When Eating Disorders and Anxiety Disorders Co-exist

Do you know how eating disorders and anxiety disorders can go hand in hand? (photo credit: BigStockPhoto.com)
Do you know how eating disorders and anxiety disorders can go hand in hand? (photo credit: BigStockPhoto.com)

For many people with eating disorders, the challenge of overcoming their disorder is complicated because of other coexisting mental health conditions like depression and anxiety.  In fact, a University of Pittsburg Medical Center study conducted in 2004 found that two-thirds of those diagnosed with eating disorders also suffered from some form of anxiety disorder over the course of their lives.  In many cases, the anxiety disorder started in childhood, predating the eating disorder.   This underlines how important it is for parents to understand the warning signs of both anxiety disorders and eating disorders and to seek treatment for either condition or both conditions as soon as they see the signs.

When someone suffers from an anxiety disorder, they struggle with excessive, persistent, pervasive worry and fear that is unreasonable to the reality of their situation.  This constant anxiety may center on specific circumstances or activities or it can apply to a broader experience or concern.  There are several different types of anxiety disorders that each manifest differently and can cause different symptoms.  The most common anxiety disorders are:

Signs of Commonly Co-Existing Anxiety Disorders

Obsessive-compulsive disorder (OCD) is the anxiety disorder that is most frequently seen with eating disorders.  When OCD and an eating disorder co-exist, the two disorders can intertwine causing the person to develop ritualistic behaviors associated with food.  An example of how this would look to parents would be a teenager that obsessively counts calories, weighs their food, or will only eat at specific times of day.  Other anxiety disorders that commonly co-exist with eating disorders are post-traumatic stress disorder (PTSD) and social anxiety disorder.

Obsessive-compulsive disorder (OCD) is characterized by repetitive and persistent thoughts, behaviors, or impulses that are unwanted, involuntary, and often seem nonsensical, even to the person who is doing them.  People with this disorder generally experience obsessive thoughts that drive compulsive behaviors.  These behaviors are often repetitive and are meant to ease the anxiety resulting from the obsessive thought.  They are compulsions which makes it very difficult not to do them, people with this disorder can feel driven to complete the compulsive acts and distress can quickly amplify if they are unable to do so.  Examples of obsessive thoughts and compulsions include:

  • Fear of germs, dirt, or contamination that results in avoidance and/or compulsive behaviors like frequent hand washing
  • Needing things to be kept orderly and symmetrical or in a specific order or pattern and experiencing pain, stress, or anger when things are out of place
  • Fear of forgetting things like locking the door or turning off the stove that results in checking and rechecking behavior

Post-traumatic stress disorder (PTSD) symptoms come in three different categories.  The first, intrusive memories include things that are commonly associated with PTSD like flashbacks and nightmares.  The second, avoidance and numbing, includes avoiding thinking about, talking about, or doing anything related to the traumatic event. It can also include avoiding previously enjoyable activities, difficulties with memory and concentration, and “checking out” by retreating to a numb state.  The third, hyper-arousal, includes uncharacteristic irritability and anger, self-destructive behavior, problems sleeping, and being easily startled.


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