Coming to Terms with Eating Disorder Relapse in Your Adolescent

Stronger Family Smiling After family-based therapy

The nightmare happened. Your child was sick with an illness that you did not see coming or know how to help them. You are a loving and great parent. You supported them and learned what you needed to so that they could get the help that they needed. They are working toward finding recovery despite the attractiveness of an eating disorder relapse.

This is a victory, but, even in this victory, continued education and vigilance are necessary because relapse is still a strong possibility. Your child relapsing back into the horror of an eating disorder is a terrifying thought.

Even so, it is important to prepare for because we can only fight that which we are willing to accept and understand, and relapse may be something you and your teen will come up against. The best way to come to terms with relapse in your teen is to practice accepting it yourself and to reframe it within the family unit.

Accepting Eating Disorder Relapse

The cliché phrase that “relapse is a part of recovery” is cliché for a reason – it is true. Studies indicate that “while most patients experience brief episodes of recovery, a large proportion relapse. Moreover, the risk is particularly high within the first year [1].

Adolescents do experience reduced levels of relapse, but it is still a possibility [1]. When we don’t allow ourselves to accept this possibility, we create a false reality that it simply isn’t a part of our teen’s recovery journey, which can set them up for immense pressure and feelings of failure.

Imagine experiencing an eating disorder from your teen’s perspective. They have seen the family finances, daily life, interactions, and emotions heavily impacted by a disorder that they feel is their fault (even though it is not). Now, imagine the immense pressure your teen feels not to relapse because of this.

Many adolescents that have struggled with an eating disorder and have undergone varying levels of treatment report feeling shame and guilt for what they have “put their families through.” When we don’t discuss the falsities of their guilt and shame, or the likelihood of relapse, this pressure can actually be a trigger making them more likely to relapse.

Reframing Relapse

Father And Teenage Son hugging after discussing eating disorder relapseThe concept of what relapse is, and how typical it is, needs to be reframed throughout the entire family unit, with all members understanding that it is common, it is likely, and it is not shameful.

Consider the last resolution or goal that you made based on a behavior that was well-ingrained into your being and daily life. Whether it was to wake up earlier, answer your e-mails immediately, increase exercise, etc., I doubt that you made the goal and perfectly executed it from there-on-out.

This is how we need to look at recovery. Your teen is bravely working to change deeply embedded behaviors, and this will not be a perfect or linear process. Framing eating disorder relapse helps your teen be honest with you when they experience it, as well as helping them to not see it as the end of the world.

The hope is that, if they experience a relapse into disordered thinking or behaviors, instead of feeling as if they have already “failed” and, therefore, letting go completely, they can practice acknowledging that this is a natural part of the process and that they can continue moving toward recovery despite it happening.

Another important reframe is of relapse versus a lapse. A lapse can be a temporary return to disordered thinking or behaviors. A relapse is a full-on return to a consistent and disordered lifestyle.

Begin using this language with your teen so that they are aware that one lapsed decision does not mean all hope is lost. Sliding fully back into their disorder isn’t their only option. Teach your teen and the family that moments of lapse should be talked about so that support can be given before relapse occurs.

Bottom Line…

We all want to believe no more horrors will come to harm our child. For eating disorder recovery, this is simply not true. Your teen can achieve recovery but still struggle in certain periods to fall back into past ineffective and disordered behaviors.

As their parent, it is your responsibility to reduce fear and stigma around the possibility of this happening so that your teen does not feel guilt and shame should it occur. Doing this can make the difference between a full eating disorder relapse or a partial lapse.


Resources

[1] Khalsa, S. S. et al (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5:20.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published September 29, 2020, on EatingDisorderHope.com
Reviewed & Approved on September 29, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.