Eating Disorder Relapse Prevention Worksheet

Relapse Prevention Plan

A relapse prevention plan is an important tool for maintaining recovery. Complete this worksheet created by EDTLA’s therapist, Carly Poynter, MA.

Recovering from an eating disorder takes time. You did not develop your eating disorder overnight and it will not go away that quickly either. It is important to remember that recovery is not a linear process and there will be slips, lapses, and relapses during the recovery process. Lapses and relapses are a normal and expected part of the recovery process.

The Relapse Prevention Plan is designed to help prevent a lapse from becoming a relapse.

Helpful Behaviors and Strategies in Eating Disorder Recovery

Begin by making a list of behaviors and strategies that have been useful to you in your recovery so far. You might include things such as eating regular meals or following your prescribed meal plan, planning meals and snacks, regular social support, self-care activities, practicing coping skills you have learned, etc.

This will be your “regular maintenance and care” – how to maintain recovery.

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Relapse prevention plan [Image description: drawing of a purple car] represents a regular maintenance plan for eating disorder recovery in Los Angeles, California — Dall.e

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High Risk or Potentially Triggering Situations for Relapse

Make a list of all of the potentially high-risk or triggering situations that may make you more likely to engage in eating disordered behaviors or increase the risk for a lapse or relapse.

Relapse Prevention Potentially triggering situations - driving in bad weather [Image description: drawing of a car on a mountain road and there is rain and rocks falling] Represents a potentially trigger situation for a patient in eating disorder recovery in Los Angeles, California — Dall.e

These are your “driving in bad weather conditions”

Some common situations may include:

Stress and/or a busy schedule (making meal planning difficult)
Situations that evoke strong feelings and emotions
Significant losses
Relationship problems
Major life changes
Moving
Weight gain
Dieting or any form of restriction (including by type of food)
Missing meals or snacks
Social media
Being susceptible to the influence of someone who is “health conscious” or a “health guru”
Having friends, family, or coworkers who diet and talk about weight and diets
Being in unfamiliar environments
Having restricted access to food (religious holidays, financial constraints, etc.)
Having unrestricted access to food (buffets, holidays, potlucks, celebratory events)
Getting weighed by a doctor or having a health care professional advise you to lose weight
Having others comment on your body weight or shape
Shopping for clothes
Major changes to your body such as surgery or pregnancy
Dating
Getting sick (i.e., stomach flu)

You may use some of the suggestions from the list above (please mark or highlight those that are most relevant to you) or create your own list of high-risk situations that may increase your risk for a lapse or relapse.

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Relapse Warning Signs

Become familiar with the early warning signs that are relevant to you. These will likely include previous eating disordered behaviors such as increased urges to engage in restriction, binge-eating, purging, exercise, and other compensatory behaviors, a preoccupation with caloric intake, your weight, or body image, social withdrawal, increased sadness or anxiety, etc.

These are your “check engine light” warnings.

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Eating disorder relapse prevention warning signs. Check engine light. [Image description: drawing of a car dashboard with an engine warning sign alert on] Represents eating disorder relapse warning signs for a client in Los Angeles, California — Dall.e

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Coping Skills to Manage Warning Signs

At this point in your journey, you have learned a number of strategies to deal with challenging situations. Make a list of the coping skills you know of that work for you. You will want to make sure that your list includes distraction-based skills, social support, soothing coping skills, and cognitive coping skills. You can use these skills when one of the high-risk situations happens.

This will be your “toolbox”

Eating Disorder Recovery Toolbox for Recovery [Image description: drawing of a purple toolbox] Represents coping skills of a person in eating disorder recovery in Los Angeles, California — Dall.e

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Coping Skills to Use Instead of Eating Disorder Behaviors

In times of crisis, it can be difficult to remember healthy ways of coping. Many people in crisis resort to familiar patterns of coping, which may be maladaptive and lead to a lapse or relapse. Making a plan ahead of time can be helpful.

Make a list of 10 things you can do instead of reverting to eating-disordered behaviors as a way to cope. After this is completed, keep it in a place where it can be accessed when needed (i.e., on your phone, with your social support system, in a cupboard, at your desk, etc.). You may also want to share this with a significant other because sometimes they may notice some of the warning signs in you before you do.

This is your “roadside assistance.”

Eating Disorder Relapse Prevention roadside assistance [Image descripton: drawing of a tow truck] represents strategies for a person in eating disorder recovery in Los Angeles, California — Dall.e

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Supportive Others

It is also important to reach out during times of crisis, when you are feeling scared, alone, out of control, etc. Talking about your feelings can help to relieve some of the anxiety that you may be experiencing. Reaching out to others can help to prevent a lapse or relapse and will help remind you that you are not alone. Remember, it can be challenging to reach out, but the more you do it, the easier it becomes. The person you reach out to will be glad that you did and will welcome the call.

These people are your “mechanics”

Below, list a few people who you can reach out to.

Eating disorder recovery relapse prevention mechanic [Image description: drawing of a mechanic with a wrench in front of a purple car| represents a support person helping a person in eating disorder recovery in Los Angeles, California — Dall.e

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It can be equally as important to know what type of help each person can provide. Next to the person’s name, write if they are a distractor (i.e., someone you can call to distract you when urges are high), a supporter (i.e., someone who will give you emotional support), or a doer (i.e., someone who will do what you need – eat meals with you, cook with you, shop with you).

Come Back for A Tune-Up As Needed

Eating Disorder Recovery Journey [Image description: drawing of a happy woman driving in a purple car] Represents a client in eating disorder recovery in Los Angeles, California — Dall.e

Having completed a round of therapy for your eating disorder, you are already on the road to recovery.

Remember, just like all cars, eating disorder recovery also requires regular maintenance. There will be times that you may need to return to treatment or therapy for a “tune-up.”

The Eating Disorder Therapy LA team is happy to hear from former clients who wish to come in for “tune-ups.”

If you are earlier in recovery, remember to structure your environment to promote eating disorder recovery.

Download a fillable copy of this worksheet Relapse Prevention Plan.

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