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The Relationship between Eating Disorders and OCD

written by: Suzanne Florin • edited by: Paul Arnold • updated: 12/7/2010

What are the links between OCD and eating disorders, and why do they often go hand in hand? This article explores the claims made by researchers about the relationship between OCD and eating disorders, particularly anorexia nervosa.

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    OCD and Eating Disorders: Is there a Link Between the Two?

    Dr. Albert Rothenberg, a clinical professor of psychiatry at Harvard University, was one of the biggest proponents of the theory that anorexia nervosa is a manifestation of OCD. The foundations of his claims of how OCD and eating disorders are linked were his observations of the similarities in symptoms and traits of patients suffering from those illnesses. Among the similarities are the following:

    • The obsessions, fears, and concerns of people suffering from anorexia nervosa have similarities with those who have OCD.
    • Obsessive-compulsive symptoms are among the most recurrent and persistent symptoms of anorexia nervosa.

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    Similarities in Obsessions and Compulsions

    Anorexics have a strong focus on control; they tend to control their appetite, their thoughts, and their weight. The need for control allows them to develop and follow certain food rituals, such as chewing food longer than usual and cutting food in tiny pieces. An obsession on an ideal bodily shape and perfect appearance serve as motivating factors in adhering to a strict diet. In the same way, people with OCD have the intense desire to be in control of their thoughts, wishes, and motives. In fact, control is a core element of OCD. People who are OCD create rules for themselves that allow them to feel that everything in their life is in order.

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    OCD Symptoms as Recurrent Symptoms of Anorexia Nervosa

    Rothenberg described anorexia nervosa as the "modern obsessive compulsive syndrome". He believed that there are similarities in personalities of those who suffer from OCD and eating disorders. He described some of the traits evident in both illnesses such as rigidity, perfectionism, stubbornness, negativism, and excessive dedication to physical activity.

    Rigidity and Perfectionism

    Those who suffer from OCD and eating disorders follow rituals and self-imposed rules that allow them to achieve their goals. In the case of anorexics, their strict diet, obsession in counting calories (and consuming only the total number of calories that they set for themselves) is evidence of this. Adhering to these rituals enable them to achieve their ideal weight and gaunt appearance that they perceive as perfect. OCD patients are rigid about being in control of their impulses and actions; thus their compulsive rituals keep things in perfect order.

    Stubbornness and Negativism

    People with eating disorders have a negative attitude toward food; this is particularly true of anorexics. In addition, they are stubborn about keeping to the kind of diet that they impose on themselves. They tend to resist any interventions by concerned family members and friends. OCD patients display stubbornness as they cling to their compulsions, no matter how irrational they might seem to others. They become pessimistic or negative about being unable to take full control of themselves.

    Excessive dedication for physical activity

    Those with eating disorders have a strong desire to burn off calories by exercising excessively or by engaging themselves in a number of physical activities. In the same manner, OCD patients have several compulsions that require them to perform frequent and repetitive tasks, such as keeping things in order, repeated checking of doors and locks, and frequent cleaning of body parts, to name a few.

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    Resources

    The Relationship between Anorexia and Obsessive Compulsive Disorder, from

    http://www.vanderbilt.edu/ans/psychology/health_psychology/anorexiaocd.html

    Comorbidity of Anxiety with Eating Disorders and OCD, from

    http://ajp.psychiatryonline.org/cgi/reprint/163/2/326-a.pdf

    Eating Disorders: Comorbidity of Eating Disorders, from

    http://www.healthyplace.com