Eating Disorder Relapse Prevention: Making a Plan

An eating disorder relapse can leave you feeling confused, devastated or even ambivalent. These feelings are all normal and valid. We want you to know that, when navigating life in eating disorder recovery, relapse is fairly common. Take a look at relapse rates for anorexia and bulimia below.

Anorexia relapse rate

Rates of anorexia relapse range from 35% to 41% in the first two years after treatment [1].

Bulimia relapse rate

In a study of 116 people, rates of bulimia relapse were 27.6% within the first six months after treatment [2].

If you suspect that you may be headed for a relapse, we encourage you to reach out to your treatment team and your support network now. This is a great opportunity to restabilize in recovery.

Creating an eating disorder relapse prevention plan

A detailed, personalized relapse prevention plan is essential to help you get through recovery. If you have not made one already with your treatment team, we encourage you to take that step now. The plan can include:

• A list of warning signs that you could be at risk of relapse
• Steps you can take when you are at risk of relapse
• Steps others can take if you are at risk of relapse

Share your relapse prevention plan with your support system to provide you with support and accountability. Additionally, these tips from our experts might help you avoid a relapse:

1. Be prepared that relapse could occur and create a relapse prevention plan.
2. Share the plan with your support system and keep it handy.
3. Draw on the wisdom and strength of your treatment team and personal support system. Let them know when you’re struggling so you can prevent things from getting worse.
4. Talk compassionately to yourself, forgive yourself for slips and lapses, and know that lapses are a part of a normal and healthy eating disorder recovery.
5. Always have hope that you can achieve a long-lasting recovery.

Eating disorder lapse vs. relapse

To understand how to proceed following an eating disorder “relapse,” it’s helpful to know what a “lapse” is, as well. 

An eating disorder lapse is an isolated incident where one engages in eating disorder behaviors. Also called a “slip,” lapses are very common and can often be contained easily and quickly. 

An eating disorder relapse lasts for a longer period and can be challenging to overcome as you try to get back on track in recovery.

Eating disorder relapse triggers

Life transitions are a prime time for relapse. When we are off our normal routine or creating a new life routine, it can be hard to stick to our meal plan and remember our coping skills. Life transitions preceding a relapse include:

• Starting/ending school or college
• Starting/ending a job
• Starting/ending a relationship
• Moving to a new residence
• Becoming pregnant
• Having a baby/becoming a parent
• Weight changes associated with physical health, aging or pregnancy
• Physical injury or lessened mobility
• Experiencing a trauma

It’s okay to seek out additional support from friends, family and your treatment team when you are dealing with major life transitions and other stressors like these. And it is totally normal to struggle, at any age, when going through transitions like those listed above.

Signs of eating disorder relapse

Do you know your personal signs that you might be at risk for relapse? Some possible signs of relapse include:

• Not completing meal plan
• Eliminating individual food items or groups of foods
• Demonstrating less openness to talking about recovery or believing you can recover
• Making changes in diet
• Unexpected weight changes
• Eating alone or avoiding mealtimes with others, including not going out to eat

What to do if you relapse

If you are going through a relapse, please remind yourself that you are not alone and that you are not the first person who has faced this challenge. Next, take some time to explore your internal state. Think about what might have led to this relapse. Consider journaling as you explore the following questions:

• Did something specific cause this relapse?
• Has there been a significant change in your life recently?
• Have you been under more stress or experiencing more anxiety?
• Have you started a new job, school program or other activity?
• Has there been any change at home with your family or significant other?
• Has something been upsetting or bothering you?
• If you have a trauma history, has something triggered you or reminded you of your trauma?

Please reach out to, or make appointments with, your dietitian and therapist and discuss what you’ve learned through this journaling exercise. If journaling is not your thing, please let someone know what’s going on. Your treatment team would be more than happy to support you during this challenging time.

Other steps you can take

If you have relapsed, above all, do not assume that all hope is lost. Do not fall into a belief that you are a failure or that recovery is going to be impossible. Instead, try compassionate, supportive self-talk that is more recovery focused such as:

“I am disappointed that I used an eating disorder behavior and will now focus on the next best recovery-focused decision.”

“I do see what I need to do differently next time. And I won’t wait as long to reach out for help.”

“Slips and lapses are bound to happen in recovery. Overall, I am doing much better than before treatment and that feels hopeful.”

Self-compassion goes a long way in supporting yourself throughout recovery. Compassionate self-talk is much more beneficial in the long run than beating yourself up over any lapses that might occur.

Help for eating disorder relapse 

No matter the events that might have led to your relapse, we want you to know that you have the strength within you to get through this. One of our top recommendations for our alumni who are struggling with relapse is to attend regular eating disorder support groups. Remember: Full recovery from an eating disorder is possible!

Find an eating disorder support group here.

Read These Next:

• Is Eating Disorder Relapse Common?
• The 3 "P's" of Recovery: Finding Your Passion, Power & Purpose

Sources

1. Berends, T., van Meijel, B., Nugteren, W., et al. (2016). Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: A cohort study. BMC Psychiatry 16(316).

2. Olmsted, M.P., MacDonald, D.E., McFarlane, T., Trottier, K., & Colton, P. (2015). Predictors of rapid release in bulimia nervosa. International Journal of Eating Disorders, 48(3), 337-340. 

This page was updated on May 16, 2023.