Preventing Relapse in the Road to Recovery from Bulimia

Rainy Road

Bulimia nervosa is a potentially deadly eating disorder [1]. Bulimia is a cycle of binging and compensatory behaviors to make up for the binge. Some examples of compensatory behaviors are purging, compulsive exercise, fasting, or laxative use [1].

People with bulimia also tend to struggle with body-image because body shape or size can really impact their self-esteem. Fear of gaining weight or becoming fat can also motivate these people to use compensatory behaviors to try to avoid this.

Bulimia can cause serious mental and physical health problems [1]. Physically, bulimic behaviors can negatively impact someone’s digestive system, cause chemical imbalances, and affect other major organs, including the heart [1].

For this reason, it’s crucial for people to get treatment. However, once someone gets treatment, it doesn’t mean that the work is done. Relapse can happen.

There are things that people in recovery can do to prevent relapse. Here are three relapse prevention tips for bulimia recovery:

Know Your Bulimia Red Flags

Relapse doesn’t tend to happen overnight. It’s more likely to be a gradual increase in disordered thoughts and behaviors. Being aware of what the red flags are for you can help you catch yourself before things become more severe.

Red flags can be different for everybody, but some common ones may be that you are starting to worry more about gaining weight or isolating yourself from friends and family [1]. Being able to notice when disordered thoughts or behaviors start creeping in can be a sign that you need more emotional support [2].

Sometimes we aren’t sure what our red flags are. This can be especially hard to figure out if we don’t want to believe we are struggling. Pushing away the reality of your behaviors and thoughts can be a defense mechanism.

Angela Florio, an eating disorder therapist, often asks her clients, “If I were to be around you and notice that you were struggling, what would it be that I noticed?” [3]. Thinking about what others may notice about you can help you pinpoint what your personal red flags are.

If this is still difficult, ask your support system what they notice. They may be able to reflect back to you what kind of behaviors or changes they’ve seen when you are struggling. This is a vulnerable conversation to have but will likely be enlightening.

Know Your Triggers

Woman dealing with BulimiaOne way to prevent relapse is to be aware of your triggers. A trigger is any environmental, physical, or emotional thing that leads to negative feelings. A trigger may make someone feel anxious, scared, insecure, or any other upsetting emotion. Some examples of triggers may be wearing a swimsuit around other people or being alone.

If you know what your triggers are, you can figure out ways to cope ahead of time. Having a plan can help you feel more prepared and confident in being able to handle being triggered. This is also important since eating disorder behaviors are often a way to cope with emotional pain [2].

If you are using disordered behaviors to cope with triggers, then it’s going to be hard to stop. If you know what things make you feel upset and you can find other ways to deal with these feelings, then you’re less reliant on the eating disorder [2].

Use Your Support System

Having support from loving, trustworthy, and safe people can be really helpful in preventing relapse [2]. A support person can be family, friends, a therapist, or other members of a support group. Turning to your relationships can help you deal with days that recovery is harder to maintain.

Your support system can also help give you accountability. If they notice you are struggling, then they may intervene. This can be helpful, especially if you are struggling to get the behaviors under control or are losing motivation for recovery.

Even though recovery is hard, it’s also possible. It’s normal to have setbacks, but knowing relapse prevention tips can help you get back on track.


[1] National Eating Disorders Association. (2018). Bulimia nervosa.

[2] Costin, C. & Schubert-Grabb, G. (2012). 8 keys to recovery from an eating disorder. W.W. Norton & Company.

[3] Florio, A., personal communication, March 17, 2021.

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.

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 March 25, 2021, on
Reviewed & Approved on March 25, 2021, by Jacquelyn Ekern MS, LPC