What You Can Learn to Help Your Recovery

Anorexia nervosa has the highest mortality rate of all psychiatric illnesses1. One in 20 individuals diagnosed with this eating disorder will die from cardiac complications or suicide2,3. Treatment of anorexia nervosa often involves short-term hospitalization, which has been shown to be effective for most patients4. Although it is effective in the short term, many patients relapse within four and twelve months of receiving treatment5,6.

How to Prevent Relapse

Those who begin to experience symptoms after recovery from anorexia and other eating disorders can take steps to prevent a full relapse. The first and most important is to seek professional help. Eating disorders are persistent, and relapse is common. Taking advantage of local resources is one of the best ways to maintain your health. Visit the National Eating Disorders Association (NEDA) for tips.

Successful recovery from an eating disorder is difficult - and 65% of those with an eating disorder also suffer from an anxiety disorder. The illness is persistent, and there can be many triggers to relapse. Although recovery is complex, mental health professionals are gaining more understanding of what helps recovery and what hinders it.

Recovery vs. Relapse

Why do some people relapse while others do not? Is there anything they can do to help prevent it? The risk of relapse is much higher for people who have had more severe forms of the illness6. For example, those who greatly restrict their diet are more likely to relapse than those who place a greater emphasis on weight in determining their self-esteem.

To learn more, researchers at the University of Toronto, Canada, asked recovered and relapsed eating disorder patients to describe their post-treatment experiences8. They found several key differences between those who relapse and those who do not.

    1. Motivation to change: Recovered patients tend to exhibit a strong internal desire for change and to move past the illness. Most importantly, they initiated their own decision to recover, rather than doing so for the sake of others. Relapsed patients report feeling ambivalent about change and only went through treatment to satisfy others in their lives.
    2. Recovery takes time: Patients who recover tend to view recovery as a work in progress that takes time and persistence. The patients who relapse have unrealistic expectations about their recovery and expect it to be an easier path.
    3. Social support: Seeking and obtaining social support is one of the best ways to guard against mental health issues. Eating disorder patients who recover often make a point of getting support from family members and friends after their treatment. This support allows them to feel understood and accepted. Also, they often seek the support of those who are less focused on body weight and image. But those who relapse often do not have much social support. They may frequently feel judged or they are around people who emphasize the importance of dieting and maintaining a specific body shape.
    4. Self-validation: Making efforts to increase feelings of self-worth and personal value is commonly found in recovered patients. Many describe themselves as becoming less self-critical and more quickly taking credit for their successes and accomplishments. Those who relapse tend to get bogged down with self-criticism. They see themselves as failures and have a hard time believing that their future can be any different from their past.

You in Recovery

If you are in the recovery stages, work to maintain your motivation and be patient with the results. Although it is easy to feel discouraged, remind yourself that you can do it, you are valuable, and you have already accomplished a great deal regardless of where you are in the process.

Remember that you don't have to do this alone. Find friends and family who offer quality social support, encourage your progress, and don't pull you down. And if you start to relapse, don't delay in getting help: There is no better time than right now.

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Carol S. Lee, Ph.D.



1. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders. Archives of General Psychiatry, 68(7), 724-731.

2. Herzog, D., Greenwood, D., Dorer, D., Flores, A., Ekeblad, E., Richards, A., Blais, M, & Keller, M. (2000). Mortality in eating disorders: a descriptive study. International Journal of Eating Disorders, 28, 20-26.

3. Sullivan, P. (1995). Mortality in anorexia nervosa. The American Journal of Psychiatry, 152 (1995), 1073-1074

4. Olmsted, M. P., McFarlane, T. L., Carter, J. C., Trottier, K., Woodside, D. B., & Dimitropoulos, G. (2010). Inpatient and day hospital treatment for anorexia nervosa. In C. Grilo & J. E. Mitchell (Eds.), The Treatment of Eating Disorders: A Clinical Handbook, (pp. 198-211). New York, NY: The Guilford Press.

5. Carter, J. C., Blackmore, E., Sutandar-Pinnock, K., & Woodside, D. B. (2004). Relapse in anorexia nervosa: a survival analysis. Psychological Medicine, 34(04), 671-679.

6. McFarlane, T., Olmsted, M.P., Trottier, K., 2008. Timing and prediction of relapse in a transdiagnostic eating disorder sample. International Journal of Eating Disorders 41, 587-593.

7. National Eating Disorders Association (NEDA) Slips, Lapses and Relapses, https://www.nationaleatingdisorders.org/slips-lapses-and-relapses

8. Federici, A., & Kaplan, A. S. (2008). The patient's account of relapse and recovery in anorexia nervosa: A qualitative study. European Eating Disorders Review, 16(1), 1-10. doi:10.1002/erv.813

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