In recovery from bulimia, relapses are to be expected, as they are a normal part of the recovery process. In fact, relapse rates are estimated to be anywhere from 30 to 85% for those who’ve been successfully treated for bulimia. [1, 4] So, how does a person help a teenager relapsing into Bulimia?
To clarify, a “relapse” is the reoccurrence of bulimia behaviors after a period of their absence. Relapses often occur during times of high stress and emotional distress — as these are times when new coping skills are difficult to recall. While many teens often feel shame, helplessness, hopelessness, sadness, or frustration when a relapse occurs, it doesn’t mean that they have failed at recovery. 
Here are five ways you can help a teenager relapsing into Bulimia:
1. Express compassion and understanding. Recovery from bulimia is a laborious, tumultuous process. It is essential to acknowledge and express compassion and understanding of the teen’s emotions and experience around the relapse. Recognizing and acknowledging the challenges of recovery can go a long way. It’s equally important to hold compassion for yourself as a support person, too.
2. Acknowledge that relapse is a normal part of the recovery process. After validating the teen by expressing compassion and understanding, it can be helpful to remind them that relapse is to be expected. Relapsing is an indicator that the teen is learning how to make long-lasting changes, and thus, they are strengthening their recovery. Normalizing relapse can help diffuse any harsh judgments the teen is having about themselves and the relapse — it’s likely that these types of harsh judgments will only make the relapse worse.
3. Guide the teen back toward recovery. Support the teen by having them identify what factors contributed to the relapse. Ask the teen how they can cope with similar triggering situations in the future. Help them to identify what techniques and coping strategies they used previously in recovery that may be helpful to use now.
4. Get support. If the relapse occurs for two weeks or longer, the teen will likely benefit from increased support — including a return to treatment (a visit to their therapist or dietitian) for a booster session or two. Typically, treatment following a relapse is briefer than the original treatment and can be extremely helpful in staying the course of recovery.
5. Full recovery is possible. Reassure the teen that while recovery from bulimia is challenging, it is possible, and getting support and treatment is vital. Those who receive treatment within the first 5 years of struggling with bulimia have a recovery rate of 80%. While those who waited more than 15 years after their symptoms began to get treatment, experienced recovery rates closer to 20%. 
For a teenager relapsing into Bulimia and most people struggling with bulimia, recovery goes through several stages and is characterized by steps forward and steps back. It is crucial to stay the course, to get support, and to remember that full recovery is possible. 
1. Chakraborty, K., & Basu, D. (2010). Management of anorexia and bulimia nervosa: An evidence-based review. Indian journal of psychiatry, 52(2), 174–186. doi:10.4103/0019-5545.64596
2. Grilo, C. M., Pagano, M. E., Stout, R. L., Markowitz, J. C., Ansell, E. B., Pinto, A., … Skodol, A. E. (2012). Stressful life events predict eating disorder relapse following remission: six-year prospective outcomes. The International journal of eating disorders, 45(2), 185–192. doi:10.1002/eat.20909
3. Reas, D. L., Williamson, D. A., Martin, C. K. and Zucker, N. L. (2000), Duration of illness predicts outcome for bulimia nervosa: A long‐term follow‐up study. Int. J. Eat. Disord., 27: 428-434. doi:10.1002/(SICI)1098-108X(200005)27:4<428::AID-EAT7>3.0.CO;2-Y
4. National Collaborating Centre for Mental Health (UK). (2014). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. NICE Clinical Guidelines, No. 9. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK49318/.
About the Author:
Chelsea Fielder-Jenks, LPC is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.
She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.
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 on May 20, 2019.
Reviewed & Approved on May 20, 2019, by Jacquelyn Ekern MS, LPC
Published on EatingDisorderHope.com