Difference Between a ‘Slip’ and ‘Relapse’ In Anorexia Recovery

By December 6, 2012

Seven years ago I spent 3 months at a treatment center for anorexia. Since then, my recovery has been really solid. I have not needed to see any professionals for about 3 years now. A few months ago though, I began to notice some of the old thoughts and behaviors starting to eat away at me again. It’s getting worse and worse. I’ve lost 20 pounds so far and have recently starting purging (although I don’t binge) most days. I don’t meet the criteria for anorexia yet (I’m only about 10 lbs underweight, technically) but I can’t seem to stop this momentum. Is this just a “slip” in my recovery, or is it relapse? What’s the difference and what should I do next? – M.

Dear M.,

Great question. I’m glad to hear your recovery has been so solid over the past seven years and that you are thoughtfully aware of your current struggle. When I consider your question of whether this is a “slip” or a “relapse” two thoughts come to mind…

First, it may be a matter of semantics. Regardless of what we call this, you are struggling and may soon be at a dangerously low weight. So I’m not sure it matters what we call it. Rather, what matters is what you are going to do to reverse the downward spiral. That needs to begin with practicing what you learned in treatment and choosing to do what is right even when you don’t feel like it.

It’s obvious that there is a good part of your heart that wants recovery or you would not have written with this question. “But,” you may say, “there is another part of me that wants to practice eating disorder behavior.” I agree, that can be true, but it’s not the most powerful or genuine part of you. That is the part of you struggling to make things better through your old behaviors.

Additionally, if you have been in solid recovery for 7 years, this eating disorder does not have a grip on you like it once did. You may feel like you are sitting in a jail cell, but the door is open for you to walk out.

Second thought: You stated, “A few months ago…I began to notice some of the old thoughts and behaviors starting to eat away at me again.” If we could sit down together and talk, one of the first questions I would ask would be, “What else has been going on in your life in the last 3-6 months that might be causing stress in your life? What disappointments? What successes? What transitions?” I’d want to hear more of your story and together maybe we could unpack what it is in your life that might cause you to want to use your old coping mechanism.

Finally, though you haven’t needed professional help for the last three years, it might be time for a tune-up. Go and see your old therapist, visit with your dietitian, be sure your MD is aware of what is going on. I’m sure they would be delighted to see you. And, lean on good friends. Talk with them about the rest of your life. They may do wonders in helping you put together the pieces and help you find your way out again.


Travis Stewart, LPC