Recovery is often presented as the unquestioned destination of eating disorder treatment. It is a word that carries hope, urgency and moral weight. Clinicians want it for patients. Families long for it. Patients may fear it, crave it, reject it and grieve the distance from it – sometimes all in the same week. In early intervention work, this emphasis can be helpful.

Many people do recover from an eating disorder, particularly when treatment is timely, sustained and well matched to need.1 However, adult eating disorder services also work with other cohorts: people whose illness has lasted years or decades; people who have cycled through admissions, outpatient programmes and relapses; people living in the community with significant physical and psychological risk, yet not neatly fitting the usual categories of ‘acute crisis’ or ‘well enough for discharge’.2–5

These people may be attending appointments, managing some work, caring for children or maintaining a fragile independence. They may also be severely restricted, socially isolated, osteoporotic, exhausted, trapped in rituals or living one viral illness away from medical collapse.2–4 They are not absent from services because they do not exist. They are absent because our language often struggles to describe them.

For this group, the clinical question becomes more complex. Must recovery always be the immediate aim or can meaningful care begin elsewhere? This is not an argument against recovery. It is an argument against narrowness. In adult practice, particularly with long-standing illness, recovery may remain important but not necessarily the only clinically useful frame.2–5