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Understanding Anxiety’s Effect on Eating Disorders

By 
Sarah Shawaker
|
 September 19th, 2022|   Clinically Reviewed by 
Rajnandini Rathod

Eating disorders don’t develop in a vacuum. They often go hand in hand with other mental health conditions, like anxiety. And that can make it hard to get the treatment you need.

In rehab for eating disorders, providers know that mental and behavioral issues are connected. Eating disorders are unhealthy coping mechanisms, but they exist for a reason. And with help, you can learn better coping strategies. These skills empower people to recover from disordered eating and the anxiety that can trigger it.

Understanding Eating Disorders

These complex conditions are about more than just food. In fact, eating disorders affect 30 million Americans.1 There are a few different types of eating disorders,2 as defined by the American Psychiatric Association (APA):

  • Anorexia nervosa is the restriction of food intake. This “self-starvation” can result in weight loss and an unhealthily low weight.
  • Bulimia nervosa follows a cycle. People with this condition binge large amounts of food, then take extreme actions to avoid gaining weight. For example, a person might induce vomiting, restrict food intake, use laxatives, or exercise excessively.
  • Binge eating disorder follows a similar cycle, but does not include purging. It’s characterized by episodes of eating large amounts very quickly, followed by feelings of guilt, shame, and distress.
  • Avoidant/restrictive food intake disorder (ARFID) is an umbrella term. It describes any pattern of disordered eating that doesn’t fit the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder.

Disordered eating can appear as a wide array of symptoms and behaviors, and it’s important to not try to fit yourself into a box. Like any other diagnosis, the impact of these conditions goes beyond the definitions that you read online. And it’s especially complex for people with co-occurring disorders, like anxiety.

Where Does Anxiety Come In?

Much like eating disorders, there are a wide variety of anxiety disorders. And these 2 categories are more similar than you might think. In fact, research suggests that eating disorders could be classified as anxiety disorders.3

Even if you don’t have anxiety, most people with eating disorders have at least 1 other diagnosis. One study found that 97% of people hospitalized for an eating disorder had a co-occurring disorder.4 When you’re ready to start recovery, it’s important to seek treatment for every aspect of your mental health. Fortunately, many rehabs are prepared to treat co-occurring anxiety and eating disorders.

How Anxiety Impacts Eating Disorders: A Cycle

According to the team at Rosewood Ranch,

“about half of individuals with eating disorders also have an anxiety disorder5 and most of the time, the anxiety disorder began prior to the eating disorder.”

These behaviors may form as coping mechanisms, albeit dysfunctional ones. Some people use eating as a distraction from anxious thoughts,6 or to feel a sense of control. But when you rely on harmful tactics to deal with your emotions, it gets harder to learn healthy ones. This creates a cycle that’s hard to break. And that cycle can be seen in people with any type of anxiety disorder.

Social Anxiety

The U.S. Department of Health and Human Services defines social anxiety7 as a “disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.” And that self-consciousness can turn into anxiety about your appearance. This opens the door to eating disorders. In fact, the fear of being negatively judged is linked to a desire for thinness.8

These social fears are valid—but restricting your diet won’t necessarily make them go away. Studies reveal that levels of social anxiety are similar across all eating disorder diagnoses.9

When you recognize how your anxiety impacts your eating habits, you can start developing healthier behaviors.

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is characterized by anxiety and intrusive thoughts. Because of this, repetitive, self-destructive behaviors are a common symptom. Disordered eating can sometimes be one of those behaviors.

An article from Timberline Knolls says that for both OCD and eating disorders, the goal of the behavior “is to reduce levels of apprehension, anxiety and overall negative effect.”10 For example, you might binge a large amount of food in an attempt to self-soothe during a panic attack. These behaviors can snowball and worsen your anxiety, and keep you from learning how to handle it differently. You may need professional support to interrupt this behavioral loop.

Breaking the Cycle With Treatment

Research shows that it’s important to treat eating disorders and anxiety together.9 Because of the overlap between these issues, you might want to attend a rehab that treats co-occurring disorders.

The good news is, therapy for either of these conditions may help you recover from both. For instance, experts agree that anxiety lessens when people get treatment for anorexia.9 When you’re ready to heal, several types of therapy can help.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT)11 is a type of therapy that teaches you how to interrupt negative thoughts. It’s also the most recognized method for treating eating disorders.12 Most inpatient treatment programs offer some version of this therapy.

Holistic Therapies

Alternative therapies are an increasingly common way to treat mental health issues. These modalities encourage patients to heal their mind, body, spirit as one. In rehab, you might have access to a variety of holistic therapies. For instance, studies show that mindfulness is a powerful way to treat eating disorders.13

Medication

Evidence shows that medication can treat eating disorders.12 This treatment is normally combined with talk therapy. The combination can be hugely effective. But like any treatment, it’s not right for everyone. If you have any physical health issues due to an eating disorder, talk to your doctor (or treatment team in rehab) about your concerns.

Recovery From Eating Disorders and Anxiety

Whatever types of therapy you pursue, there’s good news: eating disorders and anxiety disorders are very treatable.9 With proper care, these conditions have high recovery success rates. And if you’re living with both diagnoses, many rehabs offer specialized care.

Connect with a rehab that treats eating disorders to learn more about the therapies they offer, housing options, and recovery from co-occurring disorders.

Reviewed by Rajnandini Rathod

  1. Caceres, V. (2020, February 14). Eating Disorder Statistics. US Health News; US Health News. https://health.usnews.com/conditions/eating-disorder/articles/eating-disorder-statistics []
  2. Guarda, A. (2021, March). What are Eating Disorders? American Psychiatric Association. https://psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders []
  3. Altman, S. E., & Shankman, S. A. (2009). What is the association between obsessive–compulsive disorder and eating disorders? Clinical Psychology Review, 29(7), 638–646. https://doi.org/10.1016/j.cpr.2009.08.001 []
  4. STATISTICS & RESEARCH ON EATING DISORDERS. National Eating Disorders Association. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders []
  5. Hunnicutt, C. (2020, February 18). The connection between anxiety and eating disorders. Rosewood Centers for Eating Disorders. https://www.rosewoodranch.com/the-connection-between-anxiety-and-eating-disorders/ []
  6. Rosenbaum, D. L., & White, K. S. (2013). The role of anxiety in binge eating behavior: A critical examination of theory and empirical literature. Health Psychology Research, 1(2), e19.
    https://www.pagepressjournals.org/index.php/hpr/article/view/hpr.2013.e19/pdf []
  7. Division (DCD), D. C. (2013, February 9). What are the five major types of anxiety disorders? [Text]. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html []
  8. Levinson, C. A., & Rodebaugh, T. L. (2012). Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears. Eating Behaviors, 13(1), 27–35. https://doi.org/10.1016/j.eatbeh.2011.11.006 []
  9. Kerr-Gaffney, J., Harrison, A., & Tchanturia, K. (2018). Social anxiety in the eating disorders: A systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S0033291718000752 [] [] [] []
  10. The relationship between eating disorders & obsessive-compulsive disorder. Timberline Knolls Residential Treatment Center. https://www.timberlineknolls.com/about/resources/the-relationship-between-eating-disorders-obsessive-compulsive-disorder/ []
  11. Cognitive behavioral therapy—Mayo Clinic. (n.d.). Retrieved August 12, 2022, from https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610 []
  12. Eating Disorders, Trauma, and PTSD. (n.d.). National Eating Disorders Association. https://www.nationaleatingdisorders.org/resources/eating-disorders-trauma-ptsd-recovery [] []
  13. Wanden-Berghe, R. G., Sanz-Valero, J., & Wanden-Berghe, C. (2010). The application of mindfulness to eating disorders treatment: A systematic review. Eating Disorders, 19(1), 34–48. https://doi.org/10.1080/10640266.2011.533604 []

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