Relapse in eating disorder recovery isn’t always obvious. It can start with small, subtle shifts that may seem harmless at first. Recognizing these early signs is crucial because it gives you the chance to step in before things spiral.
Whether it’s the return of obsessive thoughts around food, feelings of guilt after eating, or hiding your struggles from loved ones, each of these signs can point to the need for extra support. In this post, we’ll explore some of the early, often overlooked signs of relapse and how to address them so you can stay on track with your recovery.
Signs of Eating Disorder Relapse
Relapse doesn’t always show up in the obvious ways. Often, it starts with small, subtle shifts that can be easy to overlook. Recognizing these early signs can help you intervene before things progress too far.
Here are some subtle, early signs of eating disorder relapse to watch for:
1. Obsessive Thoughts Around Food and Body Image
In recovery, healthy thoughts about food and body image are flexible and based on nourishment, while obsessive thoughts focus on control, guilt, or appearance. Healthy thinking involves considering your body’s needs and making choices that align with self-care, while obsessive thoughts lead to anxiety and restriction.
Example of an Unhealthy Behavior: Thinking “I can’t have meat because it will make me gain weight.”
This thought is restrictive and rooted in fear. It’s an example of obsessing over weight rather than listening to your body’s needs.
Example of a Healthy Behavior: Thinking “I’ll choose chicken over steak today because I’ve had red meat twice this week already.”
This is a balanced, mindful choice that considers nutrition without creating stress or guilt. It shows a thoughtful approach to eating without placing undue focus on body image or control.
2. Feeling Shame or Guilt After Eating
Shame or guilt after eating is a sign that disordered thoughts are resurfacing. In recovery, eating should feel like a neutral or positive experience, and guilt should not be attached to nourishment. Healthy thoughts focus on listening to your body and honoring its hunger, while unhealthy thoughts tie food to self-worth.
Example of an Unhealthy Behavior: Thinking “I have to go to the gym and burn the amount of calories I ate for lunch.”
This is an unhealthy thought because it treats eating as a transaction where food consumed must be “paid for” through exercise. This mindset reinforces an unhealthy relationship with food and exercise, where both are driven by guilt and control.
Example of a Healthy Behavior: Thinking “I had a big lunch and skipped the gym today, so I want to make sure I work out tomorrow to stay consistent with my routine.”
This is a healthy, non-transactional approach to eating and exercise. It acknowledges the need for balance and consistency without feeling guilty or compensating for eating.
Keeping Information From Your Loved Ones and Care Team
Transparency is a key aspect of recovery. When you start withholding information from your loved ones or therapist about your eating habits, weight, or thoughts surrounding food, it can be a sign of relapse.
Recovery thrives on openness, and hiding or minimizing struggles may allow negative behaviors to escalate. Being open, even when it feels uncomfortable, is crucial for staying on track.
Example of an Unhealthy Behavior: Not telling your therapist or loved one that you’ve been having unhealthy thoughts around food.
You might think it’s not a big deal or that you don’t want to make it something bigger than it is, but small things can spiral. Keeping these thoughts to yourself might make them feel more manageable in the short term, but it allows disordered thinking to persist and grow.
Example of a Healthy Behavior: Telling your therapist about the unhealthy thoughts you’ve had this week and discussing what may have triggered them.
By sharing these thoughts openly, you allow for a collaborative approach to understanding and addressing the triggers. This kind of transparency helps prevent harmful thought patterns from controlling your behavior.
Plus, by sharing this with your care team, you’re enabling them to better help you because they’ll have a deeper understanding of what behaviors you need to heal. For example, if your biggest struggle is dealing with anxiety around eating, they can incorporate more dialectical behavioral therapy (DBT) techniques in your treatment to help you learn how to better manage those emotions.
Repeatedly Checking or Benchmarking Weight Daily
In a healthy recovery, your weight shouldn’t define your self-worth or eating habits. If weighing yourself becomes a daily habit, it may signal an unhealthy focus on numbers over physical and emotional well-being. This can lead to an obsession with weight and appearance, overshadowing more important aspects of health.
Example of an Unhealthy Behavior: Stepping on the scale multiple times a day to see if your weight has changed.
This behavior can be driven by anxiety and a desire to control how your body looks, and it often leads to frustration and self-judgment. Obsessively checking weight gives it too much power over your thoughts and emotions, creating a cycle of worry and dissatisfaction.
Example of a Healthy Behavior: Weighing yourself once a week as part of your overall health routine, but not allowing the number to affect how you feel about yourself.
This approach acknowledges that weight is just one small part of health and doesn’t let it define your worth. It’s about maintaining balance and not letting the scale control your emotions or dictate how you live your life.
Compulsively Looking at and Critiquing Your Appearance
Wanting to look your best is normal, but when you begin compulsively checking your appearance, it can be a sign that disordered thoughts are resurfacing. Compulsive behaviors, like checking the mirror multiple times or critiquing every detail of your body, can lead to feelings of dissatisfaction and self-loathing.
Example of an Unhealthy Behavior: Checking the mirror so you know how your weight looks from every angle, in multiple types of lighting, and/or on video or photo to make sure you know every way your body size can be perceived.
This behavior is driven by the need to scrutinize every detail of your body, hoping to find something that confirms your fears or insecurities. It reflects a distorted and unhealthy focus on appearance, rather than acknowledging your body for what it does for you.
Example of a Healthy Behavior: Looking in the mirror to make sure you’re put together and feel confident.
This is a functional use of the mirror, focused on practical aspects like grooming or choosing clothes. It shows a healthy, neutral approach to your reflection, focusing on self-care rather than self-criticism.
Excessive Exercise
Exercise should be about maintaining health and well-being, but when it becomes excessive, it often stems from a need to control body size or “make up” for food consumed. If exercise starts feeling like something you must do, it can be a sign of eating disorder relapse.
Exercise routines often become ritualistic and compulsive, so the longer you continue to practice the routine, the more difficult it can be to break the habit.
Example of an Unhealthy Behavior: Running every morning no matter what, even when you’re sick, sore, or experiencing inclement weather and feel extreme guilt when you skip.
In this instance, the routine becomes less about enjoyment or fitness and more about maintaining a sense of control over your body and emotions. This kind of rigid thinking can make it difficult to rest or adjust your routine in a healthy way, which can lead to physical harm or burnout.
Example of a Healthy Behavior: Making time to move your body every day because it helps clear your mind, boosts your mood, and keeps you physically active.
The key shift is moving from exercise as an obligation to movement as self-care, allowing flexibility and prioritizing well-being over rigid control. So, instead of forcing yourself to run every day without fail, check in with your body to see how it feels that day.
If you’re exhausted or injured, they might opt for gentle yoga, stretching, or a rest day instead. If you have energy and genuinely want to move, they could go for a walk or do another activity they enjoy.
Fixating on Calories and Fat
In recovery, it’s important to focus on nourishment and not obsess over the specific calorie or fat content of every food. Healthy thinking allows for balance and enjoyment in eating, whereas an obsession with calories and fat can create anxiety around food and prevent you from fully enjoying meals.
The goal is to nourish your body with a variety of foods, rather than restricting based on arbitrary numbers.
Example of an Unhealthy Behavior: Constantly scanning nutrition labels to avoid any food that has too many calories or fat.
This behavior focuses on fear and restriction, rather than nourishment. It turns food into something to be controlled, making eating a stressful activity where you’re constantly worrying about numbers instead of enjoying the food.
Example of a Healthy Behavior: Choosing a variety of foods that nourish your body, without obsessively counting every calorie or gram of fat.
This reflects a balanced mindset that focuses on overall health rather than restriction. That’s not to say you shouldn’t be aware of your food’s nutritional information, but mentally struggling when you eat more than a certain number of calories can be an early sign of eating disorder relapse.
What Do I Do If I Have Relapsed?
The key is not to become too hard on yourself, as recovery is an ongoing process.
Consistent and regular visits with your outpatient treatment team and surrounding yourself with a strong support network of family and friends can help prevent or address a relapse before it occurs.
If you have relapsed, these tips may help you:
- Remind yourself that relapse is a normal part of recovery.
- Try not to focus on the fact that you have relapsed; instead, focus on finding your way back to recovery.
- Seek help from your clinicians or support network and don’t be afraid to tell them you have relapsed.
- Try to identify the triggers that have caused the relapse and consider how you could deal with these triggers next time.
- Employ the coping skills and techniques you have learned throughout the recovery process.
- Boost your self-esteem by spending time with your support network and/or engaging in activities that you enjoy.
We Can Help
The work of eating disorder recovery doesn’t end once you’ve adopted healthy habits. It’s important to take steps to maintain your progress and prevent relapse.
The experts at The Meadows have over 20 years of eating disorder treatment experience. We understand the challenges of staying in recovery from eating disorders, but we also believe recovery is possible.
Contact us today to learn more about our eating disorder treatment and relapse prevention programs.
Eating Disorder Relapse FAQs
What can trigger eating disorder relapse?
Several factors can trigger eating disorder relapse, and they often vary from person to person. Here are some common triggers:
- Stress and Anxiety: Life challenges or pressures can lead to using disordered eating to cope.
- Body Image Issues: Negative thoughts about appearance or weight may trigger unhealthy behaviors.
- Major Life Changes: Big transitions, like moving or relationship changes, can disrupt recovery.
- Social Situations: Pressure around food or appearance in social settings can lead to relapse.
- Dieting or Restriction: Even brief dieting can trigger a return to old eating patterns.
- Trauma or Emotional Pain: Unresolved emotional issues may prompt disordered eating as a coping mechanism.
- Perfectionism: Unrealistic expectations can increase the risk of relapse.
What are some steps I can take if I feel like I’m starting to relapse in my eating disorder?
- Reach out for support: Contact your therapist, doctor, or a support group to talk about what you’re experiencing.
- Implement coping strategies: Use the tools you’ve learned in therapy, such as mindfulness or grounding techniques, to stay grounded in the present.
- Focus on self-compassion: Remind yourself that recovery is a process, and setbacks don’t mean failure. Be kind to yourself as you work through these challenges.
How can I differentiate between a setback and a relapse in eating disorder recovery?
A setback is a temporary challenge or a brief moment of unhealthy behavior that doesn’t lead to a full return of old habits. A relapse, on the other hand, involves a more prolonged return to disordered eating behaviors and thoughts. If a setback feels like it’s becoming more frequent or intense, it could be the beginning of a relapse.
Can I fully recover from an eating disorder, even if I relapse?
Yes. While relapse can be discouraging, it doesn’t mean you’re back to square one. Many people experience multiple relapses before achieving long-term recovery. The most important thing is to keep learning, seeking support, and making progress, even if it’s slow.
What role does family and support play in preventing eating disorder relapse?
Family and close friends can be a vital part of your recovery process. They can offer encouragement, notice early signs of relapse, and provide emotional support when needed. Open communication with your loved ones can help you stay grounded in your recovery.
