Is There A Link Between OCD And Eating Disorders?

Obsessive-compulsive disorder (OCD) and eating disorders often appear together, complicating diagnosis and treatment. Individuals with OCD may develop specific rituals around food, which may lead to or worsen eating disorders. For example, someone with anorexia might obsessively count calories or exercise excessively, behaviors also seen in OCD. The overlapping signs of these disorders can make seeking appropriate treatment a priority. 

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder is a mental health condition characterized by unwanted, intrusive thoughts, also known as obsessions. These obsessions are often linked to repetitive behaviors, known as compulsions, which are done to reduce anxiety or prevent a feared event.

OCD was previously classified under anxiety disorders but now stands as its own category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), alongside conditions like body dysmorphic disorder. This change from the anxiety disorder category to its own unique focus highlights that OCD involves elements beyond anxiety, like specific patterns of thought and behavior.

Symptoms of obsessive-compulsive disorder (OCD) 

The symptoms of OCD include the following: 

• Obsessions: Obsessions are persistent, unwanted thoughts, urges, or images. Common obsessions include fears about contamination, harm, or a lack of symmetry. 
• Compulsions: Compulsions are repetitive behaviors or mental acts that a person is driven to perform. Examples include excessive cleaning, checking, or counting.

People with OCD may struggle with daily routines. The compulsions can take up a significant amount of time, interfering with personal, social, and academic life.

The connection between OCD and eating disorders

People with OCD typically experience repetitive thoughts and compulsive behaviors that can also be seen in eating disorders. In some cases, overlapping symptoms of OCD and eating disorders may affect how treatment is personalized. 

Research findings on the link between OCD and eating disorders

Studies show a strong connection between eating disorders and OCD. For instance, up to 44% of individuals with anorexia nervosa may also have OCD symptoms. This high rate indicates that eating disorders and OCD often occur together and share similar traits.

There's a strong link between anorexia nervosa and OCD. Research shows that many of the genetic factors for these conditions are shared. If a person has genes that make them more likely to have OCD, they are also more likely to have anorexia nervosa, and vice versa.

In addition, research has found that people with OCD and eating disorders use more glucose (a type of sugar) in their brains. Therefore, the brains of people with OCD and eating disorders might work in similar ways. Activities like frequent hand washing or strict food rules could also come from similar brain patterns.

Shared traits: Obsessions, compulsions, and eating behaviors

People with eating disorders may have obsessive thoughts about food intake, body weight, and body image, similar to OCD obsessions. Repetitive behaviors in OCD, like checking and washing, may mirror the ritualistic behaviors seen in anorexia nervosa and bulimia nervosa. For example, someone with anorexia may obsessively count calories, similar to how someone with OCD might check their locks multiple times. Both disorders involve behaviors that reduce anxiety but can become highly disruptive.

OCD symptoms and eating disorders may feed into each other, creating a difficult cycle to break. You may see compulsive behaviors related to eating and body image, further linking the two conditions.

Co-occurrence of OCD and eating disorders

The high rate of co-occurrence between OCD and eating disorders shows the deep relationship between these conditions. Some may find recognizing the prevalence of co-occurrence between these two conditions helpful in better addressing them.

Prevalence rates of co-occurring conditions

One study evaluated how often people with eating disorders also have OCD. Researchers found that around 18% of individuals with eating disorders had OCD at some point in their lives. Additionally, ongoing OCD was more common in those with anorexia (14%) than those with bulimia nervosa (9%). With up to around 18% of people with eating disorders also having OCD, individuals with eating disorders may be around eight times more likely to have OCD than the general population, where the prevalence is around 2%.

The challenges in diagnosing OCD and an eating disorder

Diagnosing OCD alongside an eating disorder may present different challenges. Both conditions may share symptoms, making it difficult to distinguish between them. Another challenge arises from the overlap in behavioral patterns. Individuals with OCD may have ritualistic eating behaviors similar to those seen in eating disorders. They might eat foods in a specific order or with certain textures or ingredients.

Healthcare professionals gather a detailed history and use specific guidelines to accurately identify an eating disorder. Individuals may be asked to pay close attention to the exact nature and frequency of symptoms. Some providers might ask them to keep a diary about their habits and behaviors. 

How OCD and co-occurring eating disorders are managed

Successfully managing OCD and eating disorders may involve different methods. OCD and eating disorder treatment plans often include therapy, support groups, and self-care practices.

Therapy

Mental health professionals often use cognitive-behavioral therapy (CBT) to treat OCD and eating disorders. This type of therapy focuses on changing negative thought patterns and behaviors. 

Exposure and response prevention (ERP), a type of CBT, may help patients face fears that may be causing certain eating behaviors to arise at certain moments. Another approach is dialectical behavior therapy (DBT), which may help patients manage emotions and practice mindfulness. Therapy sessions can be individual or group-based. 

Medication management

Medication may help individuals manage the symptoms of OCD and some eating disorders. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for OCD. In some cases, doctors might prescribe antidepressants or anti-anxiety medications for people with co-occurring eating disorders and depression or anxiety. Specific medications are also sometimes prescribed to treat bulimia, binge eating disorder, and other eating disorders. These medications are sometimes used alongside therapy to provide better outcomes in some eating disorders. However, the effectiveness and benefits of the intervention are analyzed by a doctor on a case-by-case basis. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Nutritional counseling for an eating disorder 

Nutritional counseling may be a part of treatment plans for eating disorders, especially when they co-occur with OCD. Dietitians can work with patients to develop balanced eating habits and improve their relationship with food. Individualized meal plans may help ensure individuals get the nutrients they need. In addition, nutritional counseling may help clients identify misconceptions about food and body image. Nutritional goals recommended by a provider are often realistic and sustainable, allowing for long-term recovery and stability.

Support groups for obsessive-compulsive disorder and eating disorders

Support groups may provide a sense of community for individuals struggling with OCD and eating disorders. These groups may be led by mental health professionals or peer-led and participants cay learn helpful coping strategies in a group setting where others face similar challenges. Online support groups may also be available, providing flexibility for those who cannot attend in person.

Self-care practices

Mental health providers often recommend self-care practices for managing OCD and co-occurring eating disorders at home. Regular exercise (within moderation), mindfulness, and stress reduction techniques may help people manage symptoms. In addition, individuals may find that certain activities, such as journaling, meditating, or taking a walk, help them manage symptoms of OCD and eating disorders. Individuals can work with a therapist to devise a consistent routine that includes balanced meals, sleep, and relaxation. 

When to seek help for OCD and an eating disorder

Recognizing when to seek help for OCD and an eating disorder may be difficult for some. However, when obsessions and compulsions interfere with daily life or thoughts about food, body image, or rituals consume a lot of time, seeking help may be advised. Sudden weight changes or extreme dieting may also signal the need for professional help. 

Physical health can quickly decline, making early intervention important. Shame, guilt, and isolation may accompany these disorders. If you experience these emotions frequently, a mental health specialist may be able to offer the support you need. People with eating disorders may also benefit from speaking to a doctor, as eating disorders often have severe health risks. 

Seeking help can involve several steps:

• Reaching out to a mental health professional who specializes in both OCD and eating disorders
• Asking a primary care physician for a referral to experts in these fields
• Talking to a doctor about your physical health 

You can also look for treatment centers or specialists. Organizations like the National Eating Disorders Association (NEDA) and Eating Recovery Center provide resources and may guide you to the right professionals.

Alternative support options 

Some people with OCD and eating disorders may find online support to be a lifeline. Online therapy platforms like BetterHelp often offer flexible scheduling and allow individuals to connect with therapists on their own time. Another potential benefit of online therapy is accessibility. This form of therapy often removes the need to travel, making it possible for individuals to find specialists even if they live in remote areas. This option may be particularly helpful for those who may not have local resources that meet their unique needs.

Research supports the effectiveness of online therapy for mental health challenges, including OCD and other obsessive-compulsive disorders. One study looked at how well online therapy works for treating OCD and body dysmorphic disorder in regular healthcare settings. Researchers found that 49% of people with OCD and 69% of those with body dysmorphic disorder got better with this treatment. Most people finished the therapy, with 87% in the OCD group and 78% in the BDD group reporting high satisfaction.

Takeaway

The connection between OCD and eating disorders is evidenced. Research shows that people with eating disorders may be much more likely to also have OCD than others. Both conditions often involve repetitive thoughts and behaviors, which may require different treatment methods, such as therapy and medication. Professional support can be life-saving and life-changing if you or someone you love is facing these challenges. Consider reaching out to a provider online or in your area to get started.