Obsessive-compulsive disorder (OCD) and Eating Disorders

What Is Obsessive-compulsive disorder (OCD)?

Before diving into the differences between OCD and eating disorders, it’s helpful to have an understanding of each disorder on its own. Obsessive-compulsive disorder (OCD) is a mental health condition that involves unwanted thoughts called obsessions. These thoughts might involve taboo desires related to sex or aggression.

They can also involve fears that a person or their loved ones will be harmed or become ill, for example⁠^[2]. For people with obsessive-compulsive disorder, intrusive, unwanted thoughts are quite distressing. They can make it difficult to function in daily life and be successful with work and relationships.

Many people with OCD engage in repeated behaviors called compulsions. These behaviors are intended to stop obsessive thoughts or reduce the anxiety that comes along with them. For instance, a person who is fearful of becoming ill may repeatedly wash their hands. Alternatively, some people with OCD perform rituals they believe will cancel out unwanted thoughts related to sex or aggression⁠^[2].

What Are Eating Disorders?

Understanding the relationship between OCD and eating disorders also requires knowledge of eating disorders. The term “eating disorders” refers to a group of conditions that involve a disturbance in eating-related behaviors alongside negative or distressing emotions. There are various types of eating disorders, but the three most common are described below⁠^[2]:

• Anorexia Nervosa: Individuals with anorexia nervosa experience an extreme fear of weight gain. They are seriously worried about becoming fat, and they restrict food to avoid gaining weight. Those who live with this eating disorder engage in self-starvation and continue to do so, even when at a dangerously low body weight.
• Bulimia Nervosa: Those with bulimia nervosa engage in repeated binge-eating episodes, in which they consume much more food than a person typically would under similar circumstances. During these episodes, they lose control of their eating, and afterward, they compensate for the binge through unhealthy methods like excessive exercise, self-induced vomiting, or laxative misuse. Like those with anorexia, individuals with bulimia place a significant amount of importance on their weight and body shape when evaluating their worth.
• Binge-eating Disorder: Finally, binge-eating disorder involves repeated episodes of binge-eating, as is the case with bulimia. However, those with binge-eating disorder do not compensate for binges by engaging in inappropriate compensatory behaviors like self-induced vomiting. They lose control when eating, and often feel ashamed or disgusted with themselves for binging. People who live with binge-eating disorder are at risk of obesity-related health conditions, such as hypertension and diabetes.

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Morgan Blair, M.A.

Support for eating disorders

Obsessive-compulsive disorder (OCD) vs. Eating Disorders: Key Similarities

Now that you understand the basics of both OCD and eating disorders, it’s time to look at the similarities between the two. First, eating disorders and OCD come with similar thinking patterns.

In OCD, a person develops obsessions that can be related to various topics, such as illness, harm, or religious taboos. Similarly, with eating disorders, people experience intrusive thoughts related to weight, body shape, and food intake⁠^[1][2].

Similarly, both conditions can involve compulsive behaviors. With OCD, people engage in repetitive behaviors, like hand-washing, to help them cope with intrusive thoughts. In those with eating disorders, compulsive behaviors are related to food intake. For instance, a person with anorexia may follow food rituals, such as cutting food into small bites or only permitting themselves to eat certain types of food⁠^[1][2].

Perfectionism, rigid thinking, and rituals may occur in both OCD and eating disorders. Similarities do not make them interchangeable diagnoses⁠^[3].

Finally, both conditions involve emotional distress. In eating disorders, a person is likely to experience distress related to body image. They may also become distressed about managing their food intake; for instance, those with anorexia worry about how to keep food intake low when eating in public or attending parties.

Furthermore, a person with bulimia or binge-eating disorder is likely to become distressed about the amount of food consumed during binge episodes. In cases of OCD, distress arises from intrusive thoughts; while compulsions may serve as a method for reducing distress, they are time-consuming and interfere with daily life⁠^[1][2].

What Is Food-related Obsessive-compulsive disorder (OCD) (Food OCD)?

The similarities between OCD and eating disorders are so strong that some researchers have coined the term food OCD. While not a formal diagnosis, food OCD involves obsessions specifically related to food and eating. A person with food-related OCD worries about the health-related implications of food.

They may spend time engaged in compulsive behaviors, like checking the ingredients list of foods, double-checking expiration dates, or developing rules about what foods are safe to eat. Sometimes, the term “orthorexia” is used to describe cases of food OCD, but even orthorexia is not a formal disorder included in diagnostic manuals⁠^[4].

Obsessive-compulsive disorder (OCD) vs. Eating Disorders: Key Differences

Despite similarities between the two, OCD and eating disorders are two distinct conditions. First, the core motivations between the two differ. OCD behaviors, such as rituals and repeated checking, are driven by fear and anxiety. A person with OCD seeks to reduce their anxiety by engaging in these compulsions⁠^[2].

On the other hand, in those with eating disorders, anxiety comes from dissatisfaction with one’s body and concerns related to weight and body shape. Similarly, obsessions in eating disorders focus on food, weight, and one’s bodily appearance, whereas in OCD, obsessions can involve a wide range of fears and topics⁠^[1][2].

Finally, there are different behavioral goals associated with OCD vs. eating disorders. In cases of OCD, people engage in compulsive behaviors to reduce their anxiety and reduce the risk of perceived harm⁠^[2]. On the other hand, behaviors in anorexia and bulimia are intended to control weight and body shape⁠^[1].

Obsessive-compulsive disorder (OCD) vs. Eating Disorders: Impact

OCD can cause substantial distress and interfere with daily life. Time-consuming obsessions and compulsions may make it difficult to manage work, relationships, and routine activities. When eating-related symptoms are also present, assessment should consider their additional effects and treatment needs⁠^[5][6][7].

Can You Have Obsessive-compulsive disorder (OCD) and Eating Disorders at the Same Time?

Yes, you can have OCD and eating disorders at the same time. In fact, the comorbidity of OCD and eating disorders is high. This means that it’s common for people with eating disorders to also have OCD, and vice versa.

OCD occurs more often among people with eating disorders than in the general population. Estimates vary by sample and eating disorder subtype⁠^[3].

OCD and eating disorders can co-occur. Shared features do not establish that one causes the other; assessment and treatment should address both when present⁠^[3].

Obsessive-compulsive disorder (OCD) vs. Eating Disorders: Diagnosis

A person can have both conditions. The focus and function of symptoms matter, and treatment should address each identified disorder rather than assuming that improvement in one resolves the other⁠^[3][1][2][8].

Obsessive-compulsive disorder (OCD) vs. Eating Disorders: Treatment

Given their similarities, OCD and eating disorders may also have similar treatment regimens. Below are common treatments used for both conditions:

• Cognitive-Behavioral Therapy (CBT): CBT is a form of talk therapy that helps people to correct negative or distorted thinking patterns. It is a gold standard treatment for both OCD and eating disorders⁠^[8].
• Exposure and Response Prevention (ERP): This treatment can be used for OCD to reduce compulsive behaviors, but it’s also used in the treatment of bulimia nervosa. Exposing someone with bulimia to their favorite foods and then preventing them from binging can teach them that they can learn to control binging behavior⁠^[8].
• Medication: A type of medication called selective serotonin reuptake inhibitors (SSRIs) is prescribed for both OCD and eating disorders⁠^[8].

While eating disorders and OCD may be treated in similar fashions, there can be some differences. For example, individuals with eating disorders often benefit from nutrition counseling to help them learn healthy eating patterns⁠^[9].