Is 'body image' the cause of a bulimia relapse?

Not only that: Many things can lead to a bulimia relapse -- there is no "the" cause. Triggers may be different for each person, and part of the work of therapy is learning about them so as to work with them when they arise in daily life. For some people, chronic anger and loneliness may be big issues. Concerns about body image may flare too. There are many more possibilities.

Bulimia Relapse: I agree with Dr. Pappas. Poor self-esteem & body image can certainly contribute to a relapse. Binge eating is usually compulsive. It can dull painful emotions. Depression, poor self –esteem, difficulty addressing one’s own emotions and lack of impulse control are often factors. The release of dopamine and serotonin when eating large amounts of sugar and fat can create a “feel good” sensation.