Eating disorder recovery was a long roller coaster for Equip Peer Mentor Jamie Drago. “I would go a few steps forward, then a few steps back, maybe a mile forward, maybe three miles back, and so on. I had multiple setbacks before I got to a sustainable, long-term recovery,” she says. Looking back, she believes the reason for this pattern was that she never fully recovered during those earlier attempts. “A lot of things were better, but I was also cutting a lot of corners. So it was sort of a natural progression back to more disordered thoughts and behaviors,” she says.

Many people in eating disorder treatment experience a similar cycle of progress and setbacks, and this can lead to harsh, negative self-talk. “People talk about recovery as a singular thing: you cross a finish line, and you've done it. And if you relapse, it can feel like you failed. Or if you go in circles a few times, it can feel like that will be your life forever,” Drago says. But she stresses that this isn’t true: you haven't failed, and you don't have to live in this cycle forever.

Adriana Lindenfeld, LMHC, a primary therapist for Equip, agrees with this perspective. “A relapse is not failure. It's feedback and it’s an inevitable part of the recovery journey,” she says. “Think of it as data, not defeat: It can provide valuable insights into what triggers you, where your weaknesses are, and what strategies need reinforcement. It can be an opportunity to deepen your recovery, refine your skills, and come back stronger than before.”

Read on to learn what an eating disorder relapse (and a lapse) is, why it's so common, how to try to prevent them, and advice on what to do if you or a loved one relapse.

What is an eating disorder relapse?

Although there's no standard definition of a relapse during eating disorder treatment, Lindenfeld describes relapse as a significant return to old eating disorder behaviors and thought patterns. “It's more than just one instance,” she explains. “It signifies a substantial deviation from established recovery and a resurgence of the core symptoms of the eating disorder.”

A relapse differs from what some people call a lapse or slip. “A slip is like a stumble. It’s a momentary lapse in judgment or a one-time occurrence of an old behavior,” Lindenfeld says. For example, maybe you restrict at dinner after a super stressful day, but you have your nighttime snack and return to your usual eating in the morning. “A relapse, on the other hand, is more like falling down the stairs—it's a series of missteps leading back into the depths of the disorder,” Lindenfeld says. This might be several days of restrictive eating, along with intensifying thoughts about weight and increasing isolation from your support systems.

Or think about it this way: If a single slip happens, you can quickly get back on track to recovery. But a sustained relapse requires more intensive attention.

Many, many people in eating disorder treatment experience slips and relapses, though the exact number differs from study to study. Some estimate that 25 percent of young adults go through at least one relapse, while one study found that 52 percent of patients with anorexia nervosa relapse. Research shows that the risk appears to be highest in the first year following treatment.

Why is eating disorder relapse so common?

“The complexity of eating disorders—which involve psychological, biological, and sociocultural factors—contributes to the frequency of relapses,” Lindenfeld says.

Psychologically, eating disorders often serve as coping mechanisms, and these patterns can be deeply ingrained and resurface during stressful times. Biologically, imbalances in neurotransmitters that affect mood and appetite may make it harder to resist urges to engage in disordered eating behaviors. And societal pressures related to body image, thinness, and diet culture can significantly impact a person’s vulnerability to relapse.

There are also a number of specific factors that research has shown can increase the risk of relapse, including:

• Not achieving weight restoration (if appropriate)
• Maintaining food rules, exercise rules, and other psychological symptoms of the eating disorder
• Persistent feelings of body dissatisfaction
• Longer duration of the eating disorder
• Having more severe eating disorder symptoms
• Having a co-occurring condition
• Going through a life transition
• High stress
• Unresolved trauma
• Lack of social support
• Ending treatment early

But although relapse is common, it’s also common to go on to achieve full recovery after that.

To ensure that relapse is just a small detour on the road to recovery—and not a final destination—it’s important to view it as an opportunity to learn, adjust your treatment if appropriate, and grow.

“Relapse helped me understand my patterns better. I could look back and see from a distance the patterns of disordered thoughts that would come up and then lead to another disordered thought. Or I would realize certain triggers, like that if I traveled and came back home, that was hard for me,” Drago says. “I learned what my risks were for relapse, and I figured out what to do when those things came up.”

Get support for a relapseIf you or a loved one are slipping, you deserve help.

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How to prevent an eating disorder relapse

First, it’s important to understand that you can do everything in your power to prevent a relapse, and it may still happen. Eating disorders are that powerful and sneaky. “It was really easy to convince myself of all the reasons that it 'wasn't that bad' or 'things have been worse' or 'things could be worse,'” Drago says. “Eating disorders can be very creative with justifications, explaining things away and finding evidence for why it's 'fine.'”

Still, you can take action to make a relapse less likely to disrupt your or your loved one’s recovery—and less harmful if one does occur. Here are some tips.

Make a relapse prevention plan

Since relapse is so common, many patients collaborate with their care team to create a relapse prevention plan toward the end of their treatment. This written document often includes several lists for easy reference. That may include:

• Skills used to maintain recovery
• Tools to employ when challenging moments pop up
• Relapse warning signs to watch for
• Specific actions to take if you notice signs of a relapse
• Motivation for recovery

Maintain a strong support system

“Regularly connect with trusted friends, family members, support groups, or mentors who understand your struggles. Talking about your challenges and feelings with supportive individuals provides emotional grounding and reduces isolation, which can be a major relapse trigger,” Lindenfeld says.

Continue therapy even if you're doing well

“Ongoing therapy provides a safe space to process emotions, address underlying issues, and improve coping skills,” Lindenfeld says. It’s also a proactive step to prevent possible slips from escalating into a relapse. This is one of the reasons that we recommend patients continue treatment with Equip during the first few months of recovery.

Practice stress-reduction techniques

Managing stress reduces the risk of turning to disordered eating behaviors as a way to cope with overwhelming feelings, Lindenfeld says. Do whatever works for you, which could be spending time in nature, mindful movement, deep breathing, meditation, journaling, or something else.

Be mindful of your thoughts and triggers

“Identifying the situations, thoughts, or emotions that trigger the urge to engage in eating disorder behaviors allows you to develop strategies to navigate them, such as having a plan for challenging social events or practicing cognitive restructuring to challenge negative thoughts,” Lindenfeld explains.

Set realistic goals

With the help of your support team, break down large recovery goals into smaller, manageable steps. “Celebrating small victories and recognizing progress, however small, helps maintain motivation and prevent discouragement, which can contribute to relapse,” Lindenfeld says.

Be kind to yourself

Practice self-compassion and avoid self-criticism, Lindenfeld says. “Treating yourself with kindness and understanding helps build resilience and reduces the shame that can fuel further relapses.”

Follow your meal plan

Sticking to a meal plan created by your dietitian can provide the structure that helps prevent the eating disorder from sneaking back in. Eating disorder meal plans are specifically designed to help patients consume a well-rounded diet, eat at regular intervals, and stop engaging in food rituals and other disordered behaviors. Doing all of these things helps improve physical and mental healing, Lindenfeld says.

Don't ignore the red flags

If you notice yourself or your loved one slipping, try not to blow it off. “When you slip, it’s a sign to turn around—and the earlier you turn around, the less distance you have to walk back.” Drago says. Seek help and make a change before your slip becomes a full-blown relapse.

What to do if you relapse

If you find yourself sliding from a lapse into a relapse, be kind to yourself. Remember: Up to half of all people in recovery face this exact challenge, and acknowledging the situation is your first step back to health. “Shame only fuels the disorder,” Lindenfeld says. “Instead, understand this is part of the journey—it's a detour, not the end of the road.”

After you’ve made that recognition, it’s time to take action to keep moving toward recovery. The advice below can help.

Get support

Contact your therapist, support team, or treatment program ASAP. As Drago noted, the sooner you reach out for help, the less work you’ll have to do to get back to a healthy place. Working with trusted eating disorder specialists helps you address the underlying factors contributing to relapse so that you can back on track, Lindenfeld says.

Remember that small steps count

No matter the size, every step forward is a step closer to recovery. “When it felt like there was no imaginable chance of full recovery for me, and I felt so hopeless, my dietitian asked, 'What if we focus on your quality of life? What small steps might improve your quality of life by even one percent?' No step was too small, and thinking about it that way made it seem possible,” Drago says. “I couldn't imagine a full picture of recovery, but I could imagine making small changes. We worked our way up from there, until now—now I’m at a place where, back then, I could not even imagine what it could look like.”

Build a recovery-focused lifestyle

Rather than simply “trying to recover,” Lindenfeld recommends thinking about how to integrate recovery principles into your daily life in a sustainable way. “It’s more than just managing what you eat; it's about cultivating a peaceful relationship with food, accepting and respecting your body, and nurturing your overall well-being,” she adds. This could mean things like only surrounding yourself with supportive people and finding fulfilling activities that aren’t related to food or body image, like volunteering or hobbies.

Be honest with yourself

“Call an eating disorder thought out for what it is, and fight the urge to explain it away,” Drago recommends. “I had to come to terms with what I was losing by staying in my eating disorder—I'd say 'I have a job, it's fine. I have friends, it's fine.' But did I want ‘fine’ for myself, or did I want more?”

Don't let fear of another relapse hold you back

“When I was stuck in the cycle of recovery and relapse, I felt like my two options were either being fully recovered for the rest of life or being doomed to a miserable life with an eating disorder. But it doesn't have to be that black and white,” Drago says. “Even if you reach recovery now and then, years later, you experience setbacks or another relapse, there is value in however long you spend in recovery. There is so much joy to be had in a life with more freedom of any amount and improved quality of life overall. And that is worth it.”

What to do if a loved one relapses

If someone you care about relapses during eating disorder recovery, you may feel a storm of emotions: worry, frustration, helplessness. These reactions are natural when watching someone you love struggle. You might also feel conflicted about what to do: scared that you’re overreacting, but also afraid of doing nothing. Know that if your loved one is starting to slip, they need you perhaps more than ever. Here’s how you can provide meaningful support while respecting their autonomy.

Speak with acceptance

One of the most important things is to avoid judgment or disappointment—these types of reactions often amplify the harsh inner critic berating your loved one. Instead, approach them from a place of unwavering compassion that acknowledges their struggle without defining them by it. During every conversation, “listen actively, validate their feelings, and avoid any blame or shame,” Lindenfeld says. “Their vulnerability requires sensitivity from you.”

Help them help themselves

Encourage them to reconnect with their support team and offer practical help like driving them to appointments or preparing a meal, Lindenfeld says. Or simply ask them what would feel helpful. If your loved one is a minor, you may choose to reach out to their treatment team yourself.

Find support

Eating disorder treatment and relapses are difficult for both patients and their parents, caretakers, and other loved ones. So consider seeking therapy for yourself or finding a support group for parents of children with eating disorders. Equip offers support groups and mentors, and FEAST (Families Empowered and Supporting Treatment of Eating Disorders) is another resource that many families find helpful. Knowing you're not alone often goes a long way toward shifting your outlook about relapse.

Be patient

Eating disorder recovery can be a difficult and long journey—for you and your loved one. Whether you’re facing a first relapse or managing the fifth, it's valid to feel defeated. However, research shows that persistent support significantly improves recovery outcomes. So don't give up. Be patient, keeping in mind that each relapse is a chance for your loved one to strengthen the skills required for lasting change. With your support and love, they can do this.

The Equip takeaway on eating disorder relapse

Eating disorder recovery isn't easy, and it isn't a linear race with a finish line. Many people experience one or more relapses along the way. Though you may feel like you failed if you relapse, you haven't. Have hope, because a relapse—or a series of them—is an opportunity for growth, and can make your recovery even stronger in the end. “Recovery is a roller coaster. It won’t be easy, yet it will be the most gratifying journey to embark on. Remember that healing is possible and seeking help is a sign of strength, not weakness,” Lindenfeld says