The relationship between eating disorders and obsessive-compulsive disorder has been a topic of speculation within psychology for nearly a century. Though the two types of disorders may not seem entirely alike, the list of similar behaviors, thought processes, and personality traits that individuals with eating disorders and OCD possess are prolific.

By: Samreen Khan

What is OCD?

Repetitive, uncontrollable thoughts and behaviors characterize obsessive-compulsive disorder. It can manifest in many ways; while the stereotype of a person with OCD is often perceived as a “perfectionist” or a “neat freak,” OCD is nowhere near as simple as that. 

While obsessions and compulsions regarding cleanliness are common, there is much more nuance to these habits and thoughts. Individuals with OCD struggle to go about their day without completing certain rituals. These rituals, or compulsions, are generally implemented to cope with persistent intrusive thoughts.

Obsessions revolving around numbers are some of the most common. Certain behaviors may have to be carried out a specific number of times or at a particular time of day to quiet anxious thoughts. Comparably, individuals with eating disorders are also preoccupied with numbers and counting– when these disorders coincide, these behaviors can overlap.

The Connection between OCD and Eating Disorders 

Similarities between OCD and eating disorders were first formally recognized in a study conducted in 1939. The study’s authors, Palmer and Jones, noted that individuals who struggled with both types of disorders exhibited high levels of perfectionism and neuroticism¹. Control plays an influential role in both OCD and eating disorders. In both cases, individuals experience distressing thoughts regularly and then compulsively engage in behaviors to alleviate the anxiety that these thoughts cause.

What is the Overlap Between Eating Disorders and OCD? 

Due to the similarities between eating disorders and OCD, it is not unusual for an individual to struggle with both mental illnesses simultaneously. The comorbidity rate is almost 40% for individuals who struggle with both illnesses for their entire lifetime². Body dysmorphic disorder, which frequently co-occurs with several types of eating disorders, also falls under the classification of “obsessive-compulsive and related disorders” in the DSM-5. Behaviors related to BDD, such as body checking and over-exercising, can often result from eating disorder thoughts and compulsions as responses to obsessions.

ARFID and OCD

Eating disorders such as ARFID (avoidant-restrictive food intake disorder), where the individual is highly selective about the foods they eat, can also be closely tied to recurrent obsessions regarding the safety of certain foods. For example, a fear of choking can prevent someone with ARFID from eating most foods, and this aversion could stem from intrusive thoughts caused by OCD.

Is There a Related Cause Between OCD and Eating Disorders? 

It’s no surprise, then, that causes of OCD and eating disorders in individuals are often analogous to each other. Both disorders are commonly triggered by a lack of control in one’s life; any chain of events leading to turbulent emotions can water the seed within one’s mind and cultivate those thoughts. Patients with OCD and eating disorders often report traumatic events that elevate anxiety levels and create an imbalance within the brain, kickstarting the associated destructive behaviors. Both disorders are also observed to have some genetic influence, as the development of OCD and eating disorders are typically not unique in families.

Because of how closely entwined the two types of disorders are, it is unwise to attempt to treat one while ignoring the other when someone has both. Exposure and response prevention, colloquially known as exposure therapy, is an effective technique that allows patients to resist their compulsions and discover different methods of coping with distress. In eating disorder recovery, an example would be exposing a patient to fear foods and encouraging them to gradually overcome the anxiety surrounding that food by eating it and not engaging in disordered behaviors to compensate. Confronting a patient’s OCD and eating disorder can help them gain a new perspective on how they perceive their disordered thoughts and facilitate their recovery journey.

At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained in diagnosing and treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. In addition to our full-time Day Treatment Program and Weeknight Intensive Outpatient Program, we offer high-quality programming, nutrition counseling with a licensed dietitian, meal support, and various other groups and resources to help those seeking help for food concerns.

BALANCE also now offers exclusive insurance trials in its virtual track. With our insurance trials, eligible participants get access to treatment right away, comprehensive payment options, and our team’s support in navigating your coverage. Your insurance could cover up to 80% of your allowed amount up front, reducing the cost of your treatment, and allowing you to pay the remaining balance through a payment plan, after an initial deposit. Reach out here to see if you qualify.

Looking for eating disorder treatment programs or services in the New York City area? Learn more about our options at BALANCE eating disorder treatment center™ here or contact us here.

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This post was written by BALANCE Blog Contributor, Samreen Khan (she/her/he/him). 

Samreen is a high school graduate with an ardent drive to de-stigmatize mental illness and eating disorders. Born and raised in the Bay Area, she experienced the harmful effects of “fitspo” culture firsthand for most of her childhood. Throughout her own recovery journey, she became passionate about deconstructing diet culture and raising awareness about eating disorders in her everyday life. Samreen began extending her own ideology of intuitive eating and body neutrality to others by publishing her own writing online when she was fourteen, and has since received several awards for her prose and poetry. She has conducted research on the biological and evolutionary implications of familial mental illness, and is currently taking college-level Sociology and Psychology courses with hopes to delve further into the social and cultural constructs that bolster disordered eating, especially within marginalized communities. She’s grateful for the opportunity to combine two of her strongest passions — writing and mental health — by working with BALANCE!

References

1. Pollack, Lauren O., and Kelsie T. Forbush. “Why Do Eating Disorders and Obsessive–Compulsive Disorder Co-Occur?” Eating Behaviors, vol. 14, no. 2, 2013, pp. 211–215. PubMed, https://doi.org/10.1016/j.eatbeh.2013.01.004. Accessed 17 Sept. 2022.

2. Mandelli, Laura, et al. “Rates of Comorbid Obsessive-Compulsive Disorder in Eating Disorders: A Meta-Analysis of the Literature.” Journal of Affective Disorders, vol. 277, 8 Sept. 2020, pp. 927–939. National Library of Medicine, https://doi.org/10.1016/j.jad.2020.09.003. Accessed 17 Sept. 2022.