Eating disorders are complex chronic health conditions requiring a long-term recovery approach. Unfortunately, the road to recovery for children can be especially difficult and may involve setbacks and relapses.
A relapse in eating disorders is a return or worsening of symptoms after improvement or remission. It may occur due to stressors, such as a change in family dynamics, the experience of traumatic events, or other triggers.
The challenges of maintaining recovery over time may also cause a relapse in kids. But with care and attention, relapse prevention can be possible.
Common Signs of an Eating Disorder Relapse
Recognizing an eating disorder relapse in children with a history of disordered eating behaviors can be challenging, as the changes they exhibit in their behavior or mindset may be subtle. However, early detection is crucial to effectively and promptly implement additional treatment measures, such as a relapse prevention plan.
By keeping a close eye on these potential warning signs, it’s possible to detect relapse early and take appropriate action to address the issue.
Rapid Weight Loss or Weight Gain
A sudden change in weight is one of the biggest predictors of relapse, potentially pointing to the resurgence of a number of disordered behaviors. Weight loss may occur from skipping meals or excessive exercise, while weight gain can happen after episodes of binge eating.
If your child has been recovering from an eating disorder and starts losing or gaining weight rapidly, it could be a sign that they are struggling with the disorder again.
Avoiding Certain Foods
Eating disorder symptoms often include fearing or all together avoiding certain foods, such as carbohydrates or fats. Anorexia nervosa and bulimia nervosa, in particular, often involve a fixation on diet in general or certain foods in particular.
If your child starts avoiding certain foods they used to eat without issue, it could be a sign that their eating disorder has returned, or that they are at least experiencing a partial relapse.
Eating in Secret
Eating in secret is another of the disordered eating behaviors that manifests as part of many different eating disorders, including binge eating disorder and bulimia nervosa.
People struggling with these conditions may feel guilt or shame around how much food they’re eating, or want to hide their eating patterns from others. This is also true of children who have experienced an eating disorder.
A few signs that a child is eating in secret include eating after everyone else is asleep, hiding food, or sneaking food away to eat it alone.
A Preoccupation with Food or Weight
An increased focus on food and weight can foretell a relapse. If your child starts talking excessively about food, weight, or body image, it could be a sign that they considering or starting potentially harmful behaviors again.
Fixating on food, eating, or body shape, size, or weight can also present a slippery slope for someone struggling with eating disorder recovery. Preoccupation on these subjects can drive other eating disorder risk factors, such as low self-esteem, and lead to excessive workouts or more disordered eating behaviors.
Changes in Mood
While eating disorders take a toll on someone’s physical health, they also impact—and are impacted by—many emotional components.
Researchers found that depression and anxiety are closely linked to many eating disorders, with co-occurring diagnoses tied to a higher severity of eating disorder symptoms.  Disordered eating behaviors also often cause hormonal dysfunction or fluctuation, which can lead to mood swings. And many eating disorder symptoms, including secret eating, can lead to anti-social behavior.
If your child starts to withdraw, becomes more irritable, or seems otherwise sad or edgy, it could be a signs of a re-emergence of their condition.
What to Do If You Think Your Child Is Relapsing
Eating disorders like adolescent anorexia nervosa (AN) can devastate children and young adults. For a parent, spotting early warning signs can be the key to relapse prevention at this this crucial moment in a child’s life.
If you think your child is relapsing, try to maintain hope. Taking action quickly can be an effective way to help them get back on track.
Communicate With Your Child
It’s important to have open and honest communication with your child throughout their recovery process. This can help you understand what they are going through and how they feel.
Encourage your child to talk to you, and listen to what they have to say without judgment. If they express worrisome thoughts or talk about harmful behaviors, you may want to take the next step by talking to their primary care doctor or speaking with a mental health professional.
Encourage Healthy Eating Habits
Children who have struggled with eating disorders may have a distorted relationship with food, making it difficult for them to eat healthily.
Often, a meal plan is part of someone’s recovery. These are crafted by experts, often with a patient’s specific needs in mind, though as recovery goes on, many people may drift away from these plans.
If your child is showing signs of relapse, you may want to revisit this plan, to see what kinds of eating schedules and recipes were recommended. You can also help by generally encouraging healthy eating habits.
Try modeling a healthier relationship with food yourself. The Health at Every Size Movement has great tips for intuitive eating and other ways to avoid the traps of diet culture.
Monitor Weight and Body Measurements
Children recovering from eating disorders may be at risk for relapsing if their weight or body measurements begin to change. Parents should monitor these numbers closely but avoid making them the focus of conversations with the child.
This can be a tricky middle-path to walk. If you need help with the best way to execute this monitoring process, you may want to consult with a mental health or healthcare professional.
Address Co-Occurring Mental Health Issues
A vast majority of eating disorders co-occur with other mental health conditions, including—and especially—a variety of depression and anxiety disorders.  One primary reason for a partial relapse or full relapse is the persistence of these underlying conditions.
Full recovery from an eating disorder almost always requires progress not just with eating habits, but with mental health outlooks. That’s why many therapeutic techniques developed to treat eating disorders focus on concepts like self-acceptance and mindfulness.
It’s important to be aware of these underlying conditions, and to seek further help if you notice signs of further distress in your child. Contacting your child’s mental health therapist or primary physician is a good place to start getting appropriate advice for how to proceed.
Seek Professional Help
Preventing eating disorder relapses in children requires a multi-faceted approach. Parents have a role in their child’s recovery process and can take crucial steps to support and protect them from relapsing.
Still, while these tips can be helpful for creating an overall supportive environment for your child, ultimately, if you’re concerned that your child may be relapsing, you should seek professional help as soon as possible.
A trained mental health professional, nutritionist, or your child’s primary care physician can help create a relapse prevention program, or provide the support and guidance needed to make the appropriate next steps.
How to Seek Treatment for an Eating Disorder Relapse
It’s important to remember that recovery from an eating disorder is often a complex and lengthy process. Relapses occur frequently, for people of all ages who struggle with these difficult conditions. But the re-emergence of harmful behaviors doesn’t meant that you, as a parent, have failed.
Rather, the situation can present an opportunity for the child and their treatment team to evaluate what may have contributed to the disorder relapse. This can lead to the creation of a relapse prevention program which includes steps for both you and your child to regain footing in the recovery process.
Contacting a healthcare professional is paramount. Reach out to your child’s primary care physician, mental health therapist, nutritionist, or other members of their care team for the best advice and insight on what to do next.
Having the right level of care can make a significant difference in preventing a relapse of eating disorder behaviors in your child. And the most important thing to remember is not to give up hope. A relapse, or even partial relapse, doesn’t spell certain doom. Recovery is always possible.
Sander, J., Moessner, M., & Bauer, S. (2021). Depression, Anxiety and Eating Disorder-Related Impairment: Moderators in Female Adolescents and Young Adults. International journal of environmental research and public health; 18(5):2779.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 23, 2023
Published on EatingDisorderHope.com