Responding to an Eating Disorder Relapse

Girl in gloves fighting eating disorder relapse

Contributor: Staff at Carolina House

The most effective way to deal with any distressing or major event is to develop an action plan detailing how you will respond. Preparation can assist individuals in making more thoughtful decisions regarding their health, especially in the face of eating disorder relapse.

While relapse is an unfortunate occurrence, each individual who is recovering from an eating disorder should be aware of how to cope with relapse if this does occur. In addition to staying consistent with treatment, there are other steps you can take to avoid experiencing a relapse of eating disorder symptoms.

General rates of eating disorder relapse are especially high within the first year of recovery, with continued risk for up to two years. Relapse can impact an individual who is in recovery from any eating disorder, but the risk of relapse is particularly high in individuals who are recovering from anorexia nervosa.

A BMC Psychiatry research study analyzed relapse rates in individuals who had been in recovery from anorexia nervosa for 18 months. Results found that 11% of participants experienced a full relapse, and 19% experienced a partial relapse of eating disorder symptoms.

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Relapse statistics were similarly high in individuals who were in recovery from bulimia nervosa. Results from a study in the American Journal of Psychiatry indicated that 31% of individuals who were recovering from bulimia nervosa relapsed within two years of recovery. While this study extended the analysis through a two-year follow-up, data showed that an overwhelming majority of bulimia nervosa relapses occurred within just six months of treatment and recovery.

Additional results from the same study show that greater body image distortions and the presence of other mental health conditions are both correlated with an increased risk of eating disorder relapse. Likewise, individuals in recovery from bulimia nervosa who have demonstrated more frequent vomiting tendencies are at an increased risk of experiencing a relapse. These trends indicate that a personalized relapse prevention plan and follow-up should remain in place for at least 18 months following recovery from an eating disorder.

Eating Disorder Relapse Response Strategies

An American Journal of Psychiatry research study discovered that women who were in recovery from anorexia nervosa demonstrated symptoms of bulimia during relapse. Therefore, awareness and unbiased monitoring and assessment from a mental health professional are vital for appropriate relapse responses.

While individuals in recovery from eating disorders should continue to follow up and have honest communication with a mental health professional, their personal response to an eating disorder relapse is also crucial. Individuals who experience an eating disorder relapse should take advantage of positive support systems, such as family, friends, and mentors. You do not need to provide them with details that will only worry them; rather, disclose to them how you are feeling and ask for their continued assistance.

Young Lady in Group therapy after an Eating Disorder RelapseDuring a relapse, your thinking patterns may return to the negative and distorted beliefs you held at the beginning of the recovery process. While you should try to avoid this, it will be important for you to stay consistent with your improved eating habits. If you continue to provide your body with the nutrition you need, this will boost your brain and body’s strength and allow you to continue fighting through this period of relapse.

Focusing on your own needs during relapse is also a key part of getting the rest and continued recovery you need. This may mean sitting out of certain social gatherings, saying no to taking on extra responsibilities at work, or choosing not to interact with a toxic friend who causes you nothing but stress and triggers unhealthy thinking.

Your focus on self-care during this time is more important than ever, as this could be what prevents you from a full relapse. Take time for yourself each day and set aside portions of the weekend for rest and relaxation. Time for yourself could be alone time processing your feelings or diving into a hobby you love, or this time may be best spent relaxing with supportive figures who will encourage you.

While assistance and monitoring from mental health professionals can prevent eating disorder relapse, there are measures you can take to ensure that you remain on track with your recovery tools and maintain your progress. Relying on social supports and continuing to take time for yourself are among the most vital ways you can continue to heal from an eating disorder despite experiencing relapse.


References:

Berends, T.; Boonstra, N.; and Van Elburg, A. (2018). Relapse in anorexia nervosa: a systematic review and meta-analysis. Curr Opin Psychiatry, 31(6), 445-455. doi:10.1097/YCO.0000000000000453

Berends, T.; Van Meijel, B.; Nugteren, W.; Deen, M.; Danner, U.N.; Hoek, H.W.; and Van Elburg, A.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. doi:10.1186/s12888-016-1019-y

Keel, P.K.; Dorer, D.J.; Franko, D.L.; Jackson, S.C.; and Herzog, D.B. (2005). Postremission predictors of relapse in women with eating disorders. Am J Psychiatry, 162(12), 2263-2268. doi:10.1176/appi.ajp.162.12.2263

Khalsa, S.S.; Portnoff, L.C.; McCurdy-McKinnon, D.; and Feusner, J.D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5, 20. doi:10.1186/s40337-017-0145-3

Olmsted, M.P.; Kaplan, A.S.; and Rockert, W. (1994). Rate and prediction of relapse in bulimia nervosa. Am J Psychiatry, 151(5), 738-743. doi:10.1176/ajp.151.5.738


About the Sponsor:

Carolina House BannerCarolina House is an eating disorder treatment center that serves young adults age 17 and older. Within our residential and outpatient programs, we offer a range of services, including LGBTQ- and male-inclusive programming, to assist individuals who are struggling with eating disorders and co-occurring mental health conditions. Our treatment connects individuals with the care they need to achieve long-term healing.


The opinions and views of our guest contributors are shared to provide a broad perspective of 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 on December 18, 2019.
Reviewed & Approved on December 18, 2019, by Jacquelyn Ekern, MS, LPC

Published on EatingDisorderHope.com

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.