It can be difficult to know when you are fully recovered from your eating disorder. The concept of full recovery and when it can be determined is often controversial, even among mental health professionals. The relatively high rate of recurrence of anorexia nervosa is something those in the field aim to reduce through improved treatment and aftercare.
Rates of Recurrence of Anorexia Nervosa
A 2013 study  by researchers at the University of Toronto reports that the relapse rates of anorexia nervosa range from 9 to 65 percent. This large and inconclusive range is representative of the need for more research relating to various aspects of eating disorder development, treatment, and recovery.
An older study from 1999  published in the Journal of the American Academy of Child & Adolescent Psychiatry found that only 33 percent of anorexia nervosa patients in the study reached full recovery after approximately 90 months of follow up. This data also suggested that 83 percent of anorexia nervosa patients achieved partial recovery and that approximately one-third of anorexia nervosa patients who achieved full recovery later relapsed.
These numbers might seem daunting to those currently battling an eating disorder, but being aware of the high relapse rates and the possibility of relapsing after full recovery can help individuals stay focused on their journey and be aware of warning signs.
Eating disorders are vicious diseases that attack both the mind and body. It is not surprising that it can be difficult to recover from anorexia nervosa, but it is important to remember that full recovery is possible.
There are many factors that contribute to high relapse rates. The University of Toronto study determined that having the binge-purge type of anorexia nervosa and/or a childhood history of physical abuse were two factors that made patients more likely to relapse following discharge from treatment. Another top struggle for patients in the study was maintaining the motivation to recover.
When in an eating disorder treatment program, an individual is likely sheltered from the outside world and all its triggers. Upon discharge, he or she is faced with these triggers and must navigate life with the coping skills learned in treatment. It can be tempting to resort to old eating disorder habits when unable to cope with these stressors.
Treatment and Aftercare to Reduce Likelihood
Eating disorders often co-occur with substance abuse and other mental health conditions. In the past, these were believed to be unrelated and were treated independently. Treatment centers and professionals now recognize the need for these co-occurring disorders to be treated concurrently in order to reduce the risk of relapse.
Additionally, working with a patient’s loved ones can help smooth the post-treatment transition to daily life. Eating disorders are complex, and no one expects loved ones to intuitively understand them. Family or couples’ therapy with an individual’s primary therapist in treatment can help loved ones understand what is happening and avoid being unintentionally triggering.
Aftercare is another important part of the treatment process. People typically cannot jump straight from inpatient or residential treatment to regular life without any aftercare or outpatient therapy. In fact, most facilities will not discharge patients until they have appointments set up with an outside therapist, psychiatrist (if needed), and nutritionist. Following through on these appointments and continuing with your treatment, even if you do not think you need it, is an important step toward lasting recovery.
What If I Relapse?
If you realize you are relapsing, the worst thing you can do is try to hide it. After achieving full recovery, you might feel you cannot come forward with your current struggle to loved ones, or even yourself. Be honest about your struggle and seek help. Remember that you are only as sick as your secrets.
If you are doing well in recovery, it is best to still check in with yourself about your food thoughts and behaviors. This is a healthy thing to do, regardless of whether an individual has a history of disordered eating. Confirming your intuitive relationship with food can be empowering.
Whether you have relapsed or are doing well in recovery, feel your feelings and speak your truth to loved ones. If your eating disorder voice is back with a vengeance, reach out to a mental health professional today and fight for your right to lead a fully recovered life.
About the Author: Courtney Howard graduated summa cum laude with a B.A. from San Diego State University, holds a paralegal certificate in Family Law, and is a Certified Domestic Violence Advocate. After obtaining her certification as a life coach, Courtney launched Lionheart Eating Disorder Recovery Coaching in 2015 and continues to be a passionate advocate for awareness and recovery.
References:: Carter, J., et al. (2013). “Tackling Relapse Among Anorexia Nervosa Patients,” Eating Disorders Review, Volume 24, Number 1.
: Herzog, D.B., et al. (1999). “Recovery and Relapse in Anorexia and Bulimia Nervosa: A 7.5-Year Follow-up Study,” Journal of the American Academy of Child & Adolescent Psychiatry, Volume 38, Issue 7, 829 – 837.
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.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 6, 2018
Published on EatingDisorderHope.com