Is it an Eating Disorder or an Obsessive Compulsive Disorder?

Many individuals, who are diagnosed with an eating disorder such as anorexia nervosa, binge eating disorder or bulimia nervosa will often exhibit signs of obsessive-compulsive disorder as well, which is a specific type of anxiety disorder. In fact, approximately 40% of individuals with an eating disorder are diagnosed with obsessive-compulsive disorder and two-thirds of individuals with eating disorders have a previous history of at least one anxiety disorder. Obsessive-compulsive disorder and eating disorders often co-occur together because they both exhibit a need to perform compulsive ritualistic behaviors in order to attempt to remove the anxiety provoking thoughts that precede these behaviors. Whether it is self-induced vomiting to rid the body of calories in the case of anorexia nervosa or constantly checking whether the stove is switched on in the case of obsessive-compulsive disorder, these behaviors exert a need for control in order to reduce the severe underlying anxiety.

OCD

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by intrusive unwanted thoughts known as obsessions that are relieved through repetitive acts known as compulsions. This relatively common disorder results in significant distress and impairment in one’s social, personal and professional life and is known as ego-dystonic meaning the individual realizes these thoughts are abnormal and unpleasant. Fear of contamination followed by ritualistic cleaning, need for symmetry and order followed by organizing, and concerns about losing something valuable followed by hoarding are common obsessive thoughts and compulsive actions that occur with OCD. An individual with OCD might perform a ritual by chewing their food for a pre-meditated number of times that feels “just right” before swallowing. Similarly, a person with anorexia may count bites or pieces of food eaten in a sitting as a means of restricting or limiting portions in order to reduce caloric intake.  In both of these cases, rituals are developed to reduce the anxiety caused by a triggering obsession, such as fear of eating or weight gain.

Obsessive ThoughtsCompulsive Actions
Fear of contaminationChecking
Need for symmetry and orderCounting
Sexual thoughtsCleaning
Aggressive thoughtsPraying
Feelings of doubts associated with leaving the stove on or doors unlockedRearranging, balancing and ordering
Concerns about losing something or throwing away something valuableAsking for reassurance
Fears about having a disease or medical illnessHoarding
Fears about practicing sinful behaviorBinge eating