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Relapse in Eating Disorders: A Systematic Review and Thematic Synthesis of Individuals' Experiences

Natasha Heal-Cohen, S. Allan, Nieve Gauvain, Rachel Nabirinde, Aaron Burgess

Clinical Psychology and Psychotherapy, 2025

8 citations

Abstract

ABSTRACT Objective Relapse is common in eating disorders (EDs); however, it has received significantly more attention within quantitative research. This systematic review aimed to synthesize qualitative findings regarding the experiences of relapse for people with EDs. Method A search for studies reporting qualitative data that included experiences of relapse in individuals with EDs was conducted. This included a systematic search of MEDLINE, CINAHL, PsycInfo, Scopus, SSCI, and PQDT Global along with supplementary searching. A total of 1594 titles and abstracts and 168 full texts were screened for eligibility. Sixteen studies were included in the review. Quality appraisal was conducted using the CASP checklist. Data were extracted from each paper and thematic synthesis of relevant data from study findings/discussion was completed in NVivo. Results Most included studies involved female participants in the United States, Canada, and United Kingdom with anorexia and bulimia nervosa. Five analytical themes were generated: 1) “I wasn't letting go”: Relapse as enticing; 2) “Bound to lose”: Relapse as unstoppable; 3) “If the going gets tough I've always got this”: Relapse as protective; 4) “Coming back with your tail between your legs”: Relapse as destructive; 5) “So much of this journey … is learning”: Relapse as instructive. Discussion Findings highlight the gap between psychological and behavioral improvements that precede relapse, and the contrasting ways relapse is described…

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