I was about 10 years old when I was diagnosed with Obsessive Compulsive Disorder (OCD). This came about following a series of events that raised considerable concern for my parents regarding my mental well-being. Although it was years before any discernible worries about my connection with food, exercise, and body image surfaced, the trajectory of my personal experience is not uncommon. A significant amount of research underscores a strong correlation between anxiety (and related anxiety disorders) and eating disorders – a connection that, when recognized and accurately identified, holds the potential to guide individuals toward the essential care and treatment they require.

The onset of my OCD diagnosis traced back to a family vacation, where my room in a loft required me to climb a ladder. During one such climb, I simultaneously attempted to put my hair in a ponytail. A seemingly simple act revealed an unexpected observation: I could loop the ponytail holder around my hair three times, one more than the typical two. At this age, I used the number of times I could loop a ponytail holder around my ponytail as an indicator of my hair’s health.

From Trivial Discovery to Complex Connections: Ponytail Holders, OCD, and and Eating Disorders

This trivial discovery, linked to my perception of hair health, so the ponytail holder going around one extra time sent my brain into a panic. I started crying, convinced that this meant that my hair was falling out, and I was going bald. In the wake of my panic, I fell off the ladder leading up to the loft, which prompted a series of events and appointments that ultimately led to my OCD diagnosis.

At the time of my OCD diagnosis, an eating disorder was not a concern, but later on, my history with anxiety – specifically with OCD – was something that helped healthcare professionals understand, contextualize, and best address my eating disorder. 

Anxiety and Eating Disorders: What Does the Research Actually Say?

As we mentioned, research suggests and supports a strong link between anxiety and eating disorders.  This is not to say that everyone who develops an eating disorder will develop an anxiety disorder or that everyone who has an anxiety disorder will develop an eating disorder, but becoming more knowledgeable about the link can be an imperative step to healing.

  • In most cases of individuals who are clinically diagnosed with both an anxiety disorder and eating disorder (47-94% of the time), symptoms of anxiety develop before disordered eating or eating disorder symptoms show up
  • 58% of people with an ARFID diagnosis (avoidant and restrictive food intake disorder) also have an anxiety disorder diagnosis.
  • Over 25% of individuals with anorexia nervosa also have OCD.  
  • About 34% of individuals with anorexia nervosa experience social anxiety disorder 
  • Between 24 and 31% of individuals with anorexia nervosa and bulimia nervosa have Generalized Anxiety Disorder (GAD) and about 8% of individuals with binge eating disorder have GAD. 
  • 42% of those who have an eating disorder also have Post Traumatic Stress Disorder (PTSD)

Learn more about these connections directly from Dr. Colleen Reichmann below:

The Interplay Between Anxiety and Eating Disorders: What are the Signs and Implications?

While having an eating disorder can certainly lead to anxiety, it is more often noted that an anxiety disorder precedes, triggers, and perpetuates an eating disorder. Anxiety and eating disorders are often intertwined in a way that causes one to perpetuate the other.

Below are some of the signs, symptoms, and implications to to watch for when one has both an anxiety disorder and an eating disorder:

1. Vicious Cycle

Anxiety and eating disorders often create a vicious cycle where one exacerbates the other. For example, individuals with anxiety might turn to food restriction or binge-eating as a way to cope with their emotions. Conversely, the distress caused by an eating disorder can trigger anxiety, creating a cycle that is challenging to break.

2. Perfectionism and Control

Both anxiety and eating disorders are often closely linked to issues of control and perfectionism. Individuals with anxiety might seek control through strict dietary habits or extreme exercise routines, while those with eating disorders may experience anxiety related to their perceived loss of control over their eating behaviors.

3. Body Image Distortion

Anxiety can distort an individual’s perception of their body, leading to increased preoccupation with appearance and perceived flaws. This distorted body image can fuel the development and maintenance of eating disorders, as those with anxiety and an eating disorder may strive for an unrealistic ideal.

4. Social and Cultural Pressures

The societal emphasis on “wellness,” food, work out regimens, and the constant comparison on social media can amplify both anxiety and eating disorders. The fear of not fitting in or not meeting society’s standards can contribute to heightened anxiety levels, which in turn can fuel disordered eating habits.

Discovering Hope and Healing When Dealing with Anxiety and Eating Disorders

By recognizing the  relationship between anxiety and eating disorders, it becomes evident that the intersection of these two challenges carries profound implications for both diagnosis and treatment. As my own journey illustrates, understanding the connection between anxiety and eating disorders and the prevalence of co-occurrence is taking a step to understand someone’s (maybe even our own) struggles and path to healing.  If you are in need of help for anxiety, an eating disorder, or both, please do not hesitate to seek help. A life in color is waiting for you, and there are many of us eager to help you get there.

By: Erika Muller, Assistant for Wildflower Therapy LLC

All images via Unsplash

How Can Eating Disorder Therapy in Philadelphia, PA Help You?

If you’re looking for someone to come alongside you to help you unpack and approach the the complex set of emotions you may experience while on your eating disorder recovery journey, our therapists in Pennsylvania are honored to help!  In fact, you can get to know a little bit more about them here and book a free consultation here.

Other Mental Health Services Provided by Wildflower Therapy, Philadelphia, PA

Life is a unique and sometimes messy journey for each of us; we all have our own individual battles to fight. Our therapists know there is no one-size-fits-all approach to any of life’s challenges and because of that, we offer many unique perspectives and approaches to help meet you where you are with our Philadelphia, PA Therapy services.

We offer services for eating disorder therapy, services for anxiety, and depression, and have practitioners who specialize in perinatal mental health , maternal mental health, therapy for college students and athletes. As well as LGBTQIA+ Affirming Therapy. As you can see, we have something to offer just about anyone in our Philadelphia, PA office. Reaching out is often the most difficult step you can take to improve your mental health. We look forward to partnering with you on this journey!