While few experts would say that relapse is an inevitable part of recovery from an eating disorder, it is very likely. Although the data on relapse rates among binge eating disorder sufferers is not well established, most credible sources agree that it is common and may actual be a normal part of recovery.
As we grow in our recovery, it is no wonder that we increase our odds of relapsing. We can become a bit too comfortable in our newfound relationship with food. We can experiment with foods and discover a new trigger. Other times, we can go through major life upheavals that encourage us to find our way back to our dysfunctional relationships with food.
According to the National Eating Disorders Collaboration, “It should be kept in mind that a relapse or recurrence does not signify a failure to recover; instead, it should simply be seen as a normal part of recovery.”
It’s the first part that most binge eaters have trouble with. Not the relapse itself but what it means. Given that so many of us are perfectionists or all-or-nothing thinkers, it is not wonder that even a short period back in the food can signify failure. And it isn’t just failure, but it is failure AGAIN. Just like before. Just like EVERY other time.
In reality, though, relapse can become a teachable moment, as we say in academia. The National Eating Disorders Collaborative reminds us: “Many people with eating disorders view relapses as an opportunity to learn from the experience and to improve their skills so they can cope with the relapse next time.”
No one would encourage relapse. It is a scary, dangerous place to be, but with the right way of thinking, sufferers can swim back to the safe shores of recovery.
Relapse Risk Factors and Warning Signs
A number of factors put recovery at risk, including the duration of the disease before recovery began (the more years suffered, the higher the rate of relapse), the age of the person in recovery (the older the person at disease onset, the higher the rate of relapse), low self-esteem, focus on body weight and weight, and the recurrence of stressful life events.
Of course, none of those factors will predict relapse, but understanding some of the risks might alter the ways in which sufferers live out their recovery. For example, if a binge eater has one or more of the factors, he or she might choose to be more vigilant in thinking about food and weight, measure meals, and otherwise be aware that a slip could easily lead to a slide for them.
While there is no way to definitively spot a relapse in the making, binge eaters in recovery should pay close attention potentially destructive thoughts and behaviors. Generally speaking, the relapse begins long before the first bite is taken.
Given the accepted notion that binge eating disorder is both cunning and baffling, it is easy to understand how we can become complacent in our attitudes and behaviors towards foods, trigger situations, and other issues we avoided during early recovery. We think we are stronger (and we are) and can handle those demons which used to take us into the maelstrom. But as soon as we let down our guard, we invite the disease back into our lives. A “little piece of cake that never hurt anybody” at a birthday party can lead to days, weeks, months, and even years of compulsive eating.
In addition to lapses in our thinking and behaviors, diminished focus on gratitude, believing that we deserve a treat for being so good all week/month/whatever, and assuming that we have beaten the disease once and for all can lead to a relapse.
Several well-conducted studies have been done recently that demonstrate ways of preventing relapse. According to the Epidemiology of Women’s Health, strategies including improving body acceptance and teaching sufferers to reject the thin body ideal promoted in the media.
Other ways of preventing relapse include practicing honesty in all that we do, including what we eat. This can take the form of a food journal, of a thoughtful, daily appraisal, or a relationship with a food sponsor in which meals are planned and reported each day. Whatever we do, we must not allow our delusions about how much, how often, and what we eat to drag us back into the disease.
Relapse can also begin with a similar lack of attention and reverting back to thoughts and behaviors which led us to developing and maintaining the disease. “For me, a binge never really began with the first compulsive bite, but much earlier. It began with my not taking care of myself in some other way,” says Jenni Schaefer, co-author of Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?
Nonetheless, the dangers of that first bite should never be diminished. As Jim A. reminds us in Recovery from Compulsive Eating: A Guide to the Twelve-Step Program:
One of the first things to go, along with the food, is the clarity of thinking that proper eating brought us. The mental fog returns and we actually start believing some of the stupid rationalizations we tell ourselves. . . . The sense of hopelessness returns.
Dishonesty, pride, arrogance, and just the nature of the disease can lead to relapse, and we all know that the longer the compulsive behavior continues, the harder it is to break.
Busting that Binge
But what can we do if we find ourself in the midst of a full-blown binge? How can we stop it before we feel like we are completely out of control?
One of the most effective methods for stopping a binge mid bite is practiced in Overeater’s Anonymous. It is recommended that we “play the tape forward.” That is, in your mind, follow the behavior to its disastrous end. One bite leads to another, leads to crazy behaviors, like eating out of the trash, leads to disruption of relationships, such as fights with partners and avoiding going out in public out of shame, and eventually death. As I have said in many different pieces, this disease will eventually kill you if it is not arrested.
Another way of stopping a binge is by practicing something called “urge surfing.” “If you think about a wave, it goes up, up, up, and at some point it starts to go back down,” Anderson says. “When you binge, you are acting on the urge to make it stop. Urge surfing is following the urge all the way up and down, knowing it will eventually end if you ride it out.” In other words, nothing lasts forever. I have used this strategy to get through panic attacks in the past. If I ride out the nasty symptoms, eventually, they go away.
Finally, micro-manage the situation. Slow down the binge. Think of it as a series of small decisions instead of one big one. This kind of thinking–black or white–is a hallmark of binge eating disorder reasoning. By changing the “I must eat ALL of this” to “after I finish this piece, I will throw the rest away” might arrest the binge. The thinking could become even more micro, such as I will stop after my third bite.
Of course, all of these strategies become more complicated to use with food addicts whose brains respond to very small amounts of addictive substances, but a relapse does not have to mean failure. Instead, a relapse means that you are human. You are human with a severe, chronic disease. The hard part now is getting back on track, but it can be done.
20 Ways to Beat a Binge
1. Drink water.
2. Go for a walk.
3. Phone a friend.
4. Watch a funny movie.
5. Clean out your closet.
6. Have sex.
7. Take a bath.
8. Read a great book.
10.Enjoy a cup of herbal tea.
11.Read a magazine.
12.Try some new yoga poses.
13.Write in your journal.
14.Organize your photo albums.
15.Clean out the garage.
16.Wash your car.
17.Count to 100.
18.Throw away the triggering food.
19.Help someone else.
20.Paint your nails.
from the FREE Beginner’s Guide PDF.
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