What is a Relapse in Eating Disorder Recovery?
Written by ‘Ai Pono Hawaii Staff Writer
“Healing comes in waves and maybe today the wave hits the rocks, but that’s okay, darling. You are still healing.”
- Ljeoma Umebinyuo
The journey to recovering from an eating disorder is a non linear process full of twists and turns. Temporarily relapsing into old thoughts and behaviors is a common part of the healing journey for many people. If you are in eating disorder recovery but have experienced (or are currently going through) a relapse, here are four practical tips to help you stay on the recovery track after a relapse in eating disorder recovery.
What is a Relapse?
A relapse in eating disorder recovery occurs when an individual in recovery slips back into behaviors for a period of time. While many individuals in recovery believe relapsing is a sign of failure or even evidence that they can’t fully recover, the truth is, relapses are a common occurrence on the road to recovery. In fact, one study reported that between 35 and 36 percent of anorexia and bulimia patients experience a relapse during recovery. Patients are most at risk of relapsing during the first 18 months after treatment, but relapses can occur any time (even years) after recovery.
It’s important to understand the difference between a “lapse” and a “relapse.” A lapse in recovery is an isolated instance where the individual uses a behavior. This could mean purging after one meal, engaging in obsessive exercise, or skipping a meal. These isolated instances can be thought of as slip ups, and if handled correctly, are easily contained.
A relapse, on the other hand, is where the individual engages in behaviors over a longer period of time, not just in a single, isolated instance. Whether you experience a temporary lapse or a longer relapse into behaviors, know that this is a common part of the healing process for many people.
Eating Disorder Recovery is a Labyrinth, Not a Maze
One of the mistakes many women make during recovery is looking at their eating disorder recovery process as a maze instead of as a labyrinth. Though mazes have numerous paths, twists and turns, they only have one correct way out. So if you step off the right path and wander down a back alley, you will eventually hit a dead end and have to turn around and start all the way back at the beginning.
Labyrinths, in contrast, are pathways that loop, meander, and wind their way back and forth. In a labyrinth, there is no right or wrong path. Instead, all the pathways are connected, finding their way to the center and out again. So no matter which path or side road you wander down, you’ll eventually find your way out. There are no dead ends or “roads with no return” in a labyrinth.
What Do Mazes and Labyrinths Have to do With Eating Disorder Recovery?
Eating disorder recovery is a nonlinear process, just like a journey through a labyrinth. When you turn and fall back into old thought patterns and behaviors, this doesn’t mean you’ve completely fallen off track and have to start back at the beginning. Instead, it is an opportunity to press forward, remember why you’re fighting for healing, and discover your inner courage and strength.
“The great thing about the labyrinth is that you can never truly be lost. If you slow down and simply place one foot in front of the other, you will continue to make progress,” shares our founder, Dr. Anita Johnston.
“When a woman enters the labyrinth of recovery she follows a twisting, turning, winding path to her center where she reclaims her inner authority. Finding the essence of who she is as a woman, she exits the labyrinth, integrating this vision with a new way of being in the world.”
In other words, each person’s journey through the labyrinth of recovery is unique, and the ultimate goal is to reach the center (your center) and connect with your true self. Only when you connect with your true self can you start the journey back out of the labyrinth. But in your search for the center, you may find yourself on a difficult path of relapse. However, if you keep moving forward, sooner or later, you will find the center and realize you were never off track, it was all just part of the journey.
Signs You May Be Relapsing in Recovery
While relapsing into old thought patterns and behaviors is a common part of the healing process, it’s important to recognize when a relapse is starting to happen so you can find help and support before things spiral out of control. If detected and handled properly, relapsing can be a time to tune in to your inner voice, uncover the deeper meaning hidden behind the behaviors you’re engaging in, and come out stronger and more self aware. If left to itself, however, relapses can trap you back inside the eating disorder and undermine the progress you’ve made. This is why it’s essential to know the signs of a relapse and seek help right away if you think you might be relapsing.
If you or a loved one are in recovery, here are some signs of relapse you need to look out for:
Making excuses for not eating
Skipping meals and/or snacks
Less willingness to talk about recovery efforts
Being dishonest with treatment team or others trying to help
Reducing the size of meals/snacks
Weight changes
Avoiding eating with others (not going out, eating alone, etc.)
Cutting out food groups or avoiding specific foods
Engaging in old behaviors (purging, over exercising, bingeing)
An increase in thoughts about food, eating, and body image
Frequent mirror checking
Daily weighing or “checking” (pinching fat, measuring)
Feeling ashamed or disgusted with yourself after eating
Tips on Preventing Relapse
The best way to prevent a relapse is to prepare for it. Ask your treatment specialists to help you come up with a relapse prevention plan, and share this plan with a trusted friend or family member who can help keep you accountable and detect the early signs of a relapse. Additionally, you need to be aware that certain experiences and times of life can be triggering and may make you more vulnerable to relapse. Once you’ve identified these potentially triggering circumstances, set up safeguards (extra counseling, a support system, intentional self care, etc.) to help you navigate potential challenges and keep you moving forward in recovery.
Circumstances/experiences that may make you vulnerable to relapse include:
Starting or ending school or college
Starting or ending a relationship
Starting or ending a job
Weight changes
Pregnancy and having a baby
Traumatic experiences
Moving
Physical injury
What to do After a Relapse in Eating Disorder Recovery
If you’ve experienced an eating disorder relapse, first know you are not alone. “When I first started my recovery journey six years ago, I felt like I was relapsing more than actually recovering,” shares Nicole Davenport in a National Eating Disorder Association (NEDA) article. She goes on to say, “But you know what? There is recovery in the relapse. Just because you’re going through a relapse does not mean you are failing. You are learning, growing, and becoming stronger.” The same is true for you.
Seek Help
The most important thing you can do after (and during) a relapse is to seek professional help. At the first sign of harmful thoughts or behaviors, reach out to your therapist, doctor, dietitian, school counselor, social worker, or anyone else you trust. Don’t be afraid to let them know what’s going on and ask for help. Remember, the sooner you catch and deal with a relapse, the more positive the outcome will be.
Stick to Your Nutrition Plan
During or after a relapse, it’s easy to let old thoughts and behaviors slip into your eating habits. It may seem like a “good idea” to skip breakfast after a late night purge or like “no big deal” to forgo your afternoon snack during a busy day, but these disruptions in your nutrition plan are small but significant wins for your eating disorder. So protect your health and recovery by sticking to your prescribed nutrition plan, no matter what.
Set Yourself Up For Success
After a relapse, you may struggle more with feelings of self doubt and insecurity, feel an increasing urge to weigh yourself, or find yourself obsessively checking in with the mirror. The best way to refocus on recovery and ditch these harmful thoughts and behaviors is to establish a recovery-friendly environment. This might mean throwing out all scales, covering or removing all mirrors (especially full-body ones), and taking a break from social media or simply unfriending accounts that focus on body image, food, fitness, or weight loss.
List Your Reasons for Recovery
After a relapse, it’s easy to feel discouraged and wonder if recovery is even worth it. These are the times you need to remember your “why.” So grab a piece of paper and pen, and write out all the reasons why you need to/want to recover.
If you or someone you love is suffering from an eating disorder or going through a relapse, take the first step today and talk to talk to someone about recovery or simply learn more about the eating disorder recovery programs we offer.