Relapse: Why Eating Disorder Recovery is an Imperfect Journey

It is common for those struggling with eating disorders to experience difficulty with the concept of perfection. Many commit themselves to be “perfect” in their recovery, without relapse or setbacks, just as they attempted to be “perfect” in their disorder.

Likewise, as many learned they could not be perfect in their disorder, they must also realize one cannot be perfect in recovery. Recovery is not a black-and-white process, and progress does not happen in a linear fashion.

The Odds of Relapse

It is important to be clear that relapse is common in recovery. It is more common that a lapse or relapse into old disordered eating behaviors will happen than not.

Study-upon-study has been conducted regarding statistical rates of relapse for eating disorders. These studies have found that, on average, between 22% to 51% with anorexia nervosa and bulimia nervosa will relapse [1].

Relapse is so commonly experienced because it is natural in the progression of change. Consider any behavioral resolution or goal you have ever set for yourself or witnessed. Even if the initial change was immediate, consistent behavior change takes time.

In the time between that consistency and the initiation of behavior change, lapse and relapse are happening. There is no need to justify it with fancy psychological or scientific answers because the truth is much more simple – change is hard.

Pointing out that this will be hard, and discussing the likelihood of relapse is not intended to scare you or make you feel recovery is unattainable. Recovery is absolutely possible.

What this information can do is help you feel less lonely in the rollercoaster of recovery. Accepting that you will likely stumble and reminding yourself that it is okay can help you continue to move forward despite those hiccups.

Triggers to Look Out For

Woman understanding that relapse is commonAccepting the possibility of recovery does not mean you have no control over the situation. Knowing the triggers that often cause relapse can help you to prepare for them and be compassionate with yourself if they cause you to falter in your recovery journey. Some key predictors that researchers find correlate with relapse can differ depending on the disorder you struggle with.

For example, “studies of bulimia nervosa have identified a number of post-treatment predictors of relapse…such as higher frequencies of vomiting, higher dietary restraint, greater dissatisfaction with body image, and the over-importance of weight and shape [1].”

For those with anorexia nervosa, predictors include “the BP (binge/Purge) subtype of AN (anorexia nervosa), the severity of checking behaviors at pre-treatment, decrease in motivation to recover during treatment, and lower motivation to recover at post-treatment [2].”

If these are familiar, you may be more likely to struggle with relapse; however, you ultimately have the power to make recovery-focused choices.

Forgiving Your Imperfection

The difference between a relapse that’s just a hiccup and a relapse that involves a full-on return to behaviors and the need for intensive treatment can often come down to perspective. Many individuals experience a moment or episode of relapse and bombard themselves with self-shame.

This self-shame often triggers a fall down the rabbit hole because the individual feels overwhelming physical and emotional shame and cannot think of another way to cope with this. Forgive yourself in advance for the fact that you will have slip-ups.

Acknowledging that this is a part of recovery and human of you decreases the likelihood that feelings of shame and guilt will overwhelm you and push you toward full relapse.


Resources:

[1] Keel, P.K. et al. (2005). Postremission predictors of relapse in women with eating disorders. Learning Supportive Psychotherapy, 162:12.

[2] Carter, J., et al. (2012). A prospective study of predictors of relapse in anorexia nervosa: implications for relapse prevention. Psychiatry Research, 200.


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 October 6, 2020, on EatingDisorderHope.com
Reviewed & Approved on October 6, 2020, by Jacquelyn Ekern MS, LPC

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.