Eating Disorders and Obsessive-Compulsive Disorder

There is a markedly elevated risk for Obsessive Compulsive Disorder among those with eating disorders, according to the National Eating Disorder Association.

If you are someone who struggles with multiple disorders, you are not alone and professional treatment options will help you manage the symptoms.

According to the National Eating Disorder Association, 69% of patients with anorexia and 33% of patients with bulimia suffer from OCD. This is compared to 1.2% of the overall US population and 2% worldwide according to the National Institute of Health.

OCD is a serious disorder which negatively impacts the day-to-day life of those who suffer with it. The unreasonable obsessive thoughts and resulting compulsive behaviors are not easily dismissed for fear of the result. The persistent intrusiveness creates mental and physical distress.

OCD obsessions and compulsions can generally be categorized into dimensions. The thoughts and behaviors are uniquely exemplified in individuals with eating disorders compared to those without.

Contamination:

One becomes obsessed with germs and toxins and can result in excessive food and hand washing, changing clothes often, and creating “clean zones” in their environment. The fear of illness from germs overrides all thoughts of normal exposure and cleanliness. OCD creates a deep overriding fear that without the compulsive behaviors the individual will risk severe consequences. Individuals with ED can develop fear of contaminated foods. The current rise and misinterpretation of “clean” eating and organic foods is causing an increased number of fear foods.

Perfection:

The obsession with symmetry and exactness resulting in extreme organization, arranging, or counting may force the person to stop eating in public. Individuals unrealistically fear the consequences of not executing a counting ritual or things being out of order. They will move their silverware or drinking glass to a certain location, count or lift them a certain number of times. They may only eat at specific times or locations. These result in social isolation and negatively impacts personal relationships.

Checking and Rechecking:

Individuals who experience obsessive thoughts over accidental self-harm or harm to others through negligence or inaction will compulsively check and recheck light switches, door locks, electronics, candles, etc. They experience extreme difficulty in leaving their home and staying away for fear of what they may have forgotten. The rechecks may require a specific pattern or counting ritual (three rounds of checking the stove followed by four rounds of locking and unlocking the entry door). Their daily lives are dictated by constantly reviewing what they have previously done to safeguard them from responsibility of causing harm.

Dysorexia is the pattern of disordered eating closely related to OCD. Individuals develop extreme selectivity in their eating, slowly removing foods with certain textures or colors. They may begin food hoarding as a comfort mechanism to assure the “safe” foods are available.

Orthorexia is a disordered eating pattern which also falls into the realm of OCD. Individuals are obsessively compelled to eat only “clean”, pure, non-toxic foods and ingredients. Their behaviors become more restrictive as the illness progresses and oftentimes is combined with excessive exercise.

Successful treatment for eating disorders with co-occurring OCD is individualized and may include medication or specific brain treatments. Exposure Response Therapy is the most successful form of Cognitive Behavioral Therapy (CBT) for individuals with ED and OCD. Clients and coaches work through facing fear foods and situations until the individual has successfully rewired negative thought patterns and gained confidence in understanding that the perceived consequences are no longer a threat.

Managing eating disorders along with OCD and general anxiety disorders is frustrating and can lead to a serious cycle of unhealthy negativity. Early intervention is best along with continued mindfulness and recovery care.

Recovery is possible.