Eating disorders can be devastating conditions to deal with on a physical, mental, and emotional level. And while recovery is always possible, it rarely occurs in a straight line.
Setbacks, stalling, and even full-blown eating disorder relapse are common parts of the recovery journey. But if you experienced a relapse while recovering from bulimia—or any other eating disorder—don’t despair. There are some key ways to get yourself and your recovery back on track.
Understanding Relapse in Bulimia Recovery
When it comes to eating disorder recovery, there is no official definition of a “relapse.” Broadly, the term describes a return to disordered behaviors and/or thought patterns after a period of improvement or even full recovery.
Nearly anything can bring on an eating disorder relapse, but some common triggers include: [1,2]
Negative and/or stressful life events Sudden changes or changing treatment team members A friend or family member going on a diet or losing weight The person gaining weight, even if that is part of their recovery plan Pregnancy, menopause, or infertility struggles An injury that prevents or changes exercise routine Starting an activity- or health-tracking app Accidentally (or intentionally) watching “thinspo” or similar online content
Some treatment providers further designate between a “lapse” and “relapse,” with lapses representing temporary or singular incidents and relapses referring to more consistent reverted behavior. In either case, some warning signs may include: [2]
Avoiding meals or events that involve food Eating alone or self-isolating Obsessive thoughts about food, eating, or body image Feeling guilty or ashamed after eating Hiding information from loved ones or treatment team members Increasing anxiety, depression, stress, or signs of perfectionism Frequent checks in the mirror Irritability, especially around the subject of food Justifying small slips, lapses, or other behavioral changes
Relapse is a normal and common part of bulimia recovery. It’s okay if you notice any of these signs in yourself or a loved one, but it is also a sign that you may need further help.
Tips for Recovery After Bulimia Relapse
Eating disorder relapses can be dangerous if left untreated, so if you or a loved one are struggling in your recovery process, it’s important to seek out help.
Aside from following the advice of your treatment team, you can follow up with some of these tips.
Reconnecting with Treatment and Support Systems
You should start by reaching out to your treatment providers or support systems. These professionals and peers can help you remember the progress you made and remind you of why recovery is a worthwhile goal.
Talking to your therapist or dietitian can help you revisit your treatment goals and coping strategies and evaluate why those strategies didn’t work. You’ll also have the chance to develop new approaches or healthier coping mechanisms for recovery management. If medication is part of your treatment, you should speak with your psychiatrist about changing dosage, switching medications, or going off medication.
You can also benefit from reaching back out to your support network, whether that’s friends and family or members of support groups. These people can help you understand that you’re loved and supported throughout this process and give you a place to share your concerns or hear how others successfully dealt with similar experiences.
Identifying Triggers and Developing Coping Strategies
Identifying the trigger(s) or other risk factors behind the relapse is a crucial part of working through the situation and getting back to recovery. You can do some of this work by yourself, but some of it should also be done with a therapist or mental health professional.
Reflection on the cause or causes behind the re-emergence of disorder symptoms can help you avoid the same triggers moving forward and help you develop different or more personalized coping strategies to address these triggers. You and your therapist can then use this information to work on a relapse prevention plan moving forward.
If you use cognitive behavioral therapy as part of your recovery, your relapse may also offer the opportunity to identify different cognitive or behavioral patterns and develop various techniques to deal with them more appropriately.
Rebuilding Healthy Eating Habits
Taking care of your mental health is a massive part of recovery, but if disordered eating behaviors return, you also need to mind your physical health.
Returning to a structured meal plan or eating pattern is a good step toward physical recovery or stabilization during bulimia relapse. Practicing mindful eating, intuitive eating, and similar strategies is another way to get back in tune with your body’s inner voice and needs.
Working with a nutritionist, dietician, or other professional is essential when reestablishing healthy eating habits. They’ll be able to give you more specific guidance around the types of foods you should be eating and can help gradually reintroduce feared foods or help you work through other food-related setbacks that have resurfaced during an eating disorder relapse.
Practicing Self-Compassion and Self-Care
Mental health and physical health are two of the three main ingredients for recovery after bulimia relapse. The third is emotional or spiritual health, which can be addressed with self-compassion or self-care.
Techniques like mindfulness, meditation, or engaging in other healthy, enjoyable activities can have a number of benefits, including reducing stress and promoting emotional well-being. [3] Focusing on a hobby or passion can help reduce the time spent on eating or body image and build self-worth around factors other than your appearance.
Self-care often involves prioritizing oneself, which is an important part of eating disorder recovery. Focusing on rest, nutrition, and regular exercise is key to rebuilding a healthy routine. Self-compassion can promote a sense of acceptance, which can help you move past difficulties and setbacks with more grace and ease.
Cultivating Resilience Moving Forward
Moving on from a relapse is just as important as seeking out help for one. Recovery after bulimia relapse is hard, but you should always maintain hope.
If you struggle with a relapse, beating yourself up for it can be damaging to both your mental health and your progress. Instead, think of how far in your recovery journey you’ve already come, and recognize the hard work that went into that progress.
You can also change your perspective to look at this “setback” instead as a learning opportunity. Now you know additional triggers to look out for and have additional coping strategies moving forward. And the experience can help you set realistic goals in your recovery.
When dealing with something so heavy, it can feel challenging to look for motivation or inspiration. Frustration, anger, and even despair are normal reactions to a relapse. But with the right mindset and support, you should be able to find the path to recovery once again.
Resources
Boyes, A. (2018, November 8). 6 Tips for Eating Disorder Relapse Prevention. Psychology Today. Accessed May 2024. Eating Disorder Relapse. (n.d.) National Eating Disorder Association. Accessed May 2024. Crego, A., Yela, J. R., Riesco-Matías, P., Gómez-Martínez, M. Á., & Vicente-Arruebarrena, A. (2022). The Benefits of Self-Compassion in Mental Health Professionals: A Systematic Review of Empirical Research. Psychology research and behavior management, 15, 2599–2620.
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