Page 185 - Nutrition Counseling and Education Skills: A Guide for Professionals

Relapse Prevention

I ate the whole thing!

G. Alan Marlatt and others developed a model of the relapse process originally for addictive behaviors.25,26 A
relapse can be defined as a complex, multi-determined process that may be considered as an individual’s
response to a series of lapses, a loss of control over food and health choices, and a return to a previous problem
eating behaviors.25 Relapse is high in obesity interventions involving weight and behavior change.27 The major
goal in counseling is to provide the skills to prevent a complete relapse, regardless of the situation or
impending risk factors.25 Relapse prevention (RP) includes both behavioral and cognitive components.28

Behaviors may be seen as overlearned habits that can be analyzed and modified. The eating behavior of
individuals with anorexia nervosa, bulimia, and obesity, for example, may be viewed as maladaptive habit
patterns with maladaptive coping mechanisms.29 These behaviors are generally followed by some sort of
immediate gratification, such as feelings of pleasure or the reduction of anxiety, tension, boredom, or
loneliness. When eating takes place prior to or during stressful or unpleasant situations, it represents a
maladaptive coping mechanism.

A Relapse Model

The model of relapse is based on the assumption that relapse events are preceded by a high-risk situations.28
An individual’s control continues until the person encounters high-risk situations, or “those that challenge the
individual’s ability to cope.”29 When faced with some situations, people tend to use maladaptive responses they
are familiar and comfortable with, such as excessive eating. See Figure 8-1 for a modification of Marlatt’s
Model of Relapse adapted for food.25

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