Obsessive-compulsive disorder can be defined as a mental health condition that
involves unwanted thoughts (intrusive thoughts, obsessions) and repetitive physical behaviors
or mental acts (compulsions). For people who suffer from OCD, engaging in obsessions and
compulsions can temporarily ease distress and ‘prevent’ an unwanted outcome. OCD can often
co-occur with other mental illnesses such as anxiety, depression, trauma, and eating disorders.
What is an Eating Disorder?
Eating disorders are a persistent disturbance of eating and eating-related behaviors that result
in altered consumption or absorption of food and significantly impair physical health or
psychosocial functioning. There are multiple types of eating disorders, such as Anorexia
Nervosa, Bulimia, Orthorexia, and ARFID. Eating Disorders can look different for everyone. They can
involve cycles of bingeing and restricting, avoiding certain foods, overconsumption,
underconsumption, and excessive exercise.
How are Eating Disorders and OCD Connected?
Eating Disorders and OCD can become difficult to distinguish because they can have very similar
behaviors. Following strict ‘rules’ surrounding food, avoiding certain foods, engaging in extreme
exercise, and adhering to routines can look like OCD and an eating disorder. A person might
experience extreme distress if they are unable to engage in their desired behaviors.
The behaviors may look similar, but underneath they are being driven by two very different
motivations. Both disorders often operate as attempts to manage uncomfortable emotions or
uncertainty.
People with OCD may be engaging in obsessions and compulsions to prevent a dreaded
outcome, solve unpredictability, or ease distress due to uncertainty. A person with an eating
disorder can create rules and rituals as a means of establishing control, reduce anxiety, and gain
predictability. In both instances, the temporary relief from engaging in compulsions or following
a food ‘rule’ can continuously reinforce the cycles for the person. Both experiences can be
similar in that a person will experience anxiety, engage in the ritual or compulsion, feel the
relief, and then continuously repeat the cycle the next time distress or uncertainty arises.
When Food Becomes the Theme of the Compulsion:
Food can often become the center of engaging in obsessions and compulsions if someone is
experiencing an overlap in disorders. For example, a person might develop food-related
behaviors and rituals, and then become preoccupied with upholding those behaviors and rituals
to avoid feeling distress. A person could also become concerned with food in its entirety, feeling
distress if it is not washed properly, cooked properly, or deemed ‘safe’ to eat. This can result in
potential avoidance of the food or ritualistic compulsions to ease the distress associated with
the perceived threat.
When an Eating Disorder Becomes Compulsive:
People with eating disorders can develop highly repetitive patterns surrounding food. This
could include the person excessively weighing themselves, following strict food rules, or
practicing repetitive exercise. These ‘rituals’ could appear similar to compulsions. However, it is
important to note the difference between the two to help manage the function of the behaviors.
What Happens When OCD and Eating Disorders Co-Occur:
When someone is experiencing both an eating disorder and OCD, it can be extremely difficult to
determine what is related to which disorder. It is important to seek professional assessment to
help treat the behaviors as a whole and to help the person determine what is driving their
behaviors. Effective treatment depends on being able to understand the thoughts, fears, and
emotional patterns of both the person’s OCD and Eating Disorder.
Treatment and Recovery for Co-Occurring OCD and Eating Disorders:
Having both an eating disorder and OCD can feel entirely overwhelming and impossible to
manage because the symptoms of the conditions are constantly reinforcing each other. However,
recovery is possible. If food-driven rituals, rules, intrusive thoughts, and ritualistic exercise is
impacting someone’s life, it is important to seek help. Early support and intervention can help
treat both conditions without overlooking the distressing functions of both.
Theory & Method Therapy offers OCD therapy in Salt Lake City, UT, and Reno, NV. Schedule a free consultation at theoryandmethod.co.