Most people with anorexia need to reach a personal tipping point to trigger their recovery, says a researcher who has reviewed the memoirs of 30 former sufferers.
This can be a religious trigger, the start of a new romance, or something positive that happens during their treatment.
Every memoir describes a tipping point, but each experience is different, says Kenneth Cho, a University of Western Sydney medical student.
"Some got there through self reflection. They realised they could continue living with anorexia, or they could learn to trust other people."
One writer in her 40s said she was looking at carefree children sitting and laughing. She said she realised it had been 10 years since she last laughed like that.
Another credited a friend who convinced her to face her demons.
"It is clear that religion, spirituality and higher values help recovery," he says.
One person writes that Jewish values about the importance of life had been an immense influence.
Another says Jesus gave them strength, says Mr Cho, who has presented his study at a Sydney meeting of the Australian Society for Medical Research.
The memoirs show people seem to need to make a decision for themselves for there to be genuine recovery, says Professor Phillipa Hay, who supervised Mr Cho's study.
But it's complex.
"We don't fully understand how, when and why they come to that point.
"Sometimes it's because of their treatment, but very often it is something positive elsewhere in their life."
Anorexia is dangerous because people can die from complications of starvation or suicide, she says.
"There sadly still is a significant loss of life. It has the highest death rate of all psychiatric illnesses."
However, the outcome is improving as a result of modern collaborative style of treatment, she says.
There is no longer an emphasis on forced feeding as there was in the 1970s.
"For genuine recovery to happen, the person needs to be part of the process."
Prof Hay says early diagnosis significantly improves the chances recovery.
This means people or family members need to seek help from a GP as soon as they notice warning signs.
"Things to look out for include unexplained weight loss, changes in eating habits, avoiding family meals, compulsive exercise or even dental decay caused by vomiting."
People seeking help with eating disorders can visit the Eating Disorders Association of NZ website or phone 09 5222679.