Relapse in eating disorders: A systematic review and thematic synthesis of individuals' experiences

Heal-Cohen, Natasha, Allan, Sophie M., Gauvain, Nieve, Nabirinde, Rachel and Burgess, Aaron (2025) Relapse in eating disorders: A systematic review and thematic synthesis of individuals' experiences. Clinical Psychology & Psychotherapy, 32 (4). ISSN 1063-3995

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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 and experienced. They support a focus on motivational factors and underlying psychological difficulties in treatment, extending beyond a behavioral focus. Further research is needed to understand relapse experiences among males and individuals from the global majority.

Item Type:	Article
Additional Information:	Data Availability Statement: Data sharing is not applicable to this review as no new data were created or analyzed. The supplemental file contains the following: database search strategy, non-English language excluded paper, full quality appraisal table, figures illustrating theme generation.
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Depositing User:	LivePure Connector
Date Deposited:	03 Jul 2025 09:30
Last Modified:	03 Jul 2025 09:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99824
DOI:	10.1002/cpp.70101

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