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Connection Between OCD and ED

By January 9, 2013

Could the fear of an eating disorder actually cause one? I’ve been independently researching a couple theoretical eating disorders that involve obsessive fear of anorexia nervosa. One of them is the simple belief that a man or woman is at risk for or already has anorexia and is eating more to compensate. As if trying to find data on that wasn’t hard enough, the other theory involves an obsession with maintaining a median body image and the use of extreme measures to maintain it. “I don’t want to be to fat, but I don’t want to be to thin either.” Using anorexia and bigorexia to balance each other. Searching these terms has left me with little or no data, but did lead me to this website. If it would not be too much trouble could you point me in the right direction or perhaps share your knowledge on such matters? Thank you for your time. –  Michael

Dear Michael, 

I am unaware of any specific research in the areas mentioned. I do believe that the fear of an ED could cause one and that an obsessive need to stay at a median weight could also involve ED behaviors. In the latter example, this would be very analogous to the extreme need for symmetry seen in OCD (obsessive-compulsive disorder). The need for symmetry has simply been applied to weight – being perfectly balanced.

Given all of this, I believe that eating disorders can be classified as Obsessive Compulsive Spectrum Disorders. Many eating disordered individuals have the same process that OCD patients have: intrusive and emotionally upsetting thoughts, images or impulses that are often remediated by compulsions. The compulsions are intended to lower the anxiety caused by the obsession. Compulsions either involve avoidance of the feared stimulus, or escape from feared stimulus. Here is an example of how an ED can follow the same pattern as OCD:

  OCD Eating Disorder
Feared Stimulus Doorknob Food
What makes stimulus frightening Germs Fat grams and calories
Feeling comes with contact Contamination Contamination
Thought that comes with contact “I am going to get sick.” “I am going to get fat.”
Ultimate fear Death Rejection
Avoidance Compulsion Avoid touching doorknobs Avoid eating food with fat/calories
Escape Compulsion Washing hands Purging or other compensatory behavior (e.g., exercise)

Given the connection between OCD and ED, I would recommend searching OCD Spectrum Disorders in a search combine with ED. In some cases I believe that the OCD is the primary disorder and the ED is the form it takes, which matches your hypothesis.

David Wall, Phd