Timing and prediction of relapse in a transdiagnostic eating disorder sample

To identify factors that predict relapse in eating disorders to direct the development of effective relapse prevention interventions.

Fifty-eight participants who had partially remitted from their eating disorder after intensive treatment were prospectively followed for up to 24 months. A transdiagnostic sample was included based on current recommendations.

The 12-month survival rate was 0.59, indicating that 41% of the sample had relapsed at this time, and four factors emerged as significant predictors of relapse. These factors included more severe pretreatment caloric restriction, higher residual symptoms at discharge, slower response to treatment, and higher weight-related self-evaluation.

Clinical recommendations based on these data include encouraging clients to adopt the recommended behavioral changes immediately at the beginning of treatment, and to make complete symptom control a priority. In addition, addressing weight-related self-evaluation and teaching clients to detach from this schema that connects weight/shape with self-esteem may be an effective and feasible step toward relapse prevention.