Navigating Anorexia Relapse : Understanding Triggers and Creating Effective Coping Strategies

1. What is Anorexia Relapse?

   Anorexia relapse is the recurrence of disordered eating behaviors, thoughts, and emotional characteristics of anorexia nervosa after a period of apparent recovery or improvement. This means a person who previously struggled with anorexia and has made progress towards healthier eating habits and a positive body image, reverts back to patterns of dietary restrictions, excessive exercise, and distorted self-perception related to body weight and shape. Relapse after recovery is common. A study estimated, 31% of people relapsed after they had finished treatment.⁽¹⁾ It is common mostly in the first year post treatment.

2. Significance of Addressing Anorexia Relapse

   Anorexia relapse can pose a significant risk to physical, emotional, and psychological health, that might be needed to be addressed promptly to reestablish a path towards recovery. 

   • Physical Health: A person with anorexia relapse may suffer from weight loss and may also have physical complications such as heart problems, electrolyte imbalance, and weakened immune function.
   • Psychological Well-Being: There can be an exacerbation of feelings of depression, anxiety, and hopelessness, which can perpetuate distorted body image and self-esteem issues.
   • Impact on Relationships: The relationships with family and partner can get strained. It may lead to isolation. The loved ones may find it challenging to understand and support the individuals and their struggles.

   Anorexia relapse may escalate if not addressed. This might increase difficulty in returning to the path of recovery. This may further affect the quality of life of a person.

1. What is Anorexia Nervosa?

   Anorexia nervosa is a mental health condition that is characterized by an intense fear of gaining weight and a distorted body image.⁽⁴⁾ The average age of onset of eating disorders (anorexia nervosa and bulimia) is 18 years. Individuals with anorexia nervosa engage in persistent behavior of restricting food intake that may lead to significantly low body weight.

2. Factors cause Anorexia Relapse

   Several factors may contribute to anorexia relapse, which may vary from person to person. These factors include:⁽²⁾

   • Psychological Triggers: High stress levels can trigger relapse. The stress can be academic, professional, or personal. It may also include any past traumatic events or events that trigger a relapse of anorexia including break-ups, loss of loved ones, or traumatic incidents that can reignite eating disorder behaviors.
   • Social Influences: Having an environment with a strong emphasis on appearance and a culture of comparing oneself to others based on body image can affect recovery. There may be peer pressure, pressure from social circles, a desire to match certain body ideals, or engaging in disordered eating behaviors, which may cause anorexia relapse to occur.
   • Biological Factors: Some individuals are genetically predisposed to eating disorders. This influences vulnerability to relapse. Also, neurochemical imbalances in the brain may contribute to difficulties in regulating mood.
   • Environmental Stressors: Changes in lifestyle such as starting college, changing jobs, or moving to a new city may disrupt the routines and trigger anxiety, leading to a relapse. Insufficient support systems or lack of access to treatment can increase the risk of relapse.
   • Body Image Dissatisfaction: Exposure to images and messages in media promoting unrealistic beauty ideals may contribute to body dissatisfaction, which is a risk factor for relapse. Small weight changes, perceived as significant or distressing can trigger relapse behavior.
   • Co-occurring Disorders: Depression and anxiety can intensify negative thought patterns and emotions related to body image and self-worth.
   • Lack of Coping Mechanism: Not developing healthy coping strategies may make an individual more susceptible to relapse.
   • Unresolved Underlying Issues: Unresolved emotional conflicts or low self-esteem can contribute to relapse if not addressed adequately.

The signs of anorexia relapse may vary from person to person. These include: 

• Avoiding special occasions that involve eating
• Resuming obsession over foods
• Returning to repeatedly obsessing over monitoring appearance
• Getting easily agitated and irritable. Or experiencing rapid mood changes
• Avoiding eating with others
• Feeling guilty and shameful after eating
• Isolating from family and friends
• Feeling anxious, irritable, depressed, and stressed
• Frequently checking body weight, body image, and appearance in mirrors

Relapse is a normal part of a recovery process, but is also a sign that additional support and intervention may be needed. One should seek help from a medical professional if any of the signs of anorexia relapse are observed.

Coping with anorexia relapse needs a multifaceted approach. It includes a need for professional guidance, support from loved ones, and personal strategies for managing the challenges of recovery.

The several factors to cope with relapse include:⁽³⁾

• Therapy and Counseling: Continuing or restarting therapy with a mental health professional experienced in treating eating disorders is essential. Cognitive behavior therapy, dialectical behavior therapy, and family-based treatments are effective approaches.
• Nutritional Guidance: Working with a registered nutritionist or a dietician to develop a balanced meal plan tailored to specific needs.
• Utilizing Support Systems: Emotional support can be taken from loved ones and support groups. This can help recover from eating disorders. Sharing experiences with others who can understand can be of incredible value.
• Implementing Self-Care Practices: Mindfulness and meditation can be practiced to stay in the present moment, manage anxiety, and develop a healthier relationship with food and body. Engaging in physical activities promoting overall well-being can be helpful. Pursuing creative activities such as art, writing, or music can provide a constructive outlet for emotions.⁽⁶⁾
• Monitoring Negative Thoughts: Thought records or journals that identify and challenge distorted or negative thoughts related to body image and food can be used. Practicing positive self-talk and affirmations can help counteract self-criticism and self-doubt.
• Regular Checks with Treatment Plan: Maintaining consistent communication with the treatment plan, therapist, doctor, and dietician is important. Discussing progress, challenges, and adjustments to the treatment plan is needed.
• Educate Yourself: Having an understanding of eating disorders, recovery strategies, and self-help resources can be helpful.
• Medical Intervention: A healthcare provider can be consulted for a comprehensive medical evaluation, especially if there are signs of severe physical deterioration or malnutrition.

Coping with anorexia relapse can be difficult. Time and patience may be needed. Being surrounded by a strong support system, including professionals who specialize in eating disorders can help work towards recovery.

Navigating the journey beyond recovery from anorexia involves a thoughtful and holistic approach. Some key points to consider include: 

• Recognizing relapse is a common aspect of recovery for an individual. It is not a sign of failure but an opportunity for growth and learning.
• Analyze what contributed to relapse and identify triggers and stressors. This can help develop effective coping strategies.
• Having an understanding that recovery is going on. Setting realistic expectations helps in avoiding undue pressure and fosters a sustainable approach to wellness.
• Maintaining regular sessions with therapists, counselors, and support groups. These resources offer ongoing guidance, encouragement, and a safe space to discuss challenges.
• Engaging in hobbies promotes a balanced and meaningful life beyond the focus on recovery.
• Practicing self-compassion by treating yourself with the same kindness and understanding, can help in offering a friend with similar challenges.
• Paying attention to self-care, healthy relationships, and a balanced lifestyle helps in focusing on well-being in all dimensions.

Recovery is a journey, not a destination. It is a progress of growth, self-discovery, and ongoing self-care. It is important to be patient with yourself and celebrate the progress made along the way. Seek out for help when needed. All this can give strength to navigate beyond recovery toward a fulfilling and balanced life.

Recovery from anorexia is a long journey that may prove to be difficult for some individuals. Experiencing relapse is common along the way, especially in times of stress. A journey beyond recovery is a process of resilience, self-discovery, and ongoing commitment to well-being. Setting realistic expectations and having an understanding that progress comes with its own set of challenges is important.

Continuing therapy, celebrating milestones, staying mindful of triggers, and fostering self-compassion, are important elements of an ongoing process. Regular follow-up with healthcare professionals ensures that physical and mental health remains a priority contributing to overall well-being. Recovery is a dynamic and evolving path. With patience, self-empowerment, and support or others, individuals can navigate beyond recovery and embrace life that is rich in fulfillment, purpose, and well-being.