What is an Eating Disorder Relapse & What To Do About It
Eating disorder recovery is a complex process that is far from linear. Many people with eating disorders will experience a relapse on their journey to recovery. A relapse occurs when an individual in recovery reverts back to their previous disordered coping mechanisms and thoughts. While a relapse may feel demoralizing, relapsing is a common part of the recovery process. There is much to learn from a relapse.
by: Enchi Dai
The journey of recovering from an eating disorder is often filled with obstacles. Relapses are common among eating disorder clients. A relapse is defined as an episode or period of time of regressing back to disordered habits, obsessing about one’s weight, and having continuous negative thoughts regarding one’s body size, weight, and food. Today, we are going to talk about the prevalence and risk factors of relapses in eating disorder recovery and what can be done about them.
Prevalence of Relapse in Eating Disorder Recovery
Studies on relapse prevention in eating disorder recovery with a follow-up period of 18 months found that the highest risk of full anorexia nervosa relapse was between 4 and 16 months (Berends et al., 2016). Research has shown that relapsing occurs in 36% of the women with anorexia nervosa and 35% of the women with bulimia nervosa. Women with anorexia nervosa restricting subtype tend to develop bulimic symptoms during a relapse, whereas women with anorexia nervosa binge-purge subtype or bulimia nervosa tended to return to bulimic patterns during a relapse (Keel et al., 2005).
Risk Factors of Relapse
Research has shown that adolescents who are not adequately weight-restored when discharged from treatment are more likely to relapse (Hetman et al., 2017). Body image disturbance and psychosocial function problems are also shown to contribute to relapse in both anorexia nervosa and bulimia nervosa (Keel et al., 2005).
Some other risk factors may include low self-esteem, poor social relationships, slower response to treatment interventions, low motivation to recover in treatment, greater eating disorder thoughts and behaviors at the time of discharge, and losing weight quickly upon discharge.
What Can Be Done to Prevent a Relapse?
Most importantly, we need to be prepared. Information about relapse prevention should be presented and emphasized early in treatment so that one can recognize a relapse when it happens and manage it more effectively. Some of the possible signs of relapse include skipping meals, reducing the size of meals or snacks, cutting out food items or groups, making excuses for not eating, extreme changes in weight, and avoiding mealtimes with others. When an individual leaves treatment, it is recommended that they have a detailed relapse prevention plan based upon their own unique circumstances. If there is any sign of relapse, seeking professional help should be the first step to take. An eating disorder treatment team can help guide and support the client toward practicing healthy eating behaviors and implementing strategies to prevent any future relapses. However, seeking help from professionals may not be enough. One should also consider social factors, such as support from one’s family and friends. Making sure to surround oneself with people who encourage, support, and love can decrease the possibility of future relapses. Having a support group to hold loved ones accountable can help them stay motivated on the path to recovery.
It is important to remember that a relapse does not equal failure. We need to get rid of our black-and-white thinking when it comes to eating disorder recovery; recognizing that one setback does not mean the whole recovery journey is ruined. In fact, even though relapses may evoke frustration, they also provide us with an opportunity to identify our weaknesses and therefore fix them, making us stronger and more resilient in the fight against eating disorders.
At BALANCE eating disorder treatment center™, we treat the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We offer a variety of virtual programs and services to help our clients not only reduce eating disorder symptoms but also move toward a more harmonious relationship with food and their bodies. Click the button below to browse our full selection of virtual programs & services.
This post was written by BALANCE Blog Intern, Enchi Dai.
Enchi is a Bachelor's-Master's student at New York University, majoring in Psychology. After her recovery from disordered eating, Enchi became passionate about spreading ED awareness, advocating for intuitive eating, and promoting Health at Every Size. Enchi is also an ACE Certified Personal Trainer and Registered Yoga Teacher (RYT 200). Her goal is to help people become healthier both physically and mentally, instead of encouraging them to pursue a certain body image. Along with her internship at BALANCE, Enchi works as a Research Assistant and Crisis Counselor to prepare herself for the future career as a Clinical/Counseling Psychologist.
References
Berends, T., van Meifel, B., Nugteren, W., Deen, M., Danner, U.N., Hoek, H.W., and van Elburg, A. (2016). Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study. BMC Psychiatry, 16(1): 316.
Hetman, I., Klomek, A.B., Goldzweig, G., Hadas, A., Horwitz, M., & Fennig, S. (2017.) Percentage from target weight (PFTW) predicts re-hospitalization in adolescent anorexia nervosa. Israel Journal of Psychiatry, 54 (3), 28-34.
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.