Signs of an Eating Disorder Relapse To Look For

Eating disorders can be tough to recover from, often even more difficult than drug or alcohol addiction. Whereas with other addictions, it is necessary to discontinue the addictive behavior completely, when it comes to ED, you can’t just give up on food. 

Relapse is common and is often just part of the recovery process. It doesn’t make it any easier when you or your loved one is struggling, but we have some telltale signs that an ED relapse might be on the horizon.

What Is a Relapse?

If you are unfamiliar with the term, a relapse occurs when a patient in recovery regresses, turning to their previous methods of coping. When it comes to drug or alcohol dependence, the person will return to using. 

With eating disorders, relapse can look like many different things. Typically, a person relapsing will return to behaviors such as:

• Restricting food
• Binging and purging
• Overusing laxatives
• Over-exercising

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Why Do Relapses Occur?

Relapses happen for several reasons. Most notably, recovery is a long and difficult process, and it is not uncommon for people to revert to their old coping mechanisms when experiencing intense stress.

Some examples of common stressors include:

• Starting a new job
• Moving to a different town, city, or country
• Going away to college
• Death of a loved one
• Financial difficulties
• Birth of a child
• Infertility/trouble getting pregnant
• Relationship problems
• Diagnosis of a different illness

Of course, relapses can happen for myriad reasons, too many to list here. These are just a few of the most common, universal stressors that tend to be inciting incidents for ED relapse.

What Are Some of the Warning Signs of a Relapse?

If you notice that the ED sufferer in your life is acting differently, you may want to reach out and encourage them to get some help. If you struggle with an eating disorder and are noticing any of these signs, it will be okay. 

There is help for you, and it is okay to reach out if you feel you are in trouble. Here are some warning signs to look for in a potential ED relapse.

Thoughts That Continue To Turn Back to Food and Weight

Having an obsession with food or weight is the most obvious sign that a relapse may be occurring. It is a slippery slope because in our society, thinness is valued, and diet and exercise are encouraged. Learn to be aware of thoughts about weight and whether or not they are invasive and continuous. 

Feeling Guilty After Eating

Whether this is your feeling or someone else's, it’s something to look out for. While it’s normal to feel a little regretful if you eat until you feel sickeningly full, it is not normal to attach excessive guilt or emotion to food.

Skipping or Purging Meals

Part of ED recovery is developing a treatment program that works for you. Typically that means following an eating routine that feels safe and consistent. Skipping meals or “forgetting to eat” might be okay for some people, but it can lead to disaster for someone in recovery.

Avoiding Social Events That Involve Food

For those in the early stages of recovery, it’s normal to want to avoid potential triggers. But if you or your loved one were previously able to attend a family cookout without trouble but are now struggling, this could signal a problem. 

Hiding Eating Habits or Concealing Information

Concealing eating habits is common for those who struggle with eating disorders. It is not common for those in recovery. If you are keeping information under wraps, you might want to think about why. 

Obsessively Checking the Mirror

Attempting to find control by achieving the perfect body often leads to ED in the first place. If looking in the mirror and picking yourself apart becomes a habit again, it may be time to look in the metaphorical mirror and think about what’s happening. 

If you notice a loved one in recovery spending a lot of time in front of the mirror, it could be time for a gentle talk.

Checking Weight Outside of Treatment

Anyone in recovery from an eating disorder should consider not having a scale in their home. If weighing yourself becomes an option, and you find yourself doing it frequently, this is a sign of relapse.

Increased Stress or Anxiety

The common stressors that lead to relapse do so because they can cause stress and anxiety. It’s important to be in touch with your feelings, or if you have a loved one struggling with ED, to talk to them about how they are feeling. 

ED recovery should include talk therapy or support groups to help you manage stress and anxiety healthily.

Increasing Need for Control and Perfection

Many people do not realize that eating disorders are not only about body image and trying to be skinny. They are mostly about control, so when ED sufferers go through life events in which they feel they do not have control, they can relapse.

Perfectionism might sound like a positive trait, but in reality, it can be truly debilitating. There is no such thing as perfection, and futile attempts to achieve it will ultimately lead to destruction. 

What Can I Do If My Loved One Is in Danger of Relapsing?

It can be incredibly stressful and upsetting if someone close to you is on the verge of a relapse. Make sure that you are taking care of yourself and your loved one. When you believe your loved one might be in danger of relapsing, the first step is to have a gentle and constructive conversation with them. 

Here are a few tips that may help you with this conversation:

• Make a plan: It's important to have a plan going into this conversation. It may help you to rehearse what you want to say beforehand. You also want to be sure that you can set up a time and place where you will have the privacy to talk without rushing.

• Stick to the facts: Try not to become overly emotional. Start by talking about behaviors that you have noticed.

• Use “I” Statements: Using statements from your point of view can take some of the stigma and ownership off of your loved one. It's helpful to say things like “I have noticed” or “I am worried about.” Accusations can make people feel defensive and closed off.

• Offer reassurance and encourage them to get help: Remind them that everything will be okay and that you are on their side. You should also tell them that getting professional help might be helpful. Even if your loved one has already been to treatment, let them know there is no shame in going again or talking to a therapist.

What Can I Do If I’m Worried I Might Relapse?

If you are reading this and you are in recovery but feeling like you may be in trouble, please know that everything will be okay and that you have people who care about you and want to help.

If you feel you can relate to some of the warning signs above, don’t wait until things get worse to seek help. The best place to start is with a close friend, family member, or significant other. If you have sought help for an eating disorder in the past, they will know what to do to help you this time around. 

The most important thing to remember is that this is nothing to feel ashamed about. An eating disorder is an illness like any other, and seeking help for one is the same as going to the doctor when you get sick. 

Conclusion

When looking for signs of a relapse in a loved one or yourself, the key is to look for changes in behavior. They may be things that you haven’t even thought of or noticed. Once you have noticed them, there is a strong chance that professional help or other resources are needed. 

Stay strong, and know that you are not alone. 

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Sources:

Eating Disorders Helpline | Chat, Call, or Text | NEDA

Relapse & Recurrence | NEDC

Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study | NCBI