Dr. David Herzog was the first endowed professor of psychiatry in eating disorders at Harvard Medical School and founded the Harvard Eating Disorders program. Recovery from an eating disorder is difficult and relapse can occur when under stress or during life transitions. Relapse prevention is addressed in treatment by creating an action plan to use if symptoms worsen that includes strategies like mood monitoring, scheduling, planned meals and snacks, identifying triggers, and talking to trusted individuals.

1. By Dr David Herzog

2.  Dr. David Herzog was the first Endowed
Professor of Psychiatry in the Field of Eating
Disorders at Harvard Medical School. He
founded the Harvard Eating Disorders, which
became the Harris Center for Education and
Advocacy in Eating Disorders at
Massachusetts General Hospital.

3.  Recovery from an eating disorder can be a
valuable journey of personal growth and self-
discovery; however, the road to wellness is often
arduous. It is not unusual for individuals to fall
back into “old” behavior patterns (food
restriction, binge eating, purging). Relapse can
occur after a stretch of time without symptoms
or when a patient is moving forward but is not
yet well. Some individuals who initially struggle
with food restriction and weight loss later
develop binge-purge behaviors.

4.  Vulnerability to relapse is generally heightened by
stress. Examples of situations that are commonly
perceived as stressful include losses; family health
issues; run-ins with bullies; perceived rejections or
failures; disputes with friends or family members;
exams and other tests, such as SATs; and transitions,
such as advancing from high school to college or
moving to a new city. Patients do not necessarily
reach out for help when they relapse; many feel
ashamed. They may perceive that they have failed at
treatment and disappointed or hurt their families.
Some individuals who slide back into eating disorders
do not see themselves as having a problem.

5.  Relapse prevention is often addressed as part of
treatment. With the help of the therapist, the
patient will put together an action plan to call
upon in the event that her symptoms worsen.
This may include strategies that have helped the
individual in the past, such as monitoring her
moods, structuring her time, adhering to three
planned meals and two snacks per day, reflecting
on what precipitated the unhealthy behavior, and
discussing the problem with people she trusts.