A possible explanation for these differences is that health practitioners base their knowledge on their experience with many clients, and therefore generate and rate statements based on the average person (seeing ‘the bigger picture’). The persons who regained weight may have generated and rated statements based on their own experiences, leaving more room for diversity. This emphasizes the importance of including multiple stakeholders to gather diverse views and form a more complete picture. Furthermore, results show that both stakeholder groups predominantly rate individual factors as most important perceived predictors of relapse. However, previous research indicates that environmental factors, such as a tempting environment, also influence relapse (Roordink et al., 2021). It is possible that individuals do not know or like to admit they are being influenced by their social or physical environment.

Planning coping responses to anticipated, personal, high-risk situations helps an individual to cope with difficult situations, such as negative emotions or being tempted by their social or physical environment (Sniehotta, Schwarzer, Scholz, & Schüz, 2005). Coping planning has been shown to be an efficacious technique to promote health behavior change, especially when individuals receive support when forming coping plans (Kwasnicka, Presseau, White, & Sniehotta, 2013). Therefore, we advise health practitioners to support their clients by helping them to identify personal risk situations and formulating corresponding coping plans. There are several limitations of the current study that could be altered in future study of this treatment. First, the present study examined the initial feasibility and acceptability of acceptance-based strategies in participants who had already completed Phase I of the study; it is possible that the positive reactions to Phase II could be in part due to practice effects.

An ecological momentary assessment of relapse crises in dieting

So, while learning which foods and workouts work for you is important, understanding a few different behavioral science principles can help you tackle your weight-loss goals and the obstacles keeping you from hitting them. By the end of treatment, most gamblers will have experienced a prolonged abstinence from gambling. Marlatt & Gordon’s (1985) approach to relapse prevention with alcoholics provides a very useful framework within which to prevent relapse with gamblers (for a full discussion see Marlatt & Gordon, 1985).The most important aspect of this is to have gamblers understand that a lapse is not equivalent to a relapse. This realisation reduces the abstinence violation effect and ensures that patients no longer adhere to the “one drink, one drunk” mentality which leaves them at risk for relapse. If an individual uses a substance after experiencing a remission, he/she may be vulnerable to the abstinence violation effect (AVE), which refers to an individual’s response to the recognition that he/she has broken a self-imposed rule by engaging in substance use or other unwanted behavior.

So, if you want to stop off at the gym after work several days a week, leave some spare workout clothes in the car so you don’t have to remember to bring them on the right day. If your desk is so cluttered you can’t find your bills, never mind creating a budget; spend some time getting organized so that the mess doesn’t become a barrier to managing your finances. If you can never remember whether you took your vitamins, count them into a pill container every Sunday, so you have a way to keep track. The use of such situational inducements can make a big difference in your ability to follow through on a resolution. Rachel was a 40-year-old Hispanic single woman who was employed full-time and lived with a roommate.

Outcome and methodological considerations in behavioral treatment of obesity

Rachel was successful in gradually reducing calories over time and meeting her calorie and physical activity goals. Her binge episodes decreased to zero after the first session, and remained at zero for the remainder of the treatment. Midway through treatment, Rachel reported more frequent overeating episodes (but not loss of control) due to an increase in stress and greater presence of tempting, palatable foods in her home. Strategies for coping with negative emotions and urge surfing were presented, which Rachel was able to successful practice outside of session.

This work was supported by NIH R03DK and training grants from the National Heart, Lung, and Blood Institute (T32HL076134) and the National Institute on Minority Health and Health Disparities (K23MD015092). The aforementioned institutes had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. If they responded yes, they were asked about the most proximal episode “While you were eating, to what extent did you feel that you overate?

A naturalistic investigation of eating behavior in bulimia nervosa

These alcohol-related cognitions are placed in the relapse prevention model within the overlap of the tonic stable processes and the phasic fluid responses. As such, these cognitive constructs have both a stable and enduring effect emanating from the individual’s general cognitive beliefs as well as a malleable and plastic effect emanating from upon the individual’s moment-to-moment abstinence violation effect experiences. Marlatt’s cognitive-behavioral model of relapse has been an influential theory of relapse to addictive behaviors. The model defines the relapse process as a progression centered on “triggering” events, both internal and external, that can leave an individual in high-risk situations and the individual’s ability to respond to these situations.

• As of yet, current literature still lacks an in-depth understanding of key stakeholders’ personal perspectives on relapse after weight loss.
• A longer treatment protocol would allow for additional incorporation of strategies to address comorbidities common in individuals with BE.
• By the end of Phase I, Anna’s BMI was 30.7 and she reported 2 binge episodes over the past month.
• However, previous research indicates that environmental factors, such as a tempting environment, also influence relapse (Roordink et al., 2021).

In this process, after experiencing a trigger, an individual will make a series of choices and thoughts that will lead to being placed in a high-risk situation or not. There are two major types of high-risk situations, those with intrapersonal determinants, in which the person’s response is physical or psychological in nature, and interpersonal determinants, those that are influenced by other individuals or social networks. When abstinence is violated, individuals typically also have an emotional response consisting of guilt, shame, hopelessness, loss of control, and/or a sense of failure; they may use drugs or alcohol in an attempt to cope with the negative feelings that resulted from their abstinence violation.

The abstinence violation effect and very low calorie diet success

Marlatt and Gordon postulate that newly abstinent patients experience a sense of perceived control up to the point at which they encounter a high-risk situation, which most commonly entails a negative emotional state, an interpersonal conflict, or an experience of social pressure. If individuals cope effectively in the high-risk situation, perceived control and self-efficacy increase, which in turn makes the probability of relapse decrease. Conversely, the hypothesized result of a failure to cope with a high-risk situation is a decrease in a sense of self-efficacy, which in turn increases the probability of relapse. Each experience of successful or unsuccessful coping with a high-risk situation builds up a greater or lesser sense of self-efficacy, which determines the future risk of relapse in similar circumstances. Marlatt and Gordon (1985) contend that individuals’ reactions to the initial slip and their attributions regarding the cause of the slip are the determining factors in the escalation of a lapse or setback into a full-blown relapse. The transition from slip or lapse to relapse involves the “abstinence violation effect,” which results from a state of cognitive dissonance regarding the nonabstinent behavior and the individual’s image of being abstinent.

• These alcohol-related cognitions are placed in the relapse prevention model within the overlap of the tonic stable processes and the phasic fluid responses.
• Julie had a history of repeated dieting attempts, including following commercial weight loss programs and vegan eating.
• However, weight loss is, on average, modest (Wonderlich, Gordon, Mitchell, Crosby, & Engel, 2009).
• Anna endorsed symptoms of anxiety and depression but indicated these were secondary to her eating and weight difficulties and current life stressors.
• Current gold-standard treatment for BED (i.e., CBT) does not produce meaningful weight loss, thus failing to address a critical treatment target.
• Upon initiating treatment, Rachel ate regular meals, and did not often skip meals or engage in strict dietary restriction.

She reported drinking alcohol socially on weekends, and did not report any other substance use. Overall, Rachel did not meet diagnostic criteria for a depressive or anxiety disorder, and had no history of other psychiatric diagnoses. A specific process has been described regarding attributions that follow relapse after an extended period of abstinence or moderation. The abstinence violation effect can be defined as a tendency to continue to engage in a prohibited behavior following the violation of a personal goal to abstain.