Eating Disorders Are Frequently Co-Morbid With Anxiety Disorders
Why? And What Can You Do About It?
In my professional life, I frequently come across individuals who are experiencing food-based anxieties. Sometimes these are centered around body-image, and sometimes they’re a little more ephemeral than that. When I first began to work with people suffering from anxiety disorders, I was actually surprised at how many of these suffering individuals found that mealtimes, food, and so on became an anxiety ‘flashpoint’. It was not something which my training had touched upon overmuch. When I was learning my trade (which was, admittedly, a few years ago now!) the tendency was to compartmentalize eating disorders and anxiety disorders – a tendency which, I swiftly learned, was not at all helpful. Anxiety disorders and eating disorders co-occur far more often than we are led to believe, and the relationship between the two is often extremely complex.
While not everyone with an anxiety disorder has an eating disorder, I don’t think it would be pushing the envelope too far to state that a far higher than average proportion of people with eating disorders also have an anxiety disorder. Furthermore, many individuals suffering from anxiety disorders may experience problems around food and eating – problems which may not translate into a quantifiable eating disorder, but which certainly cause a great deal of suffering. If left untreated, anxiety disorders can and often do cause eating disorders to develop. It appears that OCD is the most common anxiety disorder to co-present with an eating disorder, perhaps because the anxious obsessions of OCD lend themselves easily to the kind of food-based obsessions and compulsions associated with diseases like anorexia and bulimia nervosa. However, that does not mean that other anxiety disorders sufferers are ‘immune’ from eating disorders. Sadly, far, far from it.
Why Eating Disorders?
Like any mental illnesses, eating disorders are complicated phenomena. What triggers them, and the manner in which they manifest differ from person to person, meaning that successful treatment have to be highly individualized. However, there are certain common features which therapists and other mental health professionals see again and again in eating disorder sufferers. Most commonly, the sufferer will experience intense low moods, self-hatred, and obsessional thinking patterns. Anxiety disorder sufferers will recognize all of these, no doubt! The mental processes associated with both eating disorders and anxiety disorders fit together extremely well. Anxiety disorders and eating disorders can develop a symbiotic relationship which makes life very difficult for the poor sufferer. It is unclear whether anxiety disorders are ‘caused’ by eating disorders or vice versa – but in all honesty, it probably varies from person to person. Eating disorders can make the sufferer very anxious, and anxiety disorders can cause their sufferer to develop food-based worries and obsessions. While all mental health problems are serious, eating disorders are a matter of great concern as they have the highest death rate of all mental health problems.
Many without specific ‘eating disorders’ may also develop a food-based component to their anxieties. Eating is a phenomenon of far more significance than we tend to acknowledge. It’s not only intensely social at times, but our food choices have a huge impact upon our health, our appearance, and our lifestyle in general. Little wonder, therefore, that mealtimes and food choices can become an anxiety ‘flashpoint’. People with social anxiety may experience intense fear of judgment and of being ‘watched’ in social eating situations. It is important to remember that evolution has primed us to feel a little vulnerable while we eat – this is why going for a meal with someone is such a social phenomenon. It shows trust, and that we are at ease with our co-diner. However, this can work against those with social anxieties, who may find social dining a phenomenally anxiety-making experience.
If someone has co-morbid eating and anxiety disorders, it is essential to treat both, otherwise they will continue to reinforce one another and intensifying the suffering of the individual. Eating disorders and anxiety disorders can be treated! However, it can be difficult to get sufferers to both admit that they have a problem and to get help. If you suspect that someone you love has an eating disorder (curious behavior around food, rapid weight loss, rapid weight gain, and obsession with weight can all be indicators), it is essential that the issue is faced head on in order to start treatment as soon as possible. Don’t force the point, but do gently and firmly try to get your loved one to open up about this, and to seek help.
Helen Fields is a freelance writer and mother. She juggles her work around her home life. In the past, she has suffered anxiety problems and now seeks to help others through writing about these issues and what life is like managing these kinds of problems. She offers insight into eating disorders from her personal experience as well as what she’s learned through working in the health care industry.