Coming to Terms with Eating Disorder Relapse in Your Employee

Group of People discussing cultural differences in mental health treatment

Being an employer is a complicated position. You have a business and bottom line to consider. However, the people that work for you are real, and they lead lives with loved ones, goals, and challenges outside of the work they do for you. Straddling this line can become difficult when your employee is diagnosed with an eating disorder.

Treatment of these disorders often involves time taken off work for initial stabilization as well as ongoing maintenance of the disorder. As an employer, you may believe that it is not your job to accommodate an employee struggling with an eating disorder. But, as humans, we are called to care for one another, and this may be one of your opportunities.

Relapse Prevalence

Many that do not experience eating disorders directly are not educated in their development, psychology, and nuances. If you do not know a lot about eating disorders, that is okay, but please know that there are plenty of resources online to provide basic information that will help you in supporting your employee.

An important lesson from these resources is acknowledging that relapse is a part of recovery. Individuals with Anorexia Nervosa (AN) have a 50% relapse rate within the first year of diagnosis, even with successful hospital treatment [1].

These disorders involve deeply embedded psychology that is not easy to let go of, even when one sees the damage to their body, mental health, and daily life. The likelihood of your employee receiving appropriate and beneficial support for their eating disorder and still relapsing into old beliefs and behaviors is high. Acknowledging this means accepting that aspects of their life may need to change, such as their work.

Having a conversation with your employee on how their workplace and duties can be altered to foster their recovery gives them an opportunity to advocate for what they need. This reduces the possibility of misunderstandings in the future.

It also makes them aware that you are supporting them in this journey and that they are welcome to come to you to discuss what this may look like. The Job Accommodations Network is an organization aimed at educating individuals on their rights under the Americans with Disabilities Act and informing employers on how they can accommodate disabled workers.

The site has a helpful list of questions that you and your employee can discuss to learn more about what their eating disorder diagnosis means for their work, such as:

  • “What limitations is the employee experiencing?
  • How do these limitations affect the employee and the employee’s job performance?
  • What specific job tasks are problematic as a result of these limitations?
  • What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  • Has the employee been consulted regarding possible accommodations?
  • Once accommodations are in place, would it be useful to meet with the employee to evaluate the accommodations’ effectiveness and determine whether additional accommodations are needed?
  • Do supervisory personnel and employees need training [2]?”

Encourage Eating Disorder Prevention Efforts with your Employee

Employees on a work retreat focused on eating disordersTalking about how you can be helpful to your employee in their recovery will go a long way toward preventing relapse. A great deal has changed for your employee in their recovery, and this will likely mean making a change to certain aspects of work.

Changes that may be helpful to prevent eating disorder relapse may include discussions of what hours your employee will work, what breaks for meals they may receive, how they can request varied work times to accommodate dietitian or therapist appointments, and the policy should they find the need for a mental health day.

What these changes look like for you and your employee will vary. The point is to create a discussion wherein your employee feels supported in making the necessary adjustments to continue contributing to work without having to sacrifice their eating disorder recovery.

An additional prevention effort can also involve actively working to change your office culture. In many workplaces, employees openly discuss diet and exercise trends, or HR sends out “nutrition challenges” to encourage employees to improve their health. These aspects may need to change, as it creates an oversimplified and unrealistic culture surrounding food, weight, and appearance.

You might also consider looking at the coverage your company provides for an employee struggling with an eating disorder. The less treatment an employee receives for their rehabilitation and recovery, the less likely they are to seek help at all, and the more likely they are to continue relapsing.

The more prevention efforts are made in all areas of an individual’s life, the less likely relapse becomes. Again, the difficulty you face in being an assertive, yet supportive, employer is a valid challenge.

As complicated as it is, opening up lines of communication and approaching your employee on a person-to-person level will help both them and you work together through the waves of relapse to recovery.


[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.

[2] Unknown (2020). Accommodation and compliance: eating disorders. Job Accommodations Network, retrieved from

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 30, 2020, on
Reviewed & Approved on September 30, 2020, by Jacquelyn Ekern MS, LPC