The Intersection of OCD & Eating Disorders
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In the mental health field we frequently talk and hear about comorbidities - diagnoses that occur within the same person at the same time. An example of one of these comorbidities is anxiety and depression. How often have you heard a therapist, professor, news story, or even social media share information on depression and anxiety being experienced together?
Another commonly mentioned example is how often we hear about substance use disorders occurring with a wide range of other diagnoses. However, despite how common it is, less frequently do we hear about the interaction between eating disorders and other diagnoses, or obsessive compulsive disorder (OCD) and other diagnoses. Interestingly enough, these two diagnoses actually have rather high rates of overlap with each other.
In fact, among individuals suffering with eating disorders, more than 40% are additionally diagnosed with OCD in their lifetime, and some research reports that the numbers are as high as 69%. Additionally, for individuals with OCD, 17% of them will experience an eating disorder within their lifetime.
What is Obsessive Compulsive Disorder/OCD?
OCD is a disorder characterized by obsessions, compulsions, or both. Obsessions in OCD often are described as highly unwanted or intrusive thoughts, urges, or images that cause some level of distress. Often people attempt to ignore these thoughts or do something (a compulsion) to get them to cease.
Compulsions are described as time-consuming repetitive mental acts or behaviors that a person often feels they must complete as a response to an obsessive thought or according to obsessive rules. Typically the goal of compulsions is to prevent or reduce the distress caused by the obsessive thoughts; however, these acts are oftentimes not logically linked to the initial obsessions.
What is an Eating Disorder?
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Eating disorders are characterized by patterns related to eating that can include restriction of food intake, binging, purging, avoidance of food/indifference towards food, and more. Additionally, typically eating disorders involve a focus on one’s perception of their body. For more information on eating disorders feel free to read our comprehensive eating disorders blog.
What Do Eating Disorders and OCD Have in Common?
Eating disorders and OCD are both complex and multifaceted disorders that do not have one clear cause. They often both stem from a host of different and intertwined personal, environmental, biological, and other components. Like OCD, eating disorders also are frequently accompanied by intrusive thoughts and repetitive behaviors. In eating disorders, these obsessions are often characterized by themes of food intake, weight, or other "measurements" of food or the body. Additionally, many repetitive behaviors (such as restriction, binging, and purging) accompany these obsessions and occur as a response to the initial obsessive thought.
Examples of Similar Behaviors in OCD and Eating Disorders
Additionally, we see behaviors in eating disorders that resemble the compulsory behaviors we see in OCD. In eating disorders, these behaviors can include taking measurements of the body, “checking” certain areas of the body in the mirror or with their hands, cutting food into small pieces at mealtimes, eating food in a specific order, separating foods, chewing in a certain manner, counting calories or exercise habits, and more.
Are OCD and Eating Disorders the Same?
While eating disorders and OCD may have many aspects of their presentation in common, it is important to note that they are two distinct disorders. Some clinicians view eating disorders as a subset of OCD due to the tendency for eating disorders to be characterized by intense and obsessive thoughts about food, weight, and the body. However, the two diagnoses are as different as they are similar.
While having knowledge of both can certainly aid in treating one or the other, it is crucial to understand some key differences.
Key Differences Between OCD and Eating Disorders
For one, the content of obsessions and the behaviors of compulsions within OCD vary widely and can be extremely debilitating. Frequently these obsessions and compulsions are not easy to hide from others, and often result in a negative stigma from others’.
On the other hand, some of the obsessions and compulsions that are frequently associated with eating disorders are almost considered normal by society’s standards, and are much more widely accepted by the general public. Eating disorders also frequently come with a host of possible medical problems affecting multiple different parts of the body, including malnutrition, osteoporosis, and heart problems. While OCD is often treated with the help of a psychiatrist and therapist, a treatment team for an eating disorder almost always includes these two professionals along with a dietitian and physician.
What Does This Mean for Treatment?
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To put everything together, eating disorders and OCD have a lot of overlap. They have overlap in symptom presentation to professionals and in how they are experienced by individuals suffering with them. They are also very different in how they are perceived, experienced by the individual, and experienced by others’ or society as a whole.
It is important for professionals to be aware of the similarities and differences in order to create the best treatment environment and cultivate the best treatment team for their clients. Additionally, it is important for individuals experiencing either condition to have this knowledge so that they are able to advocate for themselves and their loved ones. Being able to recognize the differences, while also keeping in mind the frequency with which individuals are likely to experience both disorders, will help professionals and clients alike be able to better understand and address their symptoms and concerns.
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