Relapse in Long-Term Eating Disorders

Why does recovery from an eating disorder feel so fragile, even after years of hard work? In this episode of Dr. Marianne Land, Dr. Marianne Miller unpacks the realities of relapse in long-term eating disorder recovery—what causes it, how to navigate it, and why recovery doesn’t stick in a culture that constantly reinforces shame, anti-fat bias, and unrealistic expectations of healing. Episode Overview This eating disorder relapse podcast episode explores the complexity of staying recovered after years or decades of healing. Dr. Marianne explains how relapse is not a personal failure but rather an opportunity to understand what your body and nervous system are communicating. Through a neurodivergent-affirming and body-liberation lens, she breaks down why recovery ebbs and flows and how you can rebuild stability with compassion instead of judgment. Listeners will learn what it really takes to sustain long-term eating disorder recovery, how trauma and stress can reignite old coping mechanisms, and how to approach relapse as part of the process—not the end of it. Key Topics Covered The real meaning of recovery and why “staying recovered” forever is an unrealistic expectation. How the nervous system and trauma memory create vulnerability to relapse. Why life transitions, burnout, and chronic stress often trigger eating disorder relapse. How anti-fat bias, weight stigma, and cultural messaging undermine sustainable recovery. The unique challenges of neurodivergent eating disorder recovery and how to meet sensory and executive-function needs. How to rebuild body trust after relapse through curiosity, safety, and self-compassion. Practical tools for sustainable recovery strategies that evolve as your life changes. Who This Episode Is For This episode is for anyone living with a long-term eating disorder who feels discouraged by relapse or fears they are “backsliding.” It’s also for therapists, dietitians, and family members who want to understand why recovery doesn’t stickfor everyone—and how to provide affirming, compassionate support. Why This Episode Matters In a world where recovery is often portrayed as a linear journey, this episode challenges that myth. Relapse in long-term eating disorder recovery is common, but few people talk about it without shame. Dr. Marianne brings honesty, education, and hope to a topic that deserves care. Relapse is not failure, it’s feedback. And when you learn to listen to what your body needs, you can rebuild a recovery that truly fits your life. Related Episodes on Long-Term Eating Disorders Orthorexia, Quasi-Recovery, & Lifelong Eating Disorder Struggles with Dr. Lara Zibarras @drlarazib on Apple & Spotify. Navigating a Long-Term Eating Disorder on Apple & Spotify. Why Eating Disorder Recovery Feels Unsafe: Facing Ambivalence in Long-Term Struggles on Apple & Spotify. Perfectionism, People-Pleasing, & Body Image: Self-Compassion Tools for Long-Term Eating Disorder Recovery With Carrie Pollard, MSW @compassionate_counsellor on Apple & Spotify. Learn More and Get Support For more on long-term eating disorder recovery, ARFID, binge eating, body trust, and sustainable recovery strategies, visit drmariannemiller.com.