People Places And Things
Just like with drug and alcohol addiction, common triggers can be the people, places, and things that you spent time with or around when you were in a full-blown eating disorder. While it is hard to distance yourself from close friends, it is important to realize that your health is the number one priority now. Also, if they really were good friends, they would have your health and wellbeing in mind. They would not be interested in standing in your way as you work to move forward with your life. So, if they are not really supporting your new and healthier lifestyle, it is definitely best to avoid spending any more time with them.
The same goes for the places and things that are connected to the disorder you once had. If it will help you to remain healthy, get rid of the clothes that you were focused on fitting into. If there was a particular room in the house in which you would always binge eat, maybe you can make it a habit to only do healthy things there.
Know Your Own Eating Disorder Triggers
The triggers that people often experience during recovery from an eating disorder are very similar to the things that cause eating disorders to occur in the first place. Sometimes, they are directly related to the underlying causes of eating disorders. As you go through treatment, you will learn more about what your personal eating disorder triggers are. Identifying your own triggers coming up with a detailed plan of how to work through each of them will prove to be very helpful. It will help you to be strong throughout your recovery and stay on the path to success.
Now that we have talked about what triggers are and how they can vary from person to person, lets discuss some of the most common triggers. We will also talk about ways in which you can prevent these triggers from having a negative effect on your life.
How Many People Experience Relapse
The truth is, relapse is incredibly common in eating disorder recovery. While relapse is a major interruption to recovery, individuals are typically able to overcome relapse, manage their eating habits, and return to recovery. Relapse does not mean the end of recovery.
A study in the American Journal of Psychiatry found that around 35% of those in recovery from anorexia and bulimia will experience a relapse. In addition, the National Eating Disorders Collaboration states that certain individuals are more likely to experience relapse than others. Risk factors of relapse include:
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Avoiding Eating Disorder Relapse
For recovering eating disorder sufferers, it can take years before one is able to live a happy and healthy life without occasionally slipping into old ways of thinking. These moments are inevitable, but they dont necessarily mean that a relapse is unavoidable. The key is to recognize when warning signs arise and to take preventive measures. And if you havent yet sought professional eating disorder treatment, you might want to consider doing so before you revert to old habits.
Why Does It Happen
Relapses are a normal and expected part of recovery so dont feel ashamed if you experience them. Being in recovery for an eating disorder is tough work. Its unlikely that youll be able to stay on one straight path as there are always ups and downs.
Circumstances in your life can change or you may experience unavoidable triggers. There are many reasons why someone may begin to dip again into patterns of an eating disorder.
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Eating Disorder Relapse Prevention
One way to help prevent relapse is to follow the old Boy Scout motto: be prepared. Many eating disorder treatment programs offer weekly Relapse Prevention groups preventing relapse should be emphasized early in treatment. No matter what your personal situation is and what your loved one is going through, you must acknowledge the risk and prepare for the possibility of relapse. When an individual leaves treatment, experts recommend that they have a detailed, personalized relapse plan based upon their own unique circumstances. This plan should be created throughout the course of treatment and shared with loved ones who will help provide support and accountability. The plan should include specific factors that indicate the individual is struggling and the resulting actions that will be taken by the individual and by their loved ones. The more open the whole support system is about how the individual is doing, the better.
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About the Author: Crystal is a Masters-level Registered Dietitian Nutritionist with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating.
Combining clinical experience with a love of social media and writing, Crystal serves as the Special Projects Coordinator for Eating Disorder Hope/Addiction Hope, where her passion to help others find recovery and healing is integrated into each part of her work.
As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH/AH and nutrition private practice.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
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Lapses And Relapses Are Not Failures
At Alsana, we are here to support you and your client through every stage of the recovery journey. For some clients, that may include multiple re-admissions to a higher level of care or frequent transitions between levels of care. Frequency does NOT mean the loss of hope in full recovery as research tells us that breaking the chains of an eating disorder can require several admissions into a higher level of support before full recovery has been reached. Every lapse, and even a relapse, is an opportunity to learn more about the underlying thoughts and behavior patterns that your client has used to survive and cope with life in the moment and any opportunity to recognize and confront hurtful thoughts, beliefs, and behaviors within an empathetic, supportive and safe environment will strengthen the very foundation on which lasting recovery is built.
What Is An Eating Disorder Relapse
When used in relation to a substance use disorder, the term relapse is generally understood to mean a return to substance use after a period of abstinence. For those who are in recovery from addiction, using substances even once is typically considered to be a relapse.
Unfortunately, a similarly universal understanding of what qualifies as an eating disorder relapse has not yet been achieved.
For example, a study that was published June 14, 2017, in the Journal of Eating Disorders noted that experts have not established a common definition for eating disorder relapse, nor have they agreed on a standard set of criteria for determining if a person has relapsed.
This study, which was led by Sahib S. Khalsa of the Laureate Institute of Brain Research, reported that differing definitions of eating disorder relapse during prior research efforts have included:
- Having a BMI of less than 16.5 for more than two weeks or having a BMI of less than 18.5 for three months in a row
- Losing 15% of body weight after achieving a healthy/normal body weight during or after treatment
- Experiencing a return of psychiatric symptoms as indicated by achieving certain scores on the Eating Disorder Examination or Psychiatric Status Rating scales
- Engaging in disordered eating behaviors after having ceased these behaviors during treatment
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Things To Remember During A Relapse In Eating Disorder Recovery
Eating discovery recovery is a different journey for everyone. You may experience several different stays at varying levels of care over the course of several months or years, while someone else may require a few weeks of outpatient programming.
The truth is, no one journey to recovery is the same, and there is no magic timetable for recovery. Many journeys to recovery can be bumpy, and many experience relapses along the road to healing from an eating disorder.
While a relapse may feel demoralizing, or that everything you gained through recovery is gone, its actually far from that. Relapses are often natural parts of the process. As they say, sometimes you need to take a step back to take two forward.
When experiencing a relapse, its helpful to remember these seven tips:
1). Seek professional help: We know it might be scary or difficult to do this, but you have to remember help is always a phone call or email away. There is a wide range of professionals specifically trained to help with your eating disorder, including how to best get you back on track after a relapse. Theyll remind you of the skills that will help you to tolerate your emotions in a healthful way, give you strength, keep you motivated and implement strategies that can help to prevent any future relapses. Theyre here to move you forward in your recovery, not intimidate you.
If you need any extra support during this time, were always here to help.
Signs That A Loved One May Be At Risk For Eating Disorder Relapse
Contributor: Staff at Timberline Knolls Residential Treatment Center
Eating disorders often involve a long-term effort to resolve. People who have received treatment and learned to manage their symptoms are often described as being in recovery from the disorder they had developed.
Many people are able to remain in recovery without returning to the harmful behaviors that had previously threatened their well-being. Unfortunately, a significant percentage of people who make a full recovery from an eating disorder will someday relapse.
If someone you care about is in recovery from an eating disorder, your ability to recognize possible warning signs or symptoms of relapse can allow you to play an integral role in helping them maintain their health.
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Eating Disorder Relapse And Prevention Information
- Know the statistics. Relapse rates for eating disorders fall between 35-49% in patients between 4 24 months post-treatment. The highest risk was found between 6 and 17 months after residential discharge. The risk for premature death was found to be twice as high among bulimic than restricting patients. Eating disorder mortality rates are the highest, only to be surpassed by opioid overdoses, with over 10,200 deaths each year.
- Know the risk factors. Research indicates the following risk factors: previous history of a suicide attempt, previous specialized treatment for an eating disorder, severity of obsessive-compulsive symptoms at presentation, excessive exercise immediately after discharge, and residual concern about shape and weight at discharge, severe pretreatment caloric restriction, elevated work and social stressors, slower response to treatment, and higher weightrelated selfevaluation.
- Be aware of warning signs. Red flags for relapse include: falling back into old behaviors, isolating from family and friends, refraining from recovery strategies and coping skills, increased negative thinking or poor body image, and skipping meals or snacks.
Relapse does not occur with everyone who receives treatment for an eating disorder. It is important to know that it can occur and to be aware of the risk factors and warning signs.
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What Counts As A Lapse In Recovery
A lapse in recovery is when you slip and fall. But after that, you get back up and recommit to recovery. In our example, the person in bulimia recovery lapses by giving into a purging behavior once but then recommits to following their meal plan or honoring their hunger
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Finding Help To Avoid An Eating Disorder Relapse
Many of these warning signs happen at the same time and build upon each other. Most people who are struggling with some kind of set back in their recovery will report most, if not all of these experiences. If you have been working diligently on your recovery, chances are you already know some very effective strategies that can help you address these behaviors. If you feel that the symptoms are starting to overwhelm you, please reach out for help and find someone who has experience treating individuals with eating disorders.
I look forward to helping you heal and find your path to recovery.
Im Dr. Amy Boyers, a Clinical Psychologist in Miami who specializes in eating disorder treatment and other long term conditions, including addictions, bipolar, and OCD. I offer personalized and sophisticated eating disorder treatment services, individual and family psychotherapy, family member support and education, in-home meal support, cognitive behavioral therapy, anxiety treatment, depression treatment, and much more.
I look forward to helping you obtain a brighter tomorrow.
Make A Plan To Manage Eating Challenges
Another essential part of avoiding relapse during the holidays is careful planning. Ensuring you have a plan that you can successfully follow will help you be accountable and provide much-needed structure. If you are planning to attend a family gathering or another holiday function, ask questions of the event organizer. It is helpful to know where and when the event will occur. You will also want to know what type of food will be offered and what time meals will be served. Knowing these important facts about the day will help you avoid any dietary pitfalls that may impact your eating schedules or diet restrictions. Knowing what and when you will eat ahead of time will go a long way in helping reduce stress and anxiety about meals.
Also, if you follow a particular meal schedule or plan as part of your recovery, dont abandon that during the holidays. If you plan on attending a large family dinner, it is essential to still eat a balanced breakfast and lunch to avoid mealtime struggles when dinner arrives. In addition, if you are concerned about the availability of foods that feel safe for you to eat, offer to bring a dish to the gathering to share. This will help ensure you have access to the foods you need to choose recovery.
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Eating Disorder Relapse Risk
Relapse rates for anorexia and bulimia have been reported to be between 36% and 35% respectively, according to one study . Research shows that highest risk for relapse from anorexia nervosa is in the first 18 months after treatment . Unfortunately, even professionals cant always predict who is vulnerable to relapse. Research has shown that for adolescents the less weight-restored they are when leaving treatment, the more likely that they will relapse . This happens because leaving treatment before the body has had an opportunity to stabilize weight means that even slight dips in weight can leave someone in an unhealthy weight range for their body. Some other reasons that might make an individual more susceptible to relapse include the following:
- Poor body image
- A strong link between body image and self-esteem, or feeling that ones self-worth is tied to appearance
- Poor social relationships
- Slower response to treatment interventions
- Low motivation to recover during and after treatment
- Greater eating disorder thoughts and behaviors at time of discharge
- Losing weight quickly upon discharge
It is imperative to help patients maintain the gains made in their treatment. Loved ones can stay attuned to the following signs of relapse:
Loved ones can also be aware that certain times and experiences during an individuals life may be more vulnerable to relapse. These include transitions such as:
Understanding A Relapse Experience
A relapse can be described as a setback or re-engagement in eating disorder behaviors after a period of improvement or recovery. In the case of binge eating disorder, a person may experience a relapse after a significant duration of time that has essentially been free of binging episodes.
Engaging in binging behaviors after being in recovery can feel disheartening, causing an individual to feel as though they have failed, or their recovery efforts futile.
While a binge episode can feel very much like a decline backwards into the eating disorder abyss, it is important to understand how to pull yourself back on the path towards recovery.
For the many people who struggle with binge eating disorder, these behaviors have essentially become engrained in ones being, becoming the default coping mechanism for dealing with lifes hardships.
In light of this, suffering a relapse episode should be viewed more like a cry for help and a need for greater support rather than lack of strength or failure.
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What Is Classified As A Relapse
An eating disorder relapse is characterized by any return to eating disorder behaviors and symptoms. Common examples of returning to eating disorder behaviors include skipping meals, counting calories, or measuring weight. Warning signs of an impending relapse include:
- Negative self-talk and obsessive critical thoughts
- Taking weights and looking compulsively in the mirror to pinpoint perceived flaws
- Increase in thoughts about eating, food, or body image
- Isolating or withdrawing
- and more
Preemptively Addressing Eating Disorder Relapse
An important step in recovery is the acknowledgment that relapse is possible. The sooner an individual understands that the sooner they can address it with their treatment team. By acknowledging and addressing the potential for relapse early in the recovery process, its possible that individuals may prevent a relapse from developing into a full-blown eating disorder.
Its recommended that those in recovery speak to their treatment team about a relapse plan. This plan can include a list of who to reach out to for support or available treatment options.
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