Worried about Relapse?

Eating disorder recovery is challenging and it’s not one-size-fits-all. Recovery is often thought of as nonlinear because individuals sometimes don’t follow a predetermined path and may find themselves taking one step forward and two steps back. While this aspect of recovery can be frustrating, it’s important to remember that the correct path to recovery is the exact path that we are on. By not comparing ourselves to others in recovery or wishing we had an easier path, we can focus our efforts on healing and mending our relationship with food and body.

What Is Classified as a Relapse?

An eating disorder relapse is characterized by any return to eating disorder behaviors and symptoms. Common examples of returning to eating disorder behaviors include skipping meals, counting calories, or measuring weight. Warning signs of an impending relapse include:

• Negative self-talk and obsessive critical thoughts
• Taking weights and looking compulsively in the mirror to pinpoint perceived flaws
• Increase in thoughts about eating, food, or body image
• Isolating or withdrawing
• Deviation from a set meal plan
• Rigid eating habits

Signs that an individual is in a relapse include:

• Restricting food intake
• Binge eating
• Purging
• Compulsively exercising
• Restrictive dieting
• and more

How Many People Experience Relapse?

The truth is, relapse is incredibly common in eating disorder recovery. While relapse is a major interruption to recovery, individuals are typically able to overcome relapse, manage their eating habits, and return to recovery. Relapse does not mean the end of recovery.

A study in the American Journal of Psychiatry found that around 35% of those in recovery from anorexia and bulimia will experience a relapse. In addition, the National Eating Disorders Collaboration states that certain individuals are more likely to experience relapse than others. Risk factors of relapse include:

• Length of illness. The longer an individual has suffered from an eating disorder, the more likely they are to relapse in recovery.
• Where treatment occurred. If an individual was treated in a hospital or by a general clinic, that patient is more likely to relapse. Individuals treated in eating disorder specialty centers are less likely to relapse during recovery.
• Stressful life events. It is important that individuals know big life events can trigger a relapse. These events can include loss, trauma, moves, and more.
• Anxiety or obsessive tendencies. For those with anxiety or obsessive tendencies (such as obsessing about weight or appearance), relapse is more common. It is recommended that individuals suffering from an eating disorder and anxiety or depression seek ongoing care while in recovery. This care is vital to properly and productively address negative thought patterns and general anxiety.
• Lack of community. Those in recovery who lack community or strong connections may find themselves at a higher rate of relapse. A stable connection to others is often a motivating force in recovery because there is a degree of acceptance, support, and accountability.

Preemptively Addressing Eating Disorder Relapse

An important step in recovery is the acknowledgment that relapse is possible. The sooner an individual understands that the sooner they can address it with their treatment team. By acknowledging and addressing the potential for relapse early in the recovery process, it’s possible that individuals may prevent a relapse from developing into a full-blown eating disorder.

It’s recommended that those in recovery speak to their treatment team about a relapse plan. This plan can include a list of who to reach out to for support or available treatment options.

What to Do if You Are Worried About a Relapse

If you are concerned about relapse in recovery, having a plan in place is important. In addition, the process of developing a plan may ease anxiety and lessen the chance or severity of a relapse. Here are the five most important things you can do:

1. Talk about it. Have a conversation with your treatment team or therapist about relapse. Share your concerns, anxieties, and fears about the subject. By being open about the potential for a relapse into old eating disorder behaviors and talking through your fears, you may begin to feel more at ease. This conversation will also allow you to create a set plan with your treatment team should you ever relapse.
2. Make your plan known. Create a clear plan for what to do if you find yourself relapsing and share this plan with someone close to you. This plan should include what to do, who to talk to, and how to find help. For example, your plan could be, “If I find myself relapsing into old behaviors, no matter how small, I am going to call my therapist, reach out to a friend, and make sure I follow my meal plan.”
3. Understand the importance of early intervention. It’s crucial that all individuals understand that the sooner they are able to intervene during a relapse, the easier and faster it will be to get back on track with recovery.
4. Find an accountability friend. If you are unsure that you will be able to stop a relapse, ask a friend, family member, or loved one to help. If they notice any changes in behaviors, eating, or personality, ask them to have a conversation with you. Sometimes it can be hard to spot when we are starting to relapse or it can be hard to admit it, which is why having a friend to hold you accountable in recovery is often helpful.
5. Know returning to treatment is okay. It’s important to know that returning to treatment or having a relapse doesn’t make you a bad person or a failure in recovery—it makes you brave. Many folks return to treatment more than once, and that is okay! The most important thing is that you are receiving the support and care you need early on. We truly believe that recovery is possible for everyone… despite age, gender, or the number of relapses.

Are you or a loved one experiencing an eating disorder? Are you or a loved one currently experiencing relapse in recovery? Reaching out for help is not easy, but we hope you know The Emily Program is here when you are ready. We offer warm care for individuals at all stages in recovery and to those experiencing relapse. Call us at 1-888-364-5977 or find us online.

Works Cited

Keel, P.K., Dorer, D.J., Franko, D.L., Jackson, S.C., and Herzog, D.B. (2005). Post-remission predictors of relapse in women with eating disorders. American Journal of Psychiatry, 162(12), 2263-2268. [A nine-year follow-up study].