Relapse is unfortunately very common among people who struggle with disordered eating. Therefore, prevention efforts should be baked into a successful treatment plan. Furthermore, behavioral health providers should not only take measures to monitor patients’ progress but also teach patients how to identify signs of relapse and what to do if they notice these signs. It is also important to ensure that good resources are available and accessible.
Medical Meaning of Relapse
Relapse refers to an instance where someone who has suffered from symptoms of a disease later becomes symptomatic once again after a period of improvement. In the case of eating disorders, relapse may be characterized by many different symptoms or behaviors. This may include more severe symptoms such as binging and purging or intentionally failing to consume a sufficient amount of food, but may also involve more subtle behaviors such as becoming preoccupied with or secretive about food. It can be difficult to categorize a relapse, but some professionals use metrics such as amount of weight lost to designate whether a return of symptoms is considered a relapse.
Signs and Symptoms of ED Relapse
The signs of a relapse can vary widely depending not only on the type of disorder but also the individual. Signs and symptoms of eating disorder relapse can include:
- Avoiding meals;
- Being secretive about food;
- Unusual preoccupation with food, weight, or body;
- Feelings of guilt or poor self esteem after eating or when thinking about one’s body;
- Sleep problems;
- Concealing information about thoughts or behaviors from loved ones or health providers;
- Justifying or downplaying lapses or concerning behaviors;
- Mood changes;
- HIgh stress;
- Irritability in response to conversations about food or eating disorders;
- Self-isolation.
Specific eating disorders may also have their own common warning signs. For example, people suffering from anorexia nervosa may experience plummeting weight, those suffering from bulimia may frequently use the bathroom following meals, and people with binge eating disorder may buy unusually large quantities of unhealthy food. Therefore, it is important to be aware of symptoms associated with your particular diagnosis or that of your patient.
How To Not Relapse
If possible, it is better to prevent relapse rather than address renewed symptoms. What will work best will depend somewhat on the individual and their specific lifestyle and needs. However, the following are some common steps that can be taken to prevent relapse:
- Identify triggers.
- Take note of behavioral concerns early.
- Outline coping strategies.
- Develop healthy habits.
- Cultivate hobbies.
- Practice self-care.
- Ensure a healthy support system is in place.
- Cut bad influences out.
- Stay proactive in treatment and prevention (e.g. CBT, DBT).
- Schedule regular behavioral health check-ins, interventions, and follow-ups.
It is vital to not become complacent in ongoing treatment and recovery efforts. Furthermore, it is important to bear in mind that relapses can sometimes develop into an even more severe period of symptomatic behavior.
Eating Disorder Recovery Rates
According to the National Eating Disorder Association (NEDA), 30 million Americans will have an eating disorder in their lifetime. Furthermore, the prevalence of eating disorders is on the rise worldwide (some reports state as much as twice the rate), including among teens and children. Meanwhile, across all eating disorder diagnoses, approximately one-third of sufferers will experience relapse. Many people experience multiple relapses over the course of their lives, which is why vigilance and proactive recovery efforts are so valuable.
How Long Does Eating Disorder Recovery Take?
How long it takes to recover from an eating disorder depends on many factors, and it can take anywhere from several months to many years. Relapses are one of the biggest potential barriers to recovery. Other important variables involve treatment of underlying conditions and improvement of overall habits and lifestyle.
Who Is Most Vulnerable To Eating Disorders and ED Relapse?
Individuals who are most at risk for developing eating disorders or experiencing a relapse include the following:
- Individuals with existing mental health or behavioral concerns;
- Those experiencing stressful life events (e.g. breakups, moving, career changes, grief, illness, birth, financial issues);
- People who have experienced traumatic events.
Those who have a family history of disordered eating or family members with preoccupations about weight and appearance may also be at greater risk.
Stages of ED Recovery
By understanding the stages of eating disorder recovery, patients and their providers can more effectively anticipate challenges and pitfalls. Stages of eating disorder recovery typically involve the following:
- Pre-contemplation: The individual is not yet consciously aware of the problem or its severity.
- Contemplation: The individual begins to entertain the possibility that their behaviors are harmful.
- Preparation: The individual acknowledges how unhealthy their behaviors are and begins to seek out information about recovery.
- Action: The individual actively pursues treatment and recovery.
- Maintenance: The individual proactively maintains the changes that they have developed.
Backslides may occur at any stage in the recovery process. As such, it is vital that those in recovery have a strong support system that helps keep them on track.
