In eating disorder recovery, it takes constant vigilance to maintain momentum. It can be easy to get distracted and not notice that disordered thoughts and urges are creeping back when, after years of eating disorder misery, life has more meaning again and you just want to enjoy it. Therefore, you need to know the signs of a lapse or relapse and use them as signals to slow down and put your focus fully back onto eating disorder-bashing so that ultimately, you really can enjoy your life.
This is the second of three posts about lapses and relapses in eating disorder recovery. The first post is about the differences between a lapse, relapse and pre-lapse. This post goes into the common signs than you need to know of a lapse or relapse in eating disorder recovery.
Listed below are some typical warning signs of when an eating disorder and its addictive nature is getting stronger again. These signs are telling you to recommit to your goal of aiming for overshoot which will help to remove the risk of a full lapse or relapse occurring (I know you don't want that!).
Common Signs of a Lapse or Relapse in Eating Disorder Recovery
Increased restriction—your food intake is sliding, you are eating predominantly safe foods and avoiding fears or there’s more rigidity to how, what and when you eat.
An escalating number of thoughts and urges that relate to your eating, exercise or other compensatory behaviours.
Feeling overwhelmed by things that you have to do or events in your life, whether they involve bashing the eating disorder or not.
Worsening body image—an increase in thoughts about or focus on your body shape and weight.
Urges to weigh yourself, particularly if this has been compulsive before.
A stronger fear of weight gain and becoming increasingly attracted to the thought of weight loss.
Signs of weight loss that also gives you a sense of achievement or reward.
An increasing need for control, commonly with your food intake but with other aspects of your life too.
Isolating yourself more from others.
A rise in negative thought patterns, self-talk and emotions.
Conversely to the above, an increased feeling of numbness or calmness that feels welcome.
A return of the starvation high—that feeling of being invincible and able to fly through life.
Feeling physically colder.
An increasing sense of despair with your life and the future.
Being more irritable and losing touch with the ability to find pleasure and fun.
An increased focus on numbers, whether related to weight, calories, macros, steps or anything else.
A growing need to control your money spending, stronger urges to save and an increased feeling of guilt over spending even small amounts.
Increasing lower-level movement and difficulty sitting down.
Thoughts to take up strength-training, bodybuilding, yoga or pilates.
More food thoughts, aka mental hunger, which reduces your concentration elsewhere.
Lower physical appetite and/or increased anxiety at physical hunger.
An increase in binge eating episodes—a sign your body is not getting enough food and your energy deficit is escalating.
Stronger cravings again for sugary foods—a sign your body is seeking instant energy sources.
Spending more time seeking magic answers online, through social media, blogs, YouTube etc.
Increasing mental gymnastics and negotiations, making eating and life more complicated than it should be.
Hyper-awareness of how much you ate or engaged in compensatory behaviours yesterday, with a strong drive to ensure that today you don’t eat more or compensate less.
Some of this list might be symptoms that you never have and never will experience because every eating disorder is different. But learn to recognise your unique warning signs because you will have key symptoms that kick in first and are individual to you.
What thoughts, urges or emotions commonly come up for you when things are starting to slide?
Make a note of them so you are more likely to spot them early and can quickly take action to get back on track.
Overcoming an eating disorder is tough. No matter where in the process you are when the eating disorder’s urges and cravings start to re-escalate, it can still be hard work to pull things back.
The distress and anxiety can be just as intense, especially if your dopamine levels have escalated through your re-engagement in old habits. This might result in a need to re-enter the dopamine deficit state and associated negative emotions to allow your dopamine level to rebalance again (see this post to understand this more).
Time to Re-Committ
When you notice a lapse or relapse has occurred, recommit to abstaining from restrictive eating, all compensatory behaviours and rituals and to aiming for overshoot.
You didn’t come this far to let things go backwards now.
Push against every fibre of your being that might be screaming at you not to eat or rest.
Break the rules the eating disorder creates. Do what feels so wrong, knowing it’s right.
Then Reflect...
Take a moment then to reflect on what might have triggered this lapse or relapse:
Have you been under more stress?
Are you getting busier?
Have your activity levels unintentionally increased or has your intake slipped?
Has something happened to make you more emotional?
Have you had a return of some memories, faced a situation or seen someone that has always been a powerful trigger?
Try to work out the cause of this lapse so you can establish how to protect against the same thing happening in future.
The next post covers how to prevent a relapse and achieve your very best chance of long-term success at overcoming an eating disorder... and just a heads up = continuing to aim for overshoot is critical!