Eating Disorder Relapse: Signs, Prevention, and Treatment

Eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) have numerous physical, psychological, and social impacts that can be difficult to overcome. One of the most challenging aspects of recovering from these disorders is navigating the risk of relapse.

Many people in the recovery process find themselves regressing to disordered behaviors at some point, putting their physical and mental health at risk. 

It can be difficult and disheartening to face this situation, but with the right help and support and a relapse prevention plan, it’s possible to find lasting recovery and a healthier, happier life. 

What is an Eating Disorder Relapse?

An eating disorder relapse occurs when a patient in recovery begins experiencing unhelpful thoughts again and returns to their previous unhelpful behaviors to cope. 

Relapse is common. It can occur long after disorder recovery and can be brought on by stress, significant change, or other triggers in someone’s life. 

Identifying an Eating Disorder Relapse

Eating disorder relapses often happen slowly, with people sliding down a slippery slope back into disordered thoughts and behaviors. 

These can be difficult to identify in the early stages. However, the re-emergence of eating disorder symptoms and certain other warning signs can indicate that someone may be struggling. 

Some red flags include:^1,2

• Making excuses or taking steps to avoid eating with others.
• Fixating or focusing on body shape, weight, or size.
• Feeling shame or guilt after eating.
• Deviating from their meal plan or wellness plan.
• Displaying noticeable changes in mood, attitude, energy level, and motivation.
• Spending less time with family and losing interest in activities or events they previously enjoyed. 
• Practicing an excessive exercise routine.

Stressors like a new job, moving, and other significant life changes often precede these returns to disordered eating behaviors.¹

How Common Are Eating Disorder Relapses?

Eating disorder relapse is a common occurrence and can happen at any time in the recovery journey, including after leaving treatment. 

The prevalence of eating disorder relapse varies, depending on the specific condition and an individual’s treatment history. Still, previous studies have noted some broad patterns in relapse rates.

When it comes to patients with anorexia nervosa, eating disorder experts found an overall relapse rate of 35%. The first 18 months after discharge are a particularly high-risk period for relapse.³

During a 2-year follow-up period for bulimia nervosa patients, 31% of individuals with the condition experienced a relapse.⁴ In these cases, most relapses occurred within the first six months following treatment. 

Sadly, it’s likely these statistics highlight only a portion of relapse rates, as many individuals struggle silently with their eating disorders and never seek out help.

Eating Disorder Relapse Risk Factors

Eating disorders are incredibly complex conditions, and a multi-faceted approach to wellness is paramount for a full recovery.

One of the biggest reasons people experience a re-emergence of unhelpful thoughts and behaviors is that underlying issues that drive their condition, such as low self-esteem, depression, anxiety, and past trauma, remain after treatment.⁵

Other common risk factors for the recurrence of eating disorder symptoms include:^5,6

• A history of chronic or severe illness
• Lack of support from family and friends
• Difficulty managing stress and emotions
• Increased concern with body image 
• A history of substance abuse or other mental health disorders

A mental health professional is a great resource for those worrying about slipping back into the harmful behaviors associated with an eating disorder.

Common Triggers for Relapse

Aside from risk factors, some common triggers may bring on disordered eating in people going through eating disorder recovery. Some of these include:^2,7

• Stressful life events, such as a breakup, job loss, or other major change
• Exposure to unrealistic body standards through social media or advertising
• Critical comments about body shape or weight made by a loved one or even a stranger

In some cases, these triggers can be unavoidable. That’s why those on the path to recovery need to have a relapse prevention program in place. This can help them stay focused and positive through potentially tricky situations and return to healthier coping mechanisms for any stress they may be experiencing.

Reducing Risk of Relapse

While the risk of relapse is real—and dangerous—relapse from an eating disorder is not inevitable. 

If you or a loved one is worried about an eating disorder relapse, some things can be done to prevent relapse, or at least reduce the risk of experiencing this disheartening situation. 

Some strategies include:^1,2,7

• Continuing with therapy and counseling
• Building a strong support system (friends, family, and health professionals)
• Learning healthier stress management and coping strategies
• Staying active and engaged in activities you enjoy
• Being mindful of triggers and avoiding them when possible
• Practicing self-care and self-compassion

A mental health professional, nutritionist, primary care doctor, or other expert can help you or your loved one develop a relapse prevention plan, which can include these and other helpful strategies.

What to Do If A Relapse Occurs

Eating disorder relapse is difficult for everyone it touches. However, if you or someone you know is dealing with this challenging situation, there are several steps you can take to improve the situation. 

Seek Professional Help

The first step in managing relapse prevention is seeking professional help from a therapist, counselor, or doctor who specializes in treating eating disorders. 

These experts can help you or your loved one adapt your treatment plan or develop a new one that more adeptly addresses any triggering scenarios you may have encountered. Healthcare professionals can also provide the necessary support and resources to help someone get back on track.

Reorganizing priorities can be a big help in warding off crises or potential crises.

Emphasizing self-care can make a difference in the case where someone is on the edge of relapse. This may include tasks as simple as getting enough sleep, but can also extend to eating more regularly or nutritiously, taking time to relax, or channeling stress through healthier outlets, such as practicing art or talking to friends. 

Creating a positive environment that promotes self-care and self-acceptance helps emphasize all the helpful lessons of recovery.

Be Supportive 

If someone you love is showing signs of a potential eating disorder relapse, it’s important to show them that you are there for them and care about their well-being. 

Having a trusted person to talk to about any concerns can be a big help for people and give them time and space to understand their overwhelming thoughts.

Still, while offering support and encouragement is important, it’s often better to listen than to contribute unasked-for advice. And it’s especially important to avoid criticizing or judging someone during this delicate time.

Educate Yourself

Learning more about what people with eating disorders are experiencing can be a helpful aspect of supporting them. This can include learning more about what causes certain eating disorders, as well as different treatment options and how they help.

Educating yourself will not only help you understand your loved one’s experience, but it will also equip you with the knowledge you need to be an effective support system for them. 

Join A Support Group

Eating disorders aren’t just hard on the person going through them. It can be painful to watch someone you love struggle with these devastating conditions. If your family member or friend is struggling with an eating disorder relapse, joining a support group may help. These types of experiences can provide you with a community of people who understand what you are going through and who can offer advice and support.

Emphasizing self-care can make a difference in the case where someone is on the edge of relapse. This may include tasks as simple as getting enough sleep, but can extend out toward eating more regularly or nutritiously, taking time to relax, or channeling stress through healthier channels, such as by practicing art or talking to friends.

Creating a positive environment that promotes self-care and self-acceptance helps emphasize all the helpful lessons of recovery.

Finding Help for Eating Disorder Recovery

Recovering from an eating disorder is a challenging and ongoing journey, but with the right support, it is possible to overcome it. If you or your loved one has experienced a relapse, it’s important to maintain hope.

Seeking professional help can be a crucial step toward getting back on track. Doing so as soon as possible is the best option for rejoining the path toward recovery. 

Remember, with the right treatment and support, it’s possible to live a fulfilling and healthy life, even after an eating disorder relapse. Take the first step towards recovery today and reach out for help.