Eating Disorder Relapse: Triggers, Risk Factors, and How to Get Back on Track

Like any mental health challenge, recovering from an eating disorder is a journey that is unique to each individual. The road to recovery is often filled with twists and turns and even some obstacles along the way. If you’re working toward recovery or in recovery from an eating disorder, you may experience setbacks or even relapse. Know that this is normal and quite common, and that help is available. 

Here, we’ll share triggers and risk factors that may lead to an eating disorder relapse, and how therapy can help get you back on track toward recovery. 

What are eating disorders?

Eating disorders are mental and physical health conditions that can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights. According to the National Eating Disorders Association, 28.8 million Americans will suffer from an eating disorder at some point in their lives. Common eating disorders include:

• Anorexia nervosa: Characterized by weight loss (or lack of appropriate weight gain in growing children), difficulties maintaining an appropriate body weight for height, age, and stature, and distorted body image
• Bulimia nervosa: Characterized by a cycle of binge eating and compensatory behaviors such as self-induced vomiting or excessive exercising designed to undo or compensate for the effects of binge eating
• Binge eating disorder: Characterized by recurrent episodes of eating large quantities of food, feeling a loss of control during the binge, experiencing shame, distress, or guilt afterwards, and not regularly trying to counter the binge eating through unhealthy behaviors 
• Orthorexia: Characterized by an obsession with proper or “healthful” eating that may include compulsive checking of ingredient lists and nutritional labels, cutting out an increasing number of food groups, or an inability to eat anything but a narrow group of foods that are deemed “healthy” or “pure” 
• Other Specified Feeding or Eating Disorder (OSFED): Encompasses individuals who do not meet strict criteria for anorexia or bulimia but still have a significant eating disorder

What triggers eating disorder relapse?

While there’s no official definition for an eating disorder relapse, experiencing a relapse may mean the return of eating disorder symptoms or reengaging in disordered eating behaviors after stopping those behaviors for a period of time. What triggers an eating disorder relapse can be different for each individual, but may include: 

• Pregnancy
• A family member or friend losing weight or starting a restrictive diet 
• Gaining a little weight and wanting to lose it
• Spending time with a person you perceive as very thin 
• An injury that keeps you from exercising
• Starting exercise or a sport after a period of not doing it
• Using activity/health tracking apps
• Seeing "thinspo" (thinness-inspiration) videos
• High-stress situations

It’s important to remember that what may trigger you might not trigger someone else, and vice versa. Moreover, experiencing a trigger doesn’t necessarily mean you’ll relapse. If you’re in recovery and experience a trigger, consider talking to a member of your care team, such as your therapist, about how it made you feel. Talk therapy may help you better cope with triggers and stay on track toward recovery. If you don’t have a care team or therapist, it can be helpful to connect with a therapist who specializes in eating disorders to help you build coping skills to stay on track toward recovery. 

Signs someone could be at risk for a relapse 

It’s not always obvious to see that you or someone you love is at risk of an eating disorder relapse. Here are a few risk factors to look out for: 

• Engaging in excessive exercise
• An increased focus or recurring concern with body shape and weight
• Low feelings of self-worth, self-criticism, or difficulties in relationships
• Experiencing negative and stressful life events
• Avoiding eating with others 
• Getting off track or no longer following a care plan or post-treatment plan 
• Significant changes in mood, attitude, energy level, and motivation
• Spending less time with family and friends
• Loss of interest in activities or events that were previously enjoyed 

The longer someone has experienced an eating disorder, the more at risk they may be of a relapse. Age can also play a role — the older you are at the onset of an eating disorder, the more likely you may experience a relapse. 

Remember, relapse isn’t a failure — it can be a normal part of your recovery journey and is nothing to be ashamed of. Think of it as a bump in the road. If you experience a relapse, you can overcome it, get back on track, and achieve recovery again.  

How can therapy help with eating disorders? 

Whether you’re considering getting help for an eating disorder for the first time, think you may be experiencing a relapse, or are doing well in recovery, talk therapy can help you build the skills you need to overcome setbacks and relapses and stay on the right path to reach or maintain recovery. 

If you aren’t currently working with a therapist or mental health professional, seeking therapy from a licensed professional who specializes in eating disorders is a key first step on your recovery journey. Therapy can help you: 

• Normalize your eating patterns and achieve a healthy weight
• Replace unhealthy habits with healthy ones
• Learn how to monitor your eating 
• Develop problem-solving skills
• Explore healthy ways to cope with stressful situations
• Improve your relationships and mood

What to expect from therapy for eating disorders 

In your first few sessions with your therapist, they’ll get to know you a bit better, assess your symptoms, and provide a diagnosis. If you feel they’re the right fit for you, you’ll continue to work with your therapist to set goals and develop a treatment plan to help you build the skills you need to get on track to achieve your goals and enter recovery. If you feel they aren’t the right fit, it’s okay and it is recommended to look for a different therapist. Your therapist will understand and can help you connect with someone who may be a better fit. 

There are many different types of therapy that can help someone with an eating disorder. Some of these include: 

• Cognitive behavioral therapy: This type of talk therapy focuses on behaviors, thoughts, and feelings related to your eating disorder. It aims to help you gain healthy eating behaviors and recognize and change distorted thoughts that lead to eating disorder behaviors.
• Family-based therapy. With this therapy, family members help you relearn healthy eating patterns and achieve a healthy weight until you can do it on your own. 
• Group cognitive behavioral therapy. This therapy involves meeting with a psychologist or other mental health professional along with others who are diagnosed with an eating disorder. The goal is to help you address thoughts, feelings, and behaviors related to your eating disorder, build skills to manage symptoms, and regain healthy eating patterns.

​​In addition to talk therapy, nutritional counseling, medical, and psychiatric monitoring may be a part of your treatment plan. This may mean you have a care team working together with you on your treatment. If your eating disorder symptoms are severe, treatment may involve residential care (24-hour care at a live-in facility) or in-patient care (a continuum of care 24 hours a day in a hospital setting). The therapy and treatment that’s right for you will depend on your unique needs and goals. 

It’s okay to relapse. Help is available.

Anyone who recovers from an eating disorder has some risk of relapse. However, seeking help from a mental health professional may reduce this risk and help you get back on track sooner if you do experience a setback. Moreover, having the support of family and friends who understand the risk factors of eating disorder relapse and can identify warning signs can play a big role in helping you get the support you need to stay in recovery. 

If you think you’re experiencing an eating disorder relapse or symptoms and would like to seek care from a mental health professional, SonderMind can help. Let us know a little bit about what you’re looking for in a therapist, and we can connect you with a licensed professional who specializes in eating disorders to help you get on track toward recovery.