Dealing With OCD and Anorexia: Everything You Need to Know

People with eating disorders tend to struggle with obsessive compulsive disorder (OCD) and anorexia nervosa. Both of these conditions can lead to serious consequences, if left untreated, but fortunately, there are many ways to deal with them.

Anorexia is a potentially life-threatening eating disorder characterized by an irrational fear of gaining weight, and a distorted perception of one’s own body shape or size. People with anorexia tend to see themselves as overweight, even when they are dangerously thin. They may also fixate on the number of calories in various foods, and engage in rituals surrounding eating or purging – behaviors known as compulsions.

Obsessive-compulsive disorder (OCD) is an anxiety condition that causes people to have unreasonable and uncontrollable fears and thoughts. People affected by OCD are plagued with obsessions, consisting of persistent and distressing thoughts or impulses, and/or compulsions (behaviors performed in response to the obsessions). In some cases, these rituals and routines are compulsive, hence the name – obsessive-compulsive disorder.

With this article you will learn how to deal with OCD and anorexia in a healthy way.

What is the Relationship Between OCD and Anorexia?

OCD and anorexia often go hand in hand. Studies suggest that 25-69% of OCD sufferers struggle with an eating disorder. Conversely, people with an eating disorder, like anorexia, have a higher risk of developing OCD – in comparison to those, who do not have an eating disorder. Some researchers even suggest that OCD and eating disorders are two different manifestations of the same condition.

Can OCD Make You Not Want to Eat?

Yes, it can. 

OCD-related stress, anxiety, obsessions, compulsions, worries, doubts, fears, perfectionism, and other distressing features of OCD can dramatically affect your desire to eat. 

Is Anorexia a Symptom of OCD?

Anorexia can be a symptom of OCD – or vice versa. Some mental health conditions overlap or co-exist. Anorexia and obsessive-compulsive disorder (OCD) share many similarities, and as a result, have a strong comorbidity, which means that a person can have both conditions at the same time. The most common similarities between the two conditions, when combined, include a need to be “perfect,” a need for control, intrusive thoughts, fears, and urges, and compulsive behaviors (rituals or routines).

The main differences between OCD and anorexia is that people with OCD fixate on a variety of issues, while people with anorexia tend to focus solely on food and weight. Also, people with OCD typically know that their thoughts and fears are irrational, while people with anorexia may believe their thoughts and fears are valid (when they are not).

What Causes OCD-Related Anorexia?

It is common for people with OCD-related anorexia to starve themselves, excessively exercise, take weight loss supplements, or purge as a form of punishment. These individuals become obsessed with the idea that they are too fat, or have eaten too much food, so they “punish” themselves by “eliminating the food” by any means necessary. This provides these individuals with a sense of control.

This is especially true for people, who have experience trauma (i.e., child abuse, bullying, parental or peer criticism, low self-esteem and self-confidence, feelings of inadequacy, feelings of helplessness, etc.), and feel a loss of control over their lives. Restricting their food, vomiting, exercising, or taking weight loss pills helps them regain control over their bodies and lives.

Societal pressure to live up to certain expectations, such as the ideal that to be happy and successful one must be “perfect” – i.e., skinny, beautiful, and smart. Not living up to this ideal can trigger OCD and/or anorexia in some people. These individuals become obsessed with being that skinny, beautiful, sexy, and smart person that society expects. Magazines, movies, videos, sitcoms, models, advertisements, and celebrities contribute to these ideals.

Genetics can also contribute to OCD-related anorexia. Some people are predisposed to mental health conditions, like OCD and anorexia. Studies suggest that both anorexia and OCD are linked to low levels of serotonin, the hormone/neurotransmitter responsible for mental health conditions, like OCD and anorexia. Researchers have also found that people, who are related to someone with a mental health condition, especially, OCD or anorexia, are susceptible to developing one or both conditions.

How Does OCD Manifest in People with Anorexia?

People with anorexia and OCD may fixate on the amount of food or the “heaviness” of certain foods in their stomachs. Although this can be a “normal” response to consuming food, people with OCD may interpret the amount or “heaviness” as needing to compensate for eating too much food. This, in turn, can lead to urges to compulsively exercise or “purge” (i.e., through self-induced vomiting) after each meal. The goal of this behavior is to get “back to normal.”

How Does Anorexia Manifest in People with OCD?

OCD-related anorexia is sometimes described as an obsession with being “clean” or “pure.” For instance, people, who are obsessed with being “clean” and “pure,” may view excessive exercise and calorie restrictions as a way to stay “clean” by ridding the body of “impurities,” and maintaining a healthy weight. This type of OCD-related anorexia is often accompanied by other types of obsessive thoughts, such as a fear of contamination, or a need to perform certain rituals to ward-off illnesses or harm.

What Should You Do If You Suffer from Both Conditions?

If you or a loved one is experiencing both OCD and anorexia symptoms, seek help as soon as possible. The sooner you get treatment, the better your chances are of recovering completely from both conditions. If you have recently started having symptoms, seek help right away. This is important because it could take a while to receive the right treatment. If prior OCD and anorexia treatments were ineffective, it is important to return to treatment as soon as possible.

Once you have received help for OCD and anorexia, it is important to work on maintaining your recovery. Understand that OCD and anorexia are chronic conditions that require lifelong treatment, so you will need to be aware of any OCD or anorexia symptoms. The best way to do this is to find an OCD therapist, who understands both conditions, and can help you adjust to and cope with any changes that may occur in your life.

Eight Ways to Cope With OCD-Related Anorexia

Developing healthy coping skills and strategies are essential for keeping your OCD and anorexia symptoms at bay.

Listed below are three ways you can cope with OCD and anorexia:

• Adopt a Healthy Diet

  Because anorexia often involves an obsession with calorie intake, and a fear of gaining weight, a good way to cope with OCD surrounding food is to adopt a healthy diet. More specifically, a balanced diet consisting of fresh fruits and veggies, lean protein, low-fat dairy, legumes, whole grains, and water can help your body receive important nutrients without gaining excess weight. It is important to get enough of the right calories (not “empty calories” found in sodas, high-calorie juices, chips, candy, etc.) to maintain your body temperature and keep your brain functioning properly.

• Exercise

  Exercise may be beneficial for people with OCD and anorexia, however, more research is needed to definitely determine if exercising should be added into OCD/anorexia treatment plans. Some researchers believe that exercise can help reduce obsessive thoughts and give you a “clean feeling” after a workout, if you suffer from OCD-related OCD. These individuals believe that monitored exercising can help a person with OCD and anorexia be more compliant with treatment, leading to fewer obsessive thoughts and compulsive behaviors centered on food – without sacrificing weight gain.

  However, other researchers believe that exercising while trying to recover from OCD-related anorexia could prevent the consumption of calories, delaying the restoration of one’s weight, and therefore, impeding progress. These individuals also believe that exercising could uphold or even enable the OCD aspects of anorexia (causing the sufferer to continue to be obsessed with exercising). Therefore, these researchers believe that exercising should be kept at a minimum during the OCD/anorexia recovery period.

• Challenge Your Thoughts

  It is common for people with OCD-related anorexia to have stringent thought processes. This is important because a person’s thoughts influence their behaviors, and the thoughts of people with OCD and anorexia fuel their obsessions and compulsions. Challenging these thoughts can help break free from this non-stop OCD cycle surrounding food consumption, calorie intake, weight gain, starvation, purging, and excessively exercising.

  Questioning your thoughts helps you look at your beliefs from a different perspective. So, ask yourself if there is any evidence to support your thoughts. For instance, if you become fixated on the idea that you are going to become obese, ask yourself if there is any evidence to support this belief. If not, then practice positive self-talk, like “I am a healthy weight and where I should be.” Or, “It is okay for me to eat this food because it is nutritious, and it will only help me become stronger and healthier.”

• Talk to Someone

  OCD and anorexia are very isolating conditions. Many people with these conditions try to hide them from their friends and loved ones out of shame and guilt. Sharing your concerns with someone you trust can be “freeing.” More specifically, it can provide you with the support and encouragement you need to seek and stay with treatment. A strong support system is necessary if you want to recover from OCD-related anorexia. Your support system can cheer you on and hold you accountable for your actions – or lack thereof. It can also provide you with a shoulder to lean on when things get hard.

• Give Yourself a Break

  It is common for people with OCD and anorexia to blame themselves for having these conditions, when it is not their fault. OCD and anorexia are both involuntary. No one wants to struggle with OCD or anorexia, so when the two conditions are combined it can cause even more distressing.

  Also, do not place too much pressure on yourself to quickly recover. Everyone heals differently, so give yourself time to recover in your own time. Think of recovery as a marathon – not a sprint. Be patient with yourself, and take it day-by-day. Focus on accomplishing your milestones, and making progress. Things do not have to be perfect to be successful. So, give yourself a break.

• Get Proper Sleep

  Sleep is essential for anyone, but it is especially important if you suffer from a physical or mental health condition, like OCD and anorexia. Both OCD sufferers and people with anorexia tend to struggle with insomnia. People with OCD tend to have a hard time falling and staying asleep due to racing and intrusive thoughts, while people with anorexia grapple with getting proper sleep due to their thoughts and fears of eating too much or gaining too much weight.

  Thus, people with OCD-related anorexia have a hard time getting quality sleep because of the intrusive thoughts and fears surrounding calories, food consumption, and weight gain. In other words, these individuals stay up late worrying that the food they consumed earlier will cause weight gain.

  If you are experiencing OCD-related anorexia, CBD, OTC sleeping pills, natural sleep aids, and mindfulness meditation may help you get the sleep you need to address and conquer your conditions.

• Try Psychotherapy

  People with comorbid conditions, anorexia and OCD, will benefit from psychotherapy. The first-line of treatment for these conditions is exposure-response and prevention (ERP) therapy. ERP therapy is a subtype of cognitive-behavioral therapy (CBT) that is designed to gradually expose a person to the feared stimuli, so it no longer triggers the thoughts, fears, and behaviors. In other words, the goal is to destigmatize the stimuli or trigger.

  Another psychotherapy often used to treat OCD-related anorexia is radical acceptance (RA) therapy. The goal of this therapy is to teach people with these two conditions how to deliberately let go of the distressing thoughts, fears, and urges and accept the world as it is – even if it is scary to them.

  This therapy is beneficial for OCD sufferers and people with anorexia because people with these conditions tend to engage in routines or rituals as a way to “block out” or “numb themselves” to what is happening in their lives and in the world around them – a world that feels dangerous to them.

  Radical acceptance therapy helps people with these conditions understand that although the world may be scary, they can still have happy and productive lives. As a result, there is no need to conform to the restrictions (rituals or routines) placed on them by OCD.

• Be Open to Medications

  If psychotherapy is ineffective, a psychotherapist may refer a person with both OCD and anorexia to a psychiatrist for pharmaceutical treatment (medicine). A psychiatrist may prescribe one or more of the following medications: SSRI antidepressants, anti-anxiety medications, and/or antipsychotics, depending on any underlying or secondary conditions. When therapy alone does not appear to be working, this is referred to as “treatment-resistant OCD.”

• Join An Online OCD Recovery Treatment Program

  An online OCD recovery treatment program, like Impulse Therapy, can help you with your OCD and teach you healthy coping skills to help you deal with your anorexia. This program can be used alone or combined with a formal OCD-related anorexia treatment plan to help you get a handle of both conditions at the same time. One benefit of this treatment program is that you can do it in the comfort of your home.

Conclusion

Dealing with OCD and anorexia can be difficult, but it can also be overcomed. You can help yourself by eating right, getting enough rest, talking to someone you trust about your concerns, forming a strong support system, practicing mindfulness meditation, challenging your thoughts and fears, giving yourself a break, and seeking treatment. It is important to find a therapist, who understands both OCD and anorexia and how they can combine, so he or she can help you cope with and adapt to any roadblocks that may come your way.

A therapist will teach you how to look at the situation from a different perspective, so you are prepared when stress and anxiety hits you. Keep in mind, however, that recovery from OCD and anorexia will be long and challenging, so do not become discouraged if you do not recover quickly. The good news is with the right treatment and support, you can overcome these disorders, and go on to have a happy, productive, and fulfilling life.

References

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• Cuncic, A. (2022). What is radical acceptance? Very Well Mind. Retrieved from https://www.verywellmind.com/what-is-radical-acceptance-5120614
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