Eating Disorder Relapse: Why You're Stuck and How to Unlock Progress
Overcoming stagnation in eating disorder recovery can feel impossible; stubborn symptoms and repeated eating disorder relapse are real. Feeling "stuck" in eating disorder treatment is a common and challenging experience, where progress may seem to plateau or even regress despite persistent efforts.
Here's the thing: another residential eating disorder treatment center may not be the right route.
In fact, being in and out of hospitals can be part of the problem. Instead, the personal struggling and their team need to recognize and address the underlying causes for these periods of stagnation. This is essential for moving forward and advancing in recovery, no matter how severe or enduring the eating disorder is.
First: Eating Disorder Treatment Drop-Out—Don’t Leave!
Treatment dropout is a significant challenge in the management of eating disorders, affecting a substantial portion of individuals seeking help. Research tells us that dropout rates can be as high as 70% in outpatient eating disorder treatment. Yes, seventy percent!
Factors contributing to this high dropout rate include the severity and chronicity of the eating disorder, lack of social support, and dissatisfaction with treatment progress. Additionally, comorbid mental health issues, such as depression and anxiety, often increase the potential for discontinuing treatment.
Addressing these factors through tailored, flexible treatment approaches and enhanced support systems is crucial to improving retention and overall treatment outcomes. Identifying treatment stagnation and taking action is essential for preventing drop-out.
How to Stop Eating Disorder Relapse and Get Unstuck
In order to move on from recovery—and avoid another relapse—you need to consider why this keeps happening and how your treatment needs to shift to address that (or those) particular issue(s). Here are a few places to investigate.
Understand the Purpose of Your Eating Disorder
It’s so important to understand that eating disorder behaviors almost always serve a function in an individual’s life. Behaviors like food control, binge eating, purging, and driven exercise are often coping mechanisms or ways to manage underlying emotional distress, psychological conflicts, or unmet needs.
For many individuals, disordered eating behaviors provide a semblance of control in situations where they feel powerless or overwhelmed. These behaviors can offer a temporary escape from difficult emotions or interpersonal issues, acting as a means of self-soothing or distraction.
Given the central functional role that ED behaviors serve in an individual’s life, it makes sense that at times, people will struggle to move forward and beyond the eating disorder.
Relapse Prevention: When you fully understand and acknowledge the role that the eating disorder plays in your life, you can more effectively explore alternative coping strategies and life skills. This insight allows you to move beyond reliance on the eating disorder and progress towards a healthier, more balanced life.
Respect Ambivalence
Ambivalence is a prevalent and challenging aspect of eating disorder recovery, characterized by the conflicting emotions individuals experience regarding changes in their behaviors and attitudes toward food and body image.
While they may recognize the damaging effects of their disordered eating patterns and genuinely wish for recovery, they might also feel a strong attachment to these behaviors, which provide a sense of control or comfort.
This internal conflict arises because eating disorder behaviors often serve a specific function, making it possible to both desire change and cling to the disorder simultaneously.
Such ambivalence can pose significant obstacles to progress, as individuals grapple with the tension between wanting to change and fearing the loss of the familiar comfort provided by the eating disorder.
Relapse Prevention: Addressing ambivalence is essential for successful therapy and wholly necessary for overcoming stagnation in treatment.
Connect With Your Values: What Do You Really Want?
Connecting with personal values can be a powerful tool in eating disorder recovery, as it helps individuals shift their focus from the restrictive and self-destructive behaviors of the disorder to a more meaningful and fulfilling life.
By identifying and prioritizing core values—such as relationships, health, creativity, or personal growth—individuals can gain clarity on what truly matters to them beyond the confines of their eating disorder.
Focusing in on values can be a powerful way to break through stagnation and move forward in treatment. “What do you really want from your life?” “How does [fill in the blank] eating disorder behavior get in the way of what’s important to you?” “What behaviors and actions align with your values?” “How can we increase these behaviors/actions?”
Relapse Prevention:: This value-driven approach can provide a sense of purpose and motivation, encouraging people to make choices that align with their long-term goals and well-being.
Integrating values into recovery not only fosters a more positive and sustainable mindset but also helps individuals build a life that supports their overall health and happiness, making the recovery process more engaging and impactful.
Focus on Small Steps Forward (That is Enough)
Setting and achieving small, manageable goals can significantly aid in eating disorder recovery by providing a structured and less overwhelming path toward progress.
Small goals help break down the recovery process into more attainable steps, which can reduce feelings of being overwhelmed and boost motivation through a series of incremental successes.
These manageable objectives, whether they involve gradually increasing food intake, challenging negative thoughts, or developing coping skills, allow individuals to build confidence and experience a sense of accomplishment.
Relapse Prevention:: As each small goal is achieved, it reinforces positive behavior and fosters a sense of control, ultimately creating a foundation for more substantial changes and sustained recovery.
Weigh the Pros and Cons of Your Eating Disorder
Creating a list of pros and cons of staying in an eating disorder, whether you're struggling with anorexia nervosa or binge eating disorder, can be a valuable exercise in recovery as it helps individuals critically assess the consequences of maintaining their current behaviors versus pursuing change.
Listing the perceived "benefits" of the eating disorder—such as a sense of control, coping with anxiety, or avoidance of emotional pain—can reveal underlying reasons for resistance to change. Simultaneously, identifying the drawbacks—like physical health deterioration, strained relationships, and persistent emotional distress—can highlight the long-term costs of staying entrenched in disordered behaviors.
Relapse Prevention:: This reflective process can clarify the real impact of the eating disorder on one's life and provide a more balanced perspective, helping individuals recognize the significant advantages of recovery and reinforcing their motivation to engage in treatment and embrace healthier, more fulfilling ways of living. A newfound sense of motivation can help break through stagnation to move forward with change.
Identify and Break Through the Barriers to Recovery
Feeling “stuck” in treatment can be a challenging and frustrating experience, but addressing and working through barriers is a crucial step towards moving forward. Common obstacles in eating disorder recovery often include:
Fear of getting well and facing the inevitable challenges of life
Uncertainty about one’s identity outside of being an eating disorder patient, especially if you've been in and out of residential eating disorder treatment centers
Concerns about losing the support of family, friends, or treatment providers if recovery is achieved
Lack of alternative coping mechanisms and a feeling of control over life
Overwhelm and apprehension about life beyond the eating disorder
To navigate these barriers, it’s important to engage with deep, reflective questions such as, “What would it be like if you woke up tomorrow without your eating disorder? Is there anything about this possibility that scares you?”
Exploring who you might be without your eating disorder and how you would relate to the world in a recovered body can evoke anxiety, which is actually a positive sign. This anxiety can reveal your deepest fears and beliefs about recovery, many of which may be contributing to your current stagnation.
Relapse Prevention: By confronting these questions, you can better understand and address the barriers that are holding you back from making progress.
You Can End Eating Disorder Relapse and Stagnation
Overcoming stagnation in eating disorder treatment is a multi-faceted journey that requires both insight and action. Addressing the barriers to progress is not just about identifying what's holding you back, but also about engaging deeply with the fears, uncertainties, and practical challenges that accompany recovery.
By understanding the function of disordered behaviors, respecting ambivalence, and connecting with personal values, you can create a more meaningful and motivated path forward. Setting small, manageable goals and evaluating the pros and cons of staying in your eating disorder are practical steps that can reignite progress and build momentum.
Remember, the process of recovery is not linear and requires patience, self-compassion, and resilience. By actively working through these obstacles and reflecting on your own experiences and aspirations, you pave the way for substantial and sustained progress, ultimately moving from stagnation to a healthier, more fulfilling life.
