Tanya was 14 when she developed an eating disorder. A few months later she was admitted to a residential treatment program and upon returning home did outpatient treatment with a therapist, dietitian and her doctor for the duration of high school. Tanya went off to college stable in her recovery. She met a few times with the local therapist and dietitian, but felt like she was managing well enough on her own. The relapse didn’t happen all at once. It gradually and subtly occurred over time. By the end of her sophomore year she was back in the throws of the eating disorder and knew she needed help.
This story is so common, where someone is in recovery from their eating disorder for a period of time and then relapses. It may be after weeks, months, years or even decades. Sometimes, the relapse is sudden and obvious, and other times it is gradual and covert.
Remember this: There is no shame in relapsing. You did not do anything wrong. You have not failed.
Relapse is a common part of the recovery process. In fact, sometimes relapse is a blessing in disguise because it comes with gifts of wisdom. It is often a signal that you have needs that aren’t being met.
Here are 5 key steps for getting back on track:
1. Acknowledge that you have relapsed and need help. This may be the hardest thing to do, so give yourself compassion.
2. Seek professional support. Get back in with your treatment team, or connect with a new treatment team, as soon as possible. This means therapist, dietitian, and medical doctor. You need these professionals to assess the situation and guide you. I know it sounds like a lot, but they all bring a different perspective to the table.
3. Get on a meal plan. The meal plan is the glue that is going to hold your recovery together. It not only gives your body the physical nourishment it needs to function properly; it also gives your brain the fuel to think clearly and manage your emotions. Right now the food is literally your medicine — which is ironic when it is also the thing the eating disorder is most afraid of. Talk to your dietitian about these fears. She or he will help you come up with a meal plan that safely meets what your body needs right now.
4. Be curious. Relapse is usually the symptom of more fundamental problems in a person’s life. The eating disorder swoops in as a coping mechanism. What are you coping with? What are you feeling and needing outside of anything related to food and weight? Don’t judge these needs, just notice them. It’s also ok if you aren’t sure what your needs are right now. Your therapist can help you with this.
5. Be open. Trust that your team has your best interests in mind and wants you to be happy and healthy. Be open-minded to their recommendations. They may recommend a higher level of care, such as intensive outpatient (IOP) or inpatient/residential treatment, depending on the severity of your symptoms. They may recommend taking a break from things such as work or school.
6. Be aware. Keep in mind that part of what caused your eating disorder in the first place is an underlying genetic predisposition or susceptibility to the illness. You will always have this because you can’t change your genetics. Be aware that you will be vulnerable to relapse for the rest of your life, and this means you must be on the lookout for signs of relapse. It is so much easier to get back on track the earlier you catch yourself slipping.
Relapse happens. Give yourself grace and compassion, and get back on track. Recovery is worth the effort.
Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City. She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.