Relapse and Binge Behavior - Understanding Why Women Struggle in Recovery

You may notice a shift in yourself—or a loved one: skipping a meeting, obsessing over food, or telling yourself “just this once.” These subtle changes often precede full relapse or return to harmful eating behaviors.

In recovery, relapse doesn’t always look like outright use. For many women, relapse is emotional first—or expressed through disordered eating or binge patterns. Recognizing these early signals can make all the difference.

We’ll explore how relapse and binge behavior overlap, why women are uniquely vulnerable, how to spot early warning signs, and what a trauma-informed path forward looks like. Whether you sense it in yourself or observe it in someone you care about, this is for you.

What Does “Relapse” Really Mean? A Broader View

Relapse is often misinterpreted as a single moment of use. But in modern recovery models, relapse is more of a process. It unfolds through emotional, mental, and physical stages—a gradual build-up rather than a snap decision.

Emotional relapse: internal shifts, neglecting self-care, mood swings, withdrawal
Mental relapse: internal conflict, fantasizing, planning, rationalizing
Physical relapse: acting on those impulses—using substances or engaging in harmful behaviors

Understanding relapse as a process gives you room to react early—before the cycle deepens.

If you want more background on relapse theory, check Understanding Relapse and Relapse Definition: Part of the Addiction Cycle.

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The Overlap Between Relapse and Binge Behavior

When emotional tension mounts, the brain seeks relief. For some, that relief comes through substances. For others, through food. Binge behavior and substance relapse often share the same emotional triggers: craving comfort, avoiding distress, or seeking control.

Shared Mechanisms

Reward system activation: Both substances and bingeing trigger dopamine—our brain’s “feel good” chemical—especially under stress.
Impulse control erosion: Under emotional overload, self-regulation weakens.
Trauma-driven urges: Trauma histories often drive both substance and eating behaviors as coping strategies.

Statistical Lens: Eating Disorder Relapse Rates

After treatment for anorexia nervosa, relapse rates are documented in the range of 35–41% within 18 months. (NIH)

For bulimia nervosa, relapse or return to disordered behaviors may affect ~41% of individuals within a couple of years. (NIH)

A meta-analysis indicates that across eating disorders, relapse rates of 40–50% are common over longer follow-up windows.

These numbers help ground our understanding: relapse in eating disorders is not rare. It’s common.

That shared ground makes the overlap with substance relapse all the more real.

Why Women Are Especially (and Uniquely) Vulnerable

Women in recovery often navigate emotional, physiological, and social pressures simultaneously. These create a precarious landscape where relapse and binge risk rise.

Hormonal & Biological Factors

Fluctuations during menstrual cycles, perimenopause, or hormonal changes impact mood, craving, and impulse control—making timing of relapse vulnerability more acute.

Caretaking Burdens & Role Strain

Many women juggle responsibilities—caring for children or elders, managing work and household tasks. When those roles become overwhelming, emotional collapse risk goes up.

Societal Pressure & Body Image Stress

Women face constant messaging about appearance, control, and perfection. Body image anxiety often triggers restrictive behavior, which can spiral into bingeing or substance relapse.

Trauma & Comorbidities

Women with substance-use disorders more often present co-occurring trauma, PTSD, anxiety, or depressive disorders. These underlying emotional wounds frequently fuel both relapse and eating disorder patterns.

By acknowledging these intersecting pressures, we move from blaming relapse to understanding it and designing interventions that fit real lives.

Emotional Relapse: The Silent Shift

Before thoughts of using or bingeing emerge, emotional relapse often creeps in quietly. You might notice:

Mood fluctuations: irritability, fatigue, emptiness
Disrupted sleep or appetite
Withdrawal or isolation
Neglecting self-care (skipping meals, not journaling)
Avoidance of emotional honesty

These behaviors may feel “harmless” at first—but they set the stage. If unresolved, emotional relapse can escalate to mental relapse.

You might say to yourself, “I’ll rest today,” “I don’t need therapy tonight,” “I’m just tired”—all clues.

The risk lies in letting them accumulate.

Understanding Binge Behavior as a Relapse Pattern

For many women, disordered eating serves similar emotional functions as substances: numbing, controlling, or punishing. In the context of recovery, binge behavior can be a relapse response all on its own.

Signs to Watch For

Frequent overconsumption beyond fullness
Guilt, secrecy, or shame after eating
Alternating restriction with bingeing
Preoccupation with weight or food
Eating alone or avoiding social meals

These behaviors often reconnect with old emotional fault lines—trauma, shame, control—that substance use once attempted to mask.

Because bingeing taps into self-regulation, it can weaken resolve over time, making full relapse more likely.

Common Triggers for Relapse & Binge Cycles

Triggers rarely act in isolation. They often cluster, creating a perfect storm. Watch for combinations like:

Unresolved grief or relational loss
Life transitions or change (e.g., move, job change, seasonal shifts) — see Why Women
Relapse During the Fall
Isolation or disengagement from community
Shame, guilt, self-critique
Bodies in flux / hormonal shifts
Exposure to diet culture or comparison
Lack of daily structure / boundaries

Even small lapses—skipping therapy, dodging self-care—can cascade when triggers overlap. That’s why early detection and intervention matter.

How Trauma-Informed Care Heals Both Patterns

Relapse and binge behavior are seldom separate. Healing them together via trauma-informed strategies yields deeper recovery.

Integrated Pathways of Care

Anchored Tides’ model bridges both worlds:

PHP & IOP Continuum: Women step from more structured care into outpatient support.
Dual-diagnosis approach: Substance use + eating disorder needs treated concurrently.
Therapies used across both domains: CBT, DBT, EMDR, and nutrition/body-image work.
Holistic modalities: yoga, art, mindfulness—to strengthen mind-body resilience
Relapse prevention loops to monitor both substance and eating relapse signals

How Specific Modalities Support Overlap

CBT helps reframe distorted thinking: “I’m weak,” “I deserve this,” etc.
DBT builds distress tolerance—learning to sit with emotional pain without numbing.
EMDR helps reprocess trauma that fuels both craving and self-harm behaviors.
Nutrition therapy & body image work helps reduce power of food as weapon/enemy.
Group therapy fosters connection and reduces shame—a powerful antithesis to relapse isolation.

Over weeks and months, the experience shifts: therapy doesn’t feel like coping—it becomes new identity.

How to Re-Engage After a Slipping Moment

A slip—emotional, mental, or behavioral—does not erase your recovery path. It’s a signal. Here are steps to course-correct:

Share openly with trusted support — therapist, sponsor, friend
Return to routine — journaling, self-care, meeting check-ins
Step back into treatment — temporarily increase structure (PHP or IOP)
Use micro-commitments — 10 minutes of mindfulness, call a peer
Reflect, not ruminate — “What triggered me?” not “What’s wrong with me?”
Reinforce self-compassion — setbacks are part of growth, not proof of failure

If substance or binge urges escalate, quick intervention matters. Relapse is reversible—especially early on.

Takeaway Summary

Relapse is often a slow, multi-stage process—not a sudden failure.
Emotional signs (mood shifts, withdrawal) often come before mental or behavioral relapse.
Binge behavior and substance relapse share emotional roots and neurological triggers.
Women face unique pressures that raise relapse and binge vulnerability.
Trauma-informed, integrated treatment offers the most effective pathway to healing.
Slipping is not the end—it’s a course correction point. Re-engage early with support, structure, and self-compassion.

Frequently Asked Questions

Can relapse include binge behavior?
Yes. Especially in women with co-occurring substance and eating concerns, relapse may manifest as bingeing or disordered eating rather than substance use.

Why are women more likely to relapse?
Women often face hormonal, emotional, social, and trauma-related pressures that increase relapse vulnerability compared to men.

What helps prevent relapse in women?
Integrated, trauma-informed care (PHP/IOP), strong peer connection, early symptom detection, structured boundaries, and holistic supports are all key.

How common is relapse in addiction treatment?
Studies suggest relapse rates of 40–60% among individuals recovering from substance use disorders.

How common is relapse in eating disorders?
Relapse in eating disorders is also common: 30–50% relapse rates in anorexia within one to two years; bulimia has relapse rates ~41%; meta-analyses suggest up to 40–50% across disorders.

Outpatient Programs You May Be Interested In

Anchored Tides Recovery is proud to offer holistic approaches for your recovery journey:

Our licensed clinicians create personalized treatment plans based on what each woman truly needs. We don’t just teach skills. We help our clients transform.

eating disorders and addiction iop programs outpatient rehab for women php programs relapse relapse prevention

Eating disorders are more common in individuals who suffer from addiction: 35% of individuals with a substance use disorder report disordered eating, compared with just 5% of the female population. Some experts have questioned whether this connection reveals more significant similarities between eating disorders and addiction than were previously thought.

Researchers have proposed an “addiction model” describing eating disorder behavior, where the ED is simply another form of addiction. Others have called binge-eating disorder (BED) and obesity the consequences of an addiction to food. So, just how accurate are these models in representing disordered eating and addictive behavior? Read on to find out what science has to say about it.

Eating Disorders and Addiction: Are They The Same?

There are many similarities between eating disorders and addictions that have led some experts — rightfully or wrongfully — to propose an “addiction model” of eating disorders. For example, eating disorders and addictions are both diseases with physiological and psychological components. They are also both characterized by compulsive behavior.

Researchers have proposed that individuals with “addictive personalities” may be more prone to developing substance use disorders and eating disorders. An addictive personality type is characterized by obsessive behavior, anxiety, impulsivity, and risk-taking. Individuals who develop certain eating disorders, such as anorexia nervosa, may share some of these traits — especially ones of an obsessive-compulsive nature.

Some have even said that disordered eating behaviors, such as self-starvation, may represent an addiction to the body’s endogenous opioids. Eating disorders can also sometimes resemble an addiction to diet pills or laxatives.

Still, the consensus is that eating disorders are separate diagnoses. Although addiction often co-occurs alongside eating disorders, eating disorders are not the same thing as addictions. They are different enough that they even belong to different categories of the DSM-V handbook used by psychologists to diagnose mental health conditions.

How Are Food Addiction And Eating Disorders Alike?

“Food addiction” is another explanation that has been proposed for binge-eating disorder (BED), as well as obesity—eating triggers the release of feel-good chemicals like dopamine, which tell us to keep eating so that we can survive. The idea behind “food addiction” is that we can experience a high off these chemicals, leading us to keep eating far beyond our fullness cues

People with BED share some traits in common with individuals who have an addiction. They may eat compulsively, feeling out of control and unable to stop. But binge-eating is also characterized by feelings of guilt or shame associated with the binges and disruptions in body image. It frequently starts with a failed attempt at dieting.

Sometimes, individuals may try to compensate for the binges by making themselves throw up or abusing laxatives, comprising a disorder known as bulimia nervosa.

These disordered thoughts and behaviors are not explained by the “addiction model” of eating disorders. If binge eating were the result of “food addiction,” it would not be grouped with other eating disorders but with substance use disorders instead. But because binge-eating is so closely linked to dieting and disruptions in body image, like other eating disorders, we consider it a separate disease from addiction and group it with disorders like anorexia and bulimia.

“Food addiction” has also been proposed as a potential explanation for obesity. However, what’s important to understand about obesity is that it is not considered an eating disorder. While many obese individuals suffer from binge-eating disorder, obesity is a physical health issue, not a mental health one. Whether or not “food addiction” is to blame for obesity, this is a different problem from the confusion of “food addiction” with binge-eating.

Why Substance Abuse Coexists With Eating Disorders

According to the National Eating Disorders Association (NEDA), up to half of the people with eating disorders abuse substances; this rate is five times higher than that of the general population. Other than the “addictive personality” explanation, why do eating disorders so frequently coexist with substance abuse?

The most likely reason is a nonspecific genetic predisposition to developing mental illness. Scientists believe that we inherit genes that make us more likely to develop mental health issues in general, but not to develop one mental health problem over another.

It may be likely that the gene that makes us more likely to develop eating disorders is the same as the one that makes us more likely to develop an addiction. Accordingly, many people with both eating disorders and substance use disorders also have another first-degree relative who suffers from the disorder.

Another reason is that the risk factors of eating disorders closely resemble the risk factors of substance use disorders. The two disorders may have similar motivations behind them: an individual can self-medicate with drugs or alcohol, just as they can self-medicate with starvation or purging.

This self-medication may develop as the result of anxiety, depression, or trauma. High pressure and familial expectations can also contribute to the development of eating disorders and substance use disorders.

Even so, substance use disorders do not directly cause eating disorders, nor do eating disorders directly cause substance use disorders. It is difficult to say whether the substance use disorder came first or the eating disorder in many cases. One does not necessarily precede the other. The course of these diseases is different for everyone; sometimes, the two conditions may even develop simultaneously.

For example, “drunkorexia” is a colloquial term for a disordered eating behavior where people who binge drink withhold food to make up for calories consumed through planned drinking. If an individual exhibits “drunkorexic” behavior, it may be challenging to say which came first, the alcohol abuse or the caloric restriction.

Other times, people with eating disorders may adopt addictive behaviors to distract themselves from the consequences of the eating disorder. A common example is the use of cigarettes and nicotine in place of eating meals. Some individuals may pick up smoking (or the use of other drugs) as a way to facilitate self-starvation behaviors during the course of their eating disorders.

Eating Disorders And Drug Addiction Treatment

While eating disorders closely resemble addictions in many ways, the treatments for these disorders are vastly different. Most eating disorder treatment centers are equipped to handle certain types of addictive behavior, such as the abuse of diet pills or laxatives, but not to facilitate the withdrawal from addictive substances like alcohol or drugs.

If you suffer from both an eating disorder and an addiction, it’s crucial to locate a rehabilitation facility that can treat both conditions safely and effectively. Again, not all eating disorder treatment centers will be prepared to support you through the process of withdrawal. You may need to attend separate treatment programs for your eating disorder and your addiction or find a remarkable rehab facility equipped to handle both. Sometimes the most effective treatment or aftercare is having a support group of people who can understand what you’re going through. Anchored Tides Recovery is a place for women to heal. An all-female staff and all-female client base provide a comfortable environment for growth.

We work with all types of eating disorders and substance abuse. Our team will help you achieve your long-term goals, whether that is related to drug abuse, or you just want to change your relationship with food, we are here for you.

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