By Joan Zhang

Clinically Reviewed by Sehrish Ali, PhD, LPC, CEDS

Relapses are a real part of eating disorder recovery. Are you worried you may be experiencing an eating disorder relapse or want to know how to avoid one? Perhaps you’re concerned about someone you love and are curious about the warning signs and best response. Either way, we’re here to help. Relapse is far more common than people realize and with the right support, it doesn’t need to derail all the healing that’s been done.

What Does “Eating Disorder Relapse” Mean?

Because eating disorder recovery is a lifelong process, lapses can be a common part of the journey. Sometimes it’s a small, isolated “slip”, but other times it can spiral into a longer episode.

If you’ve noticed that you’ve resumed one or more harmful eating behaviors regularly, you’re likely experiencing a relapse. This can include resuming:

• Food-restriction
• Binging or purging 
• Over-exercising
• Obsessive thoughts about food

You may also have found yourself returning to more secretive behavior around these practices. Shame is common during relapse, but we need you to know that there’s nothing shameful about it. Falling back into old habits doesn’t make you weak or a bad person – it’s a common part of recovery and something that, with help, you can find your way through. 

How Common Are Eating Disorder Relapses?

Eating disorder relapses can be incredibly scary and frustrating to go through. They are also extremely common. It’s estimated that between 21-51% of people with eating disorders will have a relapse of symptoms at some point during the recovery process.

A relapse doesn’t mean your recovery didn’t work, but that it’s just taken a different turn. It often signals important ways in which your support needs to adjust and in doing so, can provide even more opportunity for growth. 

What Makes an Eating Disorder Relapse More Likely?

An eating disorder relapse is made much more likely by two main factors:

• Going a long time without treating your eating disorder
• Experiencing high levels of body dissatisfaction or other relevant stressors

What Are Typical Relapse Stressors?

One of the best ways to avoid a relapse is to stay cognizant of possible stressors so that you make sure you have the right support around when you need it most. Here are some of the most common eating disorder relapse stressors:

Major Life Events and Changes

Moving house, break-ups, and grief are considered some of the most stressful events a person can go through. Unfortunately, times of high stress and instability make taking of ourselves even harder, which in turn raises the risk of a relapse.

If you’re changing jobs, cities, or experiencing a shift in a close relationship, make sure you’re in contact with support systems.

Pregnancy And Infertility

Conceiving a child or even trying to conceive can both be big stressors for those in eating disorder recovery. Hormonal shifts play a role in this, as does the increased attention and anxiety that a fertility journey or pregnancy can bring regarding folks’ bodies. Finding OB-GYN providers who are weight-neutral and finding community with others can help with navigating recovery in this new phase.

Shifts In Your Health

Illness and changes in your health, be they the result of disease or the natural aging process, can often bring about an eating disorder relapse. It’s very common to feel out of control and even frustrated with your body in these situations and then seek to soothe those feelings by resuming old habits. 

Experiencing Fatphobia, Body Shaming, or Bullying

Any negative attention given to your body can be a major cause of relapse. This can happen with people you love, or just by seeing something upsetting online or in the media.

Poor Interpersonal Relationships

Humans are social beings so when there are issues in our relationships or communities, it can negatively impact all parts of well-being.

Immersion In Diet Culture 

Diet culture is almost impossible to avoid but certain online habits, environments, and people can leave us more exposed than usual. If, for example, you’ve found yourself going down online spirals regarding weight loss or extreme exercising regimes, you may be heightening the chance of a relapse.

What Are Some Relapse Warning Signs?

Before a full relapse, there are usually warning signs that something is amiss. Some of the most common red flags include:

Increased Avoidance of Food

This can manifest as restrictiveness with how you eat at home or even avoiding social settings where food is involved.

Obsessive Thoughts About Food

Ruminating about your food choices and finding yourself stuck in obsessive thought cycles is one of the biggest warning signs of a potential relapse.

Increased Fear of Gaining Weight

It’s so important to recognize if you’ve been feeling extra fearful of weight gain. That fear can very easily get in the way of nourishing and caring for yourself.

Increased Body Checking

Weighing yourself, measuring parts of your body, or constantly checking the mirror are all important warning signs to watch out for. That kind of hypervigilance is usually a clear indicator that something’s up. 

Urge To Diet and Lose Weight

Sometimes the most important relapse warning signs are the unseen ones like that voice in the back of your head urging you to lose weight suddenly getting louder. 

Deviating From Your Meal Plan or Wellness Plan

Many people in recovery have a meal or wellness plan from their healthcare providers to help them stay on track. If you’ve found yourself deviating from this, check in and see if it’s just because things need updating, or if it’s a sign you’re struggling.

What Are Some Tips To Prevent A Relapse?

Here are 5 simple tips for preventing an eating disorder relapse:

1. Be mindful and pay attention to what seems like minor decisions such as resisting the urge to eat when you’re hungry or pushing yourself harder than usual in workouts.

2. Acknowledge when you’re struggling and seek support and accountability from people you trust. No stressor is too small or too silly to speak up about. 

3. Remind yourself what you’ve gained in leaving behind your ED behaviors. You can do this by writing a list or talking to someone you trust to help reaffirm why recovery matters to you. It’s a great way to re-focus on the good in your life worth protecting.

4. Continue with therapy and counseling. Consistency is key with any kind of mental health support, but especially an eating disorder. Regular support makes it much easier to catch early warning signs of a relapse and ensures that there’s a professional to turn to when things get extra challenging.

5. Staying active and engaged in activities you enjoy. What fills your cup? What allows you a glimmer of joy, even when everything feels hard? Make sure that whatever those things are, you continue to prioritize them. It can help you stay regulated through stressful periods and maintain perspective when old habits reappear.

What should you do if you relapse?

First, don’t beat yourself up. Relapses are common, and they don’t mean that you have to start from scratch with your recovery. Our main advice with a relapse is to seek help, preferably from a professional that you trust, and to get a friend or family member involved too. You don’t have to go through this alone, nor should you.

What should you do if a loved one relapses?

Being a carer or support person to someone dealing with an eating disorder relapse can be extremely tricky to navigate. It’s easy to get scared of saying the wrong thing or allowing your frustration to take over.

Here are 4 ways to respond to a loved one going through a relapse:

1. Remember, it doesn’t mean your loved one has failed. It also doesn’t mean you have. 

2. Make space for their feelings and encourage self-compassion. It’s easy to want to yell at someone when they relapse but keep in mind that they’re probably being hard enough on themselves as it is.

3. Remind them of the progress they made. This is something you can be particularly helpful in as someone on the outside of the eating disorder. You can provide much-needed perspective on all the growth that person has already accomplished, relapse or not.

4. Encourage them to get help. People often need a gentle nudge to make that therapy appointment or seek support. Offer to help make the phone call if they’re anxious or to drive them if they need it. Every little bit makes it easier.

Arise & Recovery in Real Life

Because relapse in eating disorders is so common, we’ve built our platform at Arise to provide long-term support. Here’s how:

“Recovery in Real Life”

Arise includes a treatment phase called “Recovery in Real Life” that gives folks community support to help navigate life stressors and potential relapses as they go through their daily life.

Staying Connected with the Arise Care Team

We also keep folks connected with their Arise care team to help navigate life stressors as they inevitably come up. The most important way to prevent a relapse is to have people on call who you can talk to openly without judgment or shame.

Book a free consultation here and see for yourself how our virtual and highly adaptive eating disorder program can provide support throughout your recovery. We’re here to help any time you need it.