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Going into eating disorder treatment for the first time, most people (or their families) don’t realize that relapse is considered to be a normal part of the recovery process. In bulimia nervosa treatment as with any kind of mental health illness, relapses are to be expected – but that doesn’t mean that loved ones should give up hope. There are various preventative measures and ways to respond if a relapse happens, designed by mental health professionals and time-tested over the years.

So, what is a relapse and what does it mean for an adolescent who’s completed bulimia nervosa treatment and returned to their “daily routine?” The best way to describe relapse as it pertains to an eating disorder is the return of disordered eating behaviors after they’ve been absent for an extended period. Typically, relapses occur during particularly stressful times or moments of distress, such as exams, work troubles, relationship difficulties, or experiencing PTSD symptoms. It is common for teens to feel guilt or frustration if they return to the binge-and-purge, so parents must create an environment where they feel comfortable expressing their feelings and asking for help knowing there will be no judgment or punishment.

Among eating disorder treatment professionals, it’s known that relapse is no reason to give up on the idea of enjoying long-term recovery. Instead, it’s an accepted part of the recovery journey. So how can parents manage their child’s continued recovery when a relapse happens? By remaining calm, supportive, and focused on restoring healthy behaviors. Read on to learn some tips for dealing with a bulimia nervosa relapse.

How Can Parents Talk to their Teen About Relapses?

  1. Approach The Conversation with Compassion and Understanding

Bulimia nervosa treatment isn’t a straight path – there are steps forward, steps back, and winding detours along the way. It can be intimidating and confusing for everyone involved. This means that it is essential for parents and loved ones to approach teens with compassion and understanding surrounding their condition. Recognizing the challenges that come along with navigating a return of disordered behaviors can help teens to know that they are not alone and have a solid support system behind them.

Parents should give their children plenty of opportunities to express how they feel at this crucial moment. They may not want to – as mentioned, many people feel ashamed of their eating disorder and are reluctant to talk about it. If this is the case, give them plenty of time and a gentle but firm touch, encouraging them to speak in a judgment-free space. And make sure to follow through with that promise! No matter what they say, try to understand what they’re saying with an empathetic ear.

  1. Acknowledge That Relapse Is Part of Recovery

Once parents have taken the time to validate their teen’s feelings by expressing compassion and understanding for their situation, they can help their child understand that this is not a failure or wrongdoing of any kind. When someone is in the grips of an eating disorder, it can be hard to gain perspective about the larger picture. One way to look at a relapse is to see it as an opportunity to rededicate one’s self to fighting their disordered thoughts and behaviors. Taking the time to normalize relapse can help those with bulimia nervosa or another eating disorder to avoid using harsh judgment against themselves and focus on getting their recovery back on a positive track.

Parents should also remind themselves of this fact. As hard as it can be to keep perspective for the person suffering from bulimia nervosa, it can be just as difficult for their loved ones. It’s normal to feel hopeless when you’re watching someone you love suffer. Make sure to take the time to remind yourself, relapses aren’t the end of the world; they’re an opportunity for continued growth. It’s important that parents manage their own mental health as well as their child’s in stressful situations like this.

  1. Discuss The Next Steps and the Possibility of Returning to Treatment

Next, parents should discuss what the family is going to do next. This might involve guiding teens back towards a specialized adolescent eating disorder treatment program, or it may be a less intensive proposition.Sometimes rejoining an alumni group will nudge the adolescent back to recovered status; of course, this is not a guarantee that the relapse will end. After completing a residential program, many recovered individuals will have a support system including a therapist. If this is the case, parents should reach out to them right away.

However, relapse can sometimes be intense, requiring care beyond what an alumni group or therapist can provide. If they have been experiencing relapse for 2 weeks or more, there’s a good chance that teens will benefit from increased support —including day treatment or a residential program. A PHP or IOP program can be very useful in these situations; they can reiterate the recovery techniques used in residential treatment without requiring the teen to go back to residential. Be prepared, however, for the possibility of more residential treatment if the relapse is especially intense.

  1. Remember That Long-Term Recovery Is Possible

Parents should also take the time to remind themselves and their teens that long-term recovery from bulimia nervosa is 100 percent possible – it happens every day. While the road to recovery can be very challenging, it’s not a futile endeavor. With the help of early intervention and a reliable support system surrounding them, adolescents with eating disorders like bulimia nervosa have the best chance of changing their behaviors and living a full life once again.

Many treatment centers have alumni programs for graduates from their facilities, and there are many other support groups and recovery communities. Parents of recovered adolescents should make every effort to get involved in those communities. Aside from the additional support from peers their kids can receive from these groups, there are also shining examples of people who have come through relapses and attain a full recovery themselves. A role model for recovery is a powerful asset – that’s why many eating disorder recovery centers make a point of hiring therapists who are recovered themselves.

  1. Don’t Assign Blame or Make Judgments

Since it’s been established that relapses are a normal part of a full recovery from eating disorders, it should be obvious that blaming a person for a relapse or otherwise making them feel negative about themselves is a non-starter. Assigning blame can thwart a person’s growth when it comes to openly discussing their disorder. Often the individual is willing to come forward and ask for help when a relapse occurs; they want to avoid disordered eating behaviors as much as their family or doctors do. However, if they feel they will face recriminations of made to feel worse than they already do, they’re less likely to reveal their relapse or ask for help.

Crucially, relapses are often triggered when stress or anxiety levels are high, and further raising that stress is counterproductive. It can be hard for parents to contain frustration or feelings of disappointment that a relapse has happened, but it’s essential that your adolescent always feels heard, understood, and supported. There are support groups available for parents, as well, that serve as a sounding board for these kinds of feelings, and parents can benefit from therapy themselves. The key is to always keep your child’s health and happiness at the forefront. Make sure your loved one understands it’s a setback, not an end to the journey.

Learn More About Adolescent Bulimia Nervosa Treatment

While the idea of relapse can be very disheartening for teens and their families, it’s important to keep in mind that relapse is natural and much more common than a full recovery with no setbacks. For teens who are experiencing a relapse from bulimia nervosa, it’s very common to go through several stages of recovery — which sometimes include steps forward and a few steps backward as well. The more both parents and children understand about the nature of eating disorders, the more likely it is they’ll be able to enable long-term recovery.

There are all kinds of resources available to learn more about eating disorders and their treatment. Aside from your therapist or doctor, there are many online resources. Organizations like NEDA (the National Eating Disorder Association) have large libraries and knowledge centers on virtually all eating disorder topics and can provide help and support in their community forums and help groups. You can also peruse our blog and treatment pages for more information on treatment, diagnosis, and other topics. There are also many community groups on social media platforms like Instagram and Facebook. No matter what source of education and support for eating disorders you choose, it will help to provide support for your child and arm you with greater knowledge.

If you or a loved one has been diagnosed with bulimia nervosa and is interested in learning more about our adolescent recovery programs, please reach out to your doctor or a quality eating disorder treatment center.


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.