The process of relapse in patients with bulimia

Abstract

Thirty bulimic patients who had gained control of their eating behavior for a minimum of 2 months but had subsequently relapsed were identified. These patients represented a subsample of a series of 75 patients who had been evaluated in an outpatient eating disorders clinic and followed up at 12 to 15 months. More than one-half of those who relapsed did so within two months of finishing treatment and one-third relapsed while still involved in aftercare therapy. Variables associated with relapse included stressful or difficult situations and feeling anxious, nervous, or depressed. The implications for treatment of these findings are discussed.The eating disorder of bulimia is characterized by a pattern of episodic binge-eating usually followed by self-induced vomiting and/or laxative abuse. Little is known about the course of this disorder. Most of what is known regarding the longitudinal course must be extracted from treatment papers. Several treatment programs have been described in the literature. The results from these reports are encouraging and suggest that recovery with treatment is possible (Fairburn,

Recovery and relapse in former bulimics.

“…The minority experience in this sample may reflect more realistic appraisal of current skills during the process of recovery, better planning for prevention of relapses, and/or a greater capacity and resource for coping with stress—variables associated with fewer relapses with overeating in dieters (Grilo, Shiffman & Wing, 1989), with smoking (Shiftman, 1984), and with alcohol (Marlatt & Gordon, 1985). The anticipated antecedent variables associated with a subsequent relapse are consistent with studies of relapse in persons with eating disorders (Mitchell et al, 1985) and persons with addictive disorders (Marlatt & Gordon, 1985) including stressful social situations, negative feelings, and negative cognitions. These similarities point to the need to examine the literature on addictive behaviors as research on recovery and relapse proceed in the area of eating disorders.…”

“…Based on emerging literature it was hypothesized that psychological stability (e.g., Svanum & McAdoo, 1989) and the amount of time that one has been recovered (Hunt et al, 1971; Mitchell et al, 1985) would be associated with increased confidence that one would not be likely to relapse. Moderate correlations were observed among three variables: level of psychological distress; perceived likelihood that one would slip back into an eating disorder (1 = not likely at all to 7 = very likely); and the length of time each woman has considered herself recovered.…”

Recovery and relapse in former bulimics.

“…The minority experience in this sample may reflect more realistic appraisal of current skills during the process of recovery, better planning for prevention of relapses, and/or a greater capacity and resource for coping with stress—variables associated with fewer relapses with overeating in dieters (Grilo, Shiffman & Wing, 1989), with smoking (Shiftman, 1984), and with alcohol (Marlatt & Gordon, 1985). The anticipated antecedent variables associated with a subsequent relapse are consistent with studies of relapse in persons with eating disorders (Mitchell et al, 1985) and persons with addictive disorders (Marlatt & Gordon, 1985) including stressful social situations, negative feelings, and negative cognitions. These similarities point to the need to examine the literature on addictive behaviors as research on recovery and relapse proceed in the area of eating disorders.…”

“…Based on emerging literature it was hypothesized that psychological stability (e.g., Svanum & McAdoo, 1989) and the amount of time that one has been recovered (Hunt et al, 1971; Mitchell et al, 1985) would be associated with increased confidence that one would not be likely to relapse. Moderate correlations were observed among three variables: level of psychological distress; perceived likelihood that one would slip back into an eating disorder (1 = not likely at all to 7 = very likely); and the length of time each woman has considered herself recovered.…”

Natural course of a community sample of women with binge eating disorder

“…Remission of symptoms is often seen as well in women with bulimia nervosa (Bushnell, Wells, Hornblow, Oakly-Browne, & Joyce, 1990;Rathner, Bonsch, Maurer, Walter, & Sollner, 1993). However, relapse in the eating disorders is also common (Deter & Herzog, 1994;Keller, Herzog, Lavori, Bradburn, & Mahoney, 1992;Mitchell, Davis, & Goff, 1985). Our finding of a high rate of remission is surprising in light of the fact that at study entry, all participants had experienced the eating disorder for a number of years.…”

Defining Recovery and Relapse in Bulimia Nervosa: A Systematic Review of the Literature

“… 2021 ), two months (10%, n = 1) (Mitchell et al. 1985 ), or three consecutive months (60%, n = 6) (MacDonald et al. 2015 ; McFarlane et al.…”

Recovery and relapse in former bulimics.

“…The minority experience in this sample may reflect more realistic appraisal of current skills during the process of recovery, better planning for prevention of relapses, and/or a greater capacity and resource for coping with stress—variables associated with fewer relapses with overeating in dieters (Grilo, Shiffman & Wing, 1989), with smoking (Shiftman, 1984), and with alcohol (Marlatt & Gordon, 1985). The anticipated antecedent variables associated with a subsequent relapse are consistent with studies of relapse in persons with eating disorders (Mitchell et al, 1985) and persons with addictive disorders (Marlatt & Gordon, 1985) including stressful social situations, negative feelings, and negative cognitions. These similarities point to the need to examine the literature on addictive behaviors as research on recovery and relapse proceed in the area of eating disorders.…”

“…Based on emerging literature it was hypothesized that psychological stability (e.g., Svanum & McAdoo, 1989) and the amount of time that one has been recovered (Hunt et al, 1971; Mitchell et al, 1985) would be associated with increased confidence that one would not be likely to relapse. Moderate correlations were observed among three variables: level of psychological distress; perceived likelihood that one would slip back into an eating disorder (1 = not likely at all to 7 = very likely); and the length of time each woman has considered herself recovered.…”

Natural course of a community sample of women with binge eating disorder

“…Remission of symptoms is often seen as well in women with bulimia nervosa (Bushnell, Wells, Hornblow, Oakly-Browne, & Joyce, 1990;Rathner, Bonsch, Maurer, Walter, & Sollner, 1993). However, relapse in the eating disorders is also common (Deter & Herzog, 1994;Keller, Herzog, Lavori, Bradburn, & Mahoney, 1992;Mitchell, Davis, & Goff, 1985). Our finding of a high rate of remission is surprising in light of the fact that at study entry, all participants had experienced the eating disorder for a number of years.…”

Defining Recovery and Relapse in Bulimia Nervosa: A Systematic Review of the Literature

“… 2021 ), two months (10%, n = 1) (Mitchell et al. 1985 ), or three consecutive months (60%, n = 6) (MacDonald et al. 2015 ; McFarlane et al.…”

Recovery and relapse in former bulimics.

“…The minority experience in this sample may reflect more realistic appraisal of current skills during the process of recovery, better planning for prevention of relapses, and/or a greater capacity and resource for coping with stress—variables associated with fewer relapses with overeating in dieters (Grilo, Shiffman & Wing, 1989), with smoking (Shiftman, 1984), and with alcohol (Marlatt & Gordon, 1985). The anticipated antecedent variables associated with a subsequent relapse are consistent with studies of relapse in persons with eating disorders (Mitchell et al, 1985) and persons with addictive disorders (Marlatt & Gordon, 1985) including stressful social situations, negative feelings, and negative cognitions. These similarities point to the need to examine the literature on addictive behaviors as research on recovery and relapse proceed in the area of eating disorders.…”

“…Based on emerging literature it was hypothesized that psychological stability (e.g., Svanum & McAdoo, 1989) and the amount of time that one has been recovered (Hunt et al, 1971; Mitchell et al, 1985) would be associated with increased confidence that one would not be likely to relapse. Moderate correlations were observed among three variables: level of psychological distress; perceived likelihood that one would slip back into an eating disorder (1 = not likely at all to 7 = very likely); and the length of time each woman has considered herself recovered.…”

Natural course of a community sample of women with binge eating disorder

“…Remission of symptoms is often seen as well in women with bulimia nervosa (Bushnell, Wells, Hornblow, Oakly-Browne, & Joyce, 1990;Rathner, Bonsch, Maurer, Walter, & Sollner, 1993). However, relapse in the eating disorders is also common (Deter & Herzog, 1994;Keller, Herzog, Lavori, Bradburn, & Mahoney, 1992;Mitchell, Davis, & Goff, 1985). Our finding of a high rate of remission is surprising in light of the fact that at study entry, all participants had experienced the eating disorder for a number of years.…”

Defining Recovery and Relapse in Bulimia Nervosa: A Systematic Review of the Literature

“… 2021 ), two months (10%, n = 1) (Mitchell et al. 1985 ), or three consecutive months (60%, n = 6) (MacDonald et al. 2015 ; McFarlane et al.…”