*This blog was written by community colleague Kate Dansie, LCSW-C
Eating disorders and obsessive-compulsive disorders share many symptoms. Like OCD, eating disorders can involve obsessive thinking coupled with rituals or compulsions that bring you temporary relief. Over time, though, compulsions start to consume more and more of your energy, further infringing on your life. The obsessions are strengthened by these compulsions. Now what? Keep reading to learn how OCD and eating disorders are two sides of the same coin.
Treating OCD and Eating Disorders
Exposure work can be very effective for both eating disorders and OCD. Typically, this looks like creating a hierarchy of feared situations, and ranking them using the Subjective Units of Distress (SUDS) scale. The key is to slowly introduce yourself to feared situations without engaging in any compulsions or behaviors that neutralize the fear. Confused? Try thinking of a swimming pool: you jump in the water, and it feels freezing! Slowly, though, you adjust. Your body gets used to the temperature, and it doesn’t feel so cold anymore. Exposure and Response Prevention is just like that: you are teaching yourself that you can tolerate the anxiety you feel. Similarly, you can create a hierarchy of feared foods and situations related to your eating disorder and work your way up.
In my practice, I usually start by helping clients select an exposure that is a little scary, but that they know they can handle. When they are successfully able to tolerate this exposure, they gain confidence, and the disorder, whether it’s OCD or an ED, starts to lose its power.
4 Things You Should Do If You Think You Might Have OCD and an Eating Disorder
What should you do if you think you might have an eating disorder and OCD?
1. Get help. Any therapist treating OCD should have at least some training in Exposure and Response Prevention.
2. Check out a few books. My favorite is The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive-Behavioral Therapy by Herschfield & Corboy.
3. Start writing: make a list of all your obsessions and the compulsions you engage in to neutralize the thoughts or worries. Make a list of all the rules of your eating disorder, too. Do the rules of these disorders align with your values?
4. Remember your why: how much time and energy are you giving your eating disorder and OCD? What are some things you would love to have more time and mental energy for? To put it another way, what are the pros and cons of engaging in compulsive behaviors? Are the pros and cons short-term or long-term?
Final Thoughts on OCD and Eating Disorders
Recognizing the overlap between OCD and eating disorders is key to effective treatment. Both involve obsessive thoughts and compulsive behaviors, but with approaches like Exposure and Response Prevention (ERP), you can start to break the cycle. Taking the first steps—whether by seeking help, educating yourself, or reflecting on your behaviors—can lead to meaningful change and a path toward recovery.
Contact Us
Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.
Contact us for more information. And to schedule a discovery call. Also, sign up for our client or clinician newsletter!
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* A special thanks to Kate Dansie, LCSW-C for her contribution to the Courage to Nourish Blog. Kate is a therapist in Rockville, Maryland, who specializes in working with adolescents and adults with eating disorders, including ARFID, binge-eating disorder, bulimia, OSFED, and anorexia. Kate also specializes in treating obsessive compulsive disorder, mood disorders, and self-injury. Kate can see clients virtually for therapy in Maryland, Virginia and Washington DC.