” she says. “I would burst into tears suddenly and missed a ton of work, eventually taking a year long medical leave.”
Yet according to FA’s website, 98% of members claimed to have improved mental health. (This was based on their own survey they conducted with long-term members.)
No one in Program suggested Marla get professional help.
Soon she grew skeptical. She’d also heard of the extremes her Fellows went through. “Someone said they couldn’t make any decisions without their sponsor and that you would have to reset your Abstinent Date if you committed to eating six ounces of string beans for lunch but the store didn’t have it and you had to eat broccoli instead.” Rigorous (or what some called invasive) honesty is what they strive for. Even if it was 0.1 ounce more or a bite of a carrot, Sponsees had to “start over” which often led to binges on prohibited foods.
“Any food restriction promotes rebound binge eating, or reinforces that it’s desirable to restrict or deny hunger,” says Dr. Doug Bunnell PhD FAED CEDS-S, a clinical psychologist based in Connecticut.
Another former member agreed. “Any deviation feels like failure. A small slip leads to a giant binge (I've already screwed today up so I'll eat whatever I want until midnight tonight. Or until Sunday. Or until the next diet begins.). They teach the philosophy that ‘one bite is too many and a thousand is not enough’.”
Just a bite, she says, can doom you for an uncontrollable binge.
Bingeing
Binge Eating Disorder (BED) is one of the newest eating disorders added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013. About 2.8 million adults suffer from it, though considering the stigma and misdiagnoses, the number could be much higher. And people in marginalized communities like BIPOC folks or those with disabilities or nonbinary and trans people with eating disorders are half as likely to be diagnosed or to receive treatment according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD).
“Eating disorders impact every size, race, gender,” Dr. Bunnell says. “It’s not just skinny white girls.”
EDs aren’t about weight, though many medical professionals still subscribe to the outdated and racist model of the Body Mass Index (BMI). (Journalist Kate Siber in the New York Times explains this more.)
Johnson noticed that once her clients left OA and EDA, there was a gap in their community resources. “Many reported feeling confused about food as they were used to others making those decisions for them,” Johnson says. “Typically, there is still remaining rigidity in their thought patterns regarding food and their body. Those in OA found themselves more obsessed with food and the minutiae of nutrition.”
One member states that after they left Program, their binges were remarkably worse. “For months I hadn’t been allowed to eat bread, or even think about it. I’d have dreams of Breaking [Abstinence], of taking a bite, and wake up drooling. And I just went wild after I left. I was so out of control, like I was making up for lost time.”
When Marla first left, she struggled too. “My binge-eating flared up,” she says. “It was worse than ever. I became so sick in my eating disorder that I was often late to work because I needed to stop for chips or something. I could only binge.”
She eventually left for good, but she had trouble eating certain foods, even vegetables. “I couldn’t eat salad very much for some years after that,” Marla says.
Alison Makely LPC MAC NCC, an Atlanta-based counselor specializing in eating disorders, noticed some members who left “literally needed deprogramming,” she says. “They needed to unlearn the Abstinence Violation Effect, to learn that exposure to forbidden foods is good for recovery, and to learn that they are not, in fact, addicted to certain foods.”
Getting Help
The only requirement to join these Programs is a “willingness to stop eating addictively.” This is to say, there aren’t any standards on who joins, nor limitations around age. Dr. Lauren A. Bretz, MD FAAP, Assistant Professor of Adolescent Medicine at Baylor College of Medicine, does not recommend attempting recovery without professional help.
“My concern is that eating disorders can cause significant medical complications, especially in children,” Dr. Bretz says. “Eating disorders, specifically restrictive eating disorders, are some of the most deadly mental health illnesses.”
If someone was waiting to get help and interested in finding a group on their own in the meantime, they’d have to do their research. Look at the website to see what language they use.
“Language like ‘clean’ or ‘pure’ might mean it’s a riskier group,” says Dr. Bunnell.
Dr. Lotes Nelson PhD LCMHC ACS NCC, a psychotherapist and Clinical Faculty member at the Southern New Hampshire University, refers patients to OA, though she hasn’t been to a meeting herself.
“It can be a big support from a faith-based, non-clinical perspective,” Dr. Nelson says. Her patients who have found success in OA are doing it in conjunction with a dietician and mental health professional.
Given a choice, she’d recommend a support group run by professionals though. She’s often run evidence-based eating disorder support groups utilizing strategies like Cognitive Behavior Therapy (CBT), with each meeting ranging from free to $30 per session. But she says to not let the cost be discouraging. “Oftentimes there is wiggle room for people to attend pro-bono.”
Dr. Kim Dennis, MD CEDS, co-founder and Medical Director of SunCloud Health based in Chicago, is cautious about 12-step eating groups.
“There’s a huge variation in how they’re run,” Dr. Dennis says. “Not all are supportive. Every meeting has its own personality, and, like people, some are toxic.”
Still, she refers people “quite a bit” to OA or EDA meetings as long as there aren’t any rules about weighing anything.
She has the advantage of knowing the local groups to make sure they’re positive, supportive spaces. In fact, she’s known many people who’ve found recovery with these 12-step groups, in conjunction with health professionals.
For Dr. Dennis, recovery is about freedom. “Flexibility is the hallmark of health.”
Even after all of the issues, Leah doesn’t regret her time in Program. “Ultimately, it was a vital part of my journey because it allowed me to see for the first time that being thin was not going to make me happy. I was my thinnest and saddest in Program.”
If you or someone you know is struggling with an eating disorder, contact Project HEAL, a non-profit that helps people with limited resources access care, or the National Eating Disorder Association (NEDA) which helps patients find virtual care and support groups for low to no cost and embrace the Healthy At Every Size (HAES) or weight neutral approach. Additionally, Fighting Eating Disorders in Underrepresented Populations (FED UP) offers free resources for trans and nonbinary folks.