Five Warning Signs You Need a Higher Level of Care for Eating Disorder Relapse

Woman in therapy

Recovering from an eating disorder is a process that involves diligence, perseverance, and the support of people and professionals who know how to best help you. The eating disorder recovery journey is highly individual and will look different from one person to the next. A common experience among women recovering from an eating disorder is a relapse episode, or temporary regression to past eating disorder behaviors.

While eating disorder relapses do not mean that a person has somehow “failed” at recovery, the experience of a relapse could reflect that more help and support is needed along the recovery journey.  

While eating disorder relapses do not mean that a person has somehow “failed” at recovery, the experience of a relapse could reflect that more help and support is needed along the recovery journey.  Research on eating disorder relapse is limited, but studies have found that risk of relapse may be higher among women with more severe eating disorders [1]. Studies have also found that the rates for relapse are higher in the first 18 months post-treatment [1].

Understanding Eating Disorder Relapse

Just like eating disorder recovery, the experience of a relapse will look different for everyone. While there is no current standardized definition of relapse, there are certain red flags to be aware of that might indicate a regression back to past eating disorder behaviors [2]. Understanding what these indicators might look like for you are important for early intervention and to connect to the support you need to maintain your eating disorder recovery.

Because eating disorders affect multiple aspects of a woman’s life, including her physical health, emotional and mental well-being, relationships, and more, it’s necessary to regularly assess these different areas to determine if greater help or support may be needed in recovery. For example, a woman recovering from anorexia may appear to be physically well (i.e. weight restored, eating regularly and a balanced variety of foods, etc.) but if she is struggling with intense body negativity or anxiety/depression, these are signs that shouldn’t be ignored, as more help might be needed.

Signs You Need a Higher Level of Care

Patients at The Meadows RanchPart of maintaining eating disorder recovery for the long term is to take an honest look at where you are, being proactive in caring for yourself, and not being afraid to ask for help if and when you need it.

The process of recovering from an eating disorder is not something to be “perfected” or a journey that you need to be on alone. Even after months or years of treatment, you may experience a relapse – and that is okay. Eating disorder recovery is often described as taking two steps forward and five steps backward; whatever direction you are moving in, you are still making progress toward freedom and a full life restored from what your eating disorder may have taken from you.

In some cases, an eating disorder relapse may be something you are able to recover from fairly quickly. In other situations, a relapse can be more severe and something that begins to escalate into a situation that you can’t control. Whatever your experience may be with a relapse, remember that you are not at fault. A relapse doesn’t mean you have failed or won’t be able to continue with your recovery. What is important is to connect to the resources you need to get you back on track. Be aware of these signs that might indicate you need more help and support healing from a relapse during your recovery:

1. You can no longer properly feed yourself.

If you’re having trouble feeding yourself, maintaining weight, or if you are unable to sustain a meal plan, this may mean you need some intervention to help you troubleshoot the underlying issue. Feeding your body regularly and consistently is foundational to lasting recovery, and an inability to eat should never be ignored.

2. You don’t engage in activities you previously enjoyed.

If you find yourself isolating more from the people you love or are purposefully avoiding activities and social situations, this could be a red flag related to an eating disorder relapse. Isolation is a characteristic of past eating disorder behaviors that you should be aware of.

3. You neglect self-care.

Being unable to maintain self-care, such as regular hygiene, moving your body in ways that feel good, staying current with doctor/therapy appointments, etc. can be an indicator that you are having trouble taking care of yourself appropriately.

4. Eating disorder behaviors re-emerge.

If you have slipped back into maladaptive eating behaviors, such as restricting, rigid eating, binging or purging, this can be a sign that you may need more support to help you get back on track with your eating disorder recovery plan.

5. You have obsessive thoughts about weight and food.

If you are having incessant thoughts about food and your body that you can’t seem to get rid of, this may mean that you need extra help in your recovery. It is never normal to be constantly thinking about food and your body, and if this pattern re-emerges for you, you may need additional support.

You can never have too much support along your journey…

If something seems off to you at any point of your recovery, pay close attention to these red flags. You can never have too much support along your journey, and intervention at a higher level of care, even temporarily, can help troubleshoot any issues you are encountering in your recovery.

Relapse Prevention and Hope for Recovery

Part of relapse prevention for an eating disorder is ensuring that you have adequate treatment, to begin with. Wherever you may be in the process of recovering from an eating disorder, it is never too late to connect to the help and support you need. Whether you are just starting the process or are experiencing a setback in your recovery after years of treatment, professional intervention can help you get back on track and support you in building the skills needed to maintain your efforts. You deserve a lasting recovery that allows you to experience the fullness that life has to offer you.

At The Meadows Ranch, we understand the eating disorder recovery journey and can help you through the highs and lows. You don’t have to do this alone. Connect with us today to learn how we can help you recover from an eating disorder or get you back on track after a relapse episode.


[1]: Berends, T., van Meijel, B., Nugteren, W., Deen, M., Danner, U. N., Hoek, H. W., & van Elburg, A. A. (2016). Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study. BMC Psychiatry, 16(1), 316.

[2]: Khalsa, S. S., Portnoff, L. C., McCurdy-McKinnon, D., & Feusner, J. D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5, 20.