Exploring The Link Between Eating Disorders And Mental Illness

Eating disorders and mental illness can be deeply intertwined, with research increasingly highlighting the complex relationship between the two. As the prevalence of eating disorders rises, so does the understanding that these disorders are often accompanied by other mental health conditions. This connection can be crucial to understanding the full scope and impact these disorders can have on an individual’s life. Those living with disordered eating habits and other mental health challenges can often benefit from working with a licensed mental health professional throughout their recovery journeys.

Understanding eating disorders

Eating disorders are serious mental health conditions that can have life-threatening consequences. However, they are often misinterpreted as being centered solely on food and diet. 

While individuals living with eating disorders may fixate on weight loss, food, and diet, these are often symptoms of a more serious underlying condition. These disorders usually involve extreme emotions, attitudes, and behaviors surrounding weight and food. In some cases, symptoms of eating disorders and other mental health disorders, such as depression, anxiety, or obsessive-compulsive disorder (OCD), occur simultaneously.

Anorexia nervosa

Anorexia nervosa is perhaps the most well-known eating disorder, typically characterized by an intense fear of gaining weight and a distorted body image. Individuals with this disorder often perceive themselves as overweight, even when they are dangerously underweight. 

Those with anorexia usually engage in severe food restriction, excessive exercise, and other behaviors aimed at weight loss. Anorexia nervosa can be particularly dangerous due to its high mortality rate, driven by complications like heart failure, multiorgan failure, and suicide. The condition also often co-occurs with other mental disorders, such as depression and anxiety, which can exacerbate its severity.

Bulimia nervosa

Bulimia nervosa is usually characterized by cycles of binge eating followed by purging. Individuals with bulimia nervosa may maintain what is categorized by doctors as a “normal” weight, which can make the disorder less obvious to others. 

However, the physical consequences of bulimia can be severe. Repeated vomiting can lead to esophageal damage, dental erosion, and electrolyte imbalances, which can be life-threatening. The psychological toll of bulimia can be equally significant, with many individuals experiencing deep shame, guilt, and low self-esteem, often co-occurring with anxiety and depression.

Binge eating disorder (BED)

Binge eating disorder (BED) is reported to be the most common eating disorder in the United States. It is usually characterized by episodes of consuming large amounts of food in a short period, accompanied by a sense of loss of control. 

Unlike bulimia, individuals with BED do not typically engage in purging behaviors. This disorder often leads to obesity and related health problems, such as diabetes and heart disease. The emotional distress associated with binge eating, including feelings of guilt and shame, can also contribute to the development of other mental health concerns, particularly depression.

Avoidant/restrictive food intake disorder (ARFID)

Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnosis, but it can be just as serious as other eating disorders. Unlike anorexia and bulimia, ARFID is not normally driven by a fear of gaining weight. 

Instead, individuals with ARFID tend to have an extreme aversion to certain foods, often due to sensory sensitivities or fear of choking. This can lead to significant nutritional deficiencies, especially in children, potentially affecting their growth, development, and overall health. ARFID can persist into adulthood, where it often continues to impact mental and physical health.

What are co-occurring conditions?

What conditions can co-occur with anorexia nervosa, bulimia nervosa, and other eating disorders?

Several systematic reviews have studied the association between eating disorders and other mental health conditions, revealing critical insights into how these mental health concerns can intertwine.

Research frequently suggests that individuals with eating disorders are at an increased risk of experiencing multiple mental health conditions simultaneously. Research shows that an estimated 55% to 97% of people diagnosed with an eating disorder also receive a diagnosis for at least one additional psychiatric disorder. 

These co-occurring conditions most commonly include disorders like depression, anxiety disorders, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). 

Understanding the timeline and progression of these co-occurring conditions can be crucial for effective treatment and prognosis. For instance, depression and anxiety are often both consequences and contributing factors to the development and persistence of eating disorders. 

The prevalence of co-occurring conditions in individuals with eating disorders can emphasize the importance of a comprehensive approach to treatment. Without addressing the full spectrum of psychiatric and medical conditions that often accompany eating disorders, recovery can be incomplete or short-lived. 

Identifying the symptoms of common mental health conditions 

Identifying the symptoms of eating disorders and their co-occurring conditions can be essential for early intervention. Below, find brief overviews of several common conditions that can occur alongside eating disorders.

Depression

Depression often involves a persistent feeling of sadness and a loss of interest in previously enjoyed activities. Additional symptoms can include fatigue, a sense of worthlessness and guilt, and changes in appetite and sleep.

Anxiety

Anxiety disorders usually involve excessive worry, restlessness, difficulty concentrating, irritability, and sleep disturbances.

Obsessive-compulsive disorder (OCD)

OCD symptoms can include obsessions (intrusive, unwanted thoughts) and associated compulsions (repetitive behaviors or rituals to relieve the anxiety accompanying obsessions). These obsessions and compulsions may revolve around a variety of themes, such as a need for symmetry and order or a fear of contamination.

Attention-deficit/hyperactivity disorder (ADHD)

ADHD may involve a combination of inattentiveness, impulsivity, hyperactivity, and disorganization.

Bipolar disorder

Bipolar is categorized as a mood disorder and usually consists of shifts between depression and mania or hypomania. Individuals may experience low energy and a sense of hopelessness during depressive episodes and impulsive behavior during manic episodes.

Borderline personality disorder (BPD)

BPD is usually characterized by an unstable sense of self, intense emotions, impulsive behavior, and a fear of abandonment, all of which can contribute to relationship challenges.

The importance of a healthy relationship with food, weight, and eating habits

A healthy relationship with food, body weight, and eating habits can be crucial for overall well-being. In today's society, where unrealistic body standards and dieting trends can be prevalent, it's often easy to fall into unhealthy patterns. 

The development of eating disorders often stems from pervasive, unhealthy attitudes toward food and weight. Encouraging balanced, nutritious eating habits can help prevent the development of eating disorders and promote better mental health. A positive relationship with food and body weight can serve as a cornerstone of physical and mental health.

Treatment options for co-occurring disorders

Treatment for eating disorders and co-occurring mental health conditions often involves a combination of therapy, medication, and nutritional counseling. 

Cognitive behavioral therapy (CBT) is commonly used to address the harmful thought patterns that can contribute to disordered eating habits. Medications may be prescribed by a doctor or psychiatrist to manage symptoms of depression, anxiety, or other co-occurring conditions. 

Additionally, nutritional counseling can help individuals develop healthy eating habits and restore their physical health. In some cases, inpatient or residential treatment may be necessary, particularly if the physical impacts of the eating disorder are severe or life-threatening.

How therapy can help

Therapy often plays a crucial role in the treatment of eating disorders and co-occurring conditions. Through therapy, individuals can explore the underlying challenges that may contribute to disordered eating, such as trauma, low self-esteem, and a need for control. 

Therapists typically work with individuals to develop healthier coping mechanisms and build more positive relationships with food and their bodies. Family therapy can also be beneficial, particularly for adolescents with eating disorders, as it usually involves loved ones in the treatment process. Family therapy can help family members provide effective support and address any family dynamics that may have contributed to the development of eating disorder symptoms.

The benefits of online therapy

Online therapy has become an increasingly popular option for those seeking help with eating disorders and other mental health conditions. Along with being equally effective as in-person sessions, particularly for conditions that commonly co-occur with eating disorders, like depression and anxiety, it can offer the flexibility to receive treatment from any location with an internet connection. 

Online therapy can also provide individuals with access to a broader range of specialists, allowing them to connect with mental health professionals who have experience treating eating disorders. This mode of therapy can be a valuable resource for ongoing support and may complement other forms of treatment.