Patient Resistance in Eating Disorders

Patients with eating disorders are notoriously difficult to treat and are also known to have high relapse rates. Resistance in eating disorders is common and can help explain why treatments often fail and why patients drop out. In general, resistance can refer to the conscious and unconscious factors that prevent a patient from engaging fully in the treatment process. Importantly, patient resistance is not uniform across the different eating disorder diagnoses, and how it is addressed also depends on the age of the individual.

Why patients with eating disorders resist treatment

Safety behaviors. Patients with eating disorders are typically terrified of weight gain and will go to great lengths to avoid this outcome. To decrease anxiety about weight gain, patients sometimes adopt behaviors that they believe will “protect” them from gaining weight—eg, scrutinizing body parts, daily weighing, following strict rules about when and how much to eat, and overexercising. Patients become highly invested in these safety behaviors, which results in decreased willingness to change them and increases therapeutic resistance.

Patients with eating disorders are notoriously difficult to treat and are also known to have high relapse rates. Resistance in eating disorders is common and can help explain why treatments often fail and why patients drop out. In general, resistance can refer to the conscious and unconscious factors that prevent a patient from engaging fully in the treatment process. Importantly, patient resistance is not uniform across the different eating disorder diagnoses, and how it is addressed also depends on the age of the individual.