An eating disorder diagnosis is overwhelming and challenging. It is common for those with eating disorders also to have other mental health disorders. Anxiety, depression, and obsessive-compulsive disorder are mental health disorders that often co-occur with eating disorders.

By: Dawn Lundin

Mental Health Awareness Month is celebrated in May to raise awareness for mental health. Unfortunately, the co-occurrence of multiple mental health disorders isn’t often discussed, but it is a common and valid experience. Regardless of your diagnosis, your treatment should be individualized and all-encompassing.

A co-occurring mental health disorder may be present before, alongside, or as a result of an eating disorder. Individuals with bulimia nervosa often meet the criteria for three or more other mental health disorders. Major depressive disorder is most common in individuals with bulimia nervosa. Those with binge eating disorder & co-occurring mental health disorders experience a higher level of negative affect, lower self-esteem, and current eating disorder pathology. Individuals with anorexia nervosa are at a higher risk for obsessive-compulsive disorder. Anxiety co-occurs with about half of those with eating disorder diagnoses.

Disorders That Often Co-Occur with Eating Disorders

Signs and symptoms of major depressive disorder that may overlap with an eating disorder include changes in appetite, feelings of guilt, inability to concentrate, suicidal thoughts, and difficulty sleeping. Other warning signs and symptoms include feelings of hopelessness, irritability, feelings of tension, mood swings, and panic attacks. If these symptoms impact your daily activities, cause a high level of distress, or constantly occupy your mind, you may also have depression. Depression can impact energy and motivation toward eating disorder treatment. Depression symptoms such as flat affect, apathy, fatigue, and disturbed appetite can complicate eating disorder recovery if not treated simultaneously.

Anxiety Disorder

Signs and symptoms of anxiety disorder that may overlap with an eating disorder include feeling weak or tired, difficulty concentrating, trouble sleeping, and gastrointestinal (GI) problems. Other warning signs and symptoms include nervousness, a sense of danger, increased heart rate, and rapid breathing. Anxiety and eating disorders can be treated together through Cognitive-Behavior Therapy (CBT) and medication.

Obsessive-compulsive Disorder (OCD)

Signs and symptoms of OCD fall into two categories, obsession symptoms, and compulsion symptoms. Obsession symptoms include fear of contamination, fear of making a mistake, intolerance to uncertainty, needing things to be orderly or symmetrical, aggressive thoughts about hurting yourself or others, and unwanted thoughts. Compulsion symptoms include washing & cleaning, fear of making mistakes, counting, strict routine, and demanding reassurance. While symptoms of OCD do not often mimic symptoms of an eating disorder, they can impact your ability to meet your meal plan. Fear of contamination, cleaning, checking, and a strict routine can exacerbate restriction. OCD can also affect how you can make changes in your treatment. Gradual changes that you have time to prepare for are often more successful than sudden changes when someone with an eating disorder also struggles with OCD. Medication and therapy can help treat OCD. It may be helpful to work with an OCD-specific therapist or dietitian experienced with OCD & eating disorders.

Getting Support with Eating Disorders and Other Co-Occurring Disorders

It is possible and encouraged to approach your eating disorder treatment in a way that complements the treatment of another mental health diagnosis. Advocate for a big-picture approach to your recovery which will impact your quality of life. It is possible to heal your relationship with food and your body while working on other mental health components.

BALANCE is excited to launch our 2023 Summer Break Eating Disorder Treatment Program. This summer with BALANCE, reduce eating disorder thoughts and behaviors, gain tools to navigate all the pressures the summer months bring, foster community with specialized groups, get the support you deserve, and more. Learn more about our Summer Break Program here.

Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below, or read more about our philosophy here.

This post was written by BALANCE Blog Contributor, Dawn Lundin (she/her).

Dawn Lundin, MS, RD is a registered dietitian and owner of Restore Ease Dietetics which is a virtual nutrition private practice that focuses on mental health + sports nutrition. She primarily with adolescents and young adults with eating disorders. She believes in meeting clients where they are at which provides a unique client-focused approach to recovery. She lives in Marquette, Michigan with her husband and three sons. As a family, they love to travel and spend time outdoors. She also enjoys mountain biking, running, cross-country skiing, being on or in the water, and knitting.

References

Anxiety, Depression & Obsessive Compulsive Disorder. National Eating Disorder Association. https://www.nationaleatingdisorders.org/anxiety-depression-obsessive-compulsive-disorder. Accessed May 3, 2023.

Cassiday, KL. Learning to Live Well with Depression and Eating Disorders. National Eating Disorder Association.

https://www.nationaleatingdisorders.org/blog/learning-live-well-depression-eating-disorders. Accessed May 3, 2023.

Eating Disorders & Co-Occuring Conditions. National Eating Disorder Association. https://www.nationaleatingdisorders.org/eating-disorders-co-occurring-conditions-0. Accessed May 3, 2023.

Mental Health Month. NAMI: National Alliance on Mental Illness.

https://www.nami.org/Get-Involved/Awareness-Events/Mental-Health-Awareness-Month. Accessed May 3, 2023.

Neziroglu, F and Sandler, J. The Relationship Between Eating Disorders and OCD Part of the Spectrum. International OCD Foundation.

https://iocdf.org/expert-opinions/expert-opinion-eating-disorders-and-ocd/. Accessed May 3, 2023.

Obsessive-compulsive Disorder. NAMI: National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Obsessive-compulsive-Disorder. Accessed May 3, 2023.

Eating Disorders and Co-Occurring Disorders