If you’re seeking help for mental health issues, you need a clear diagnosis. The first step, then, is finding a good mental health professional with enough expertise and experience to recognize and categorize your symptoms. A firm diagnosis allows your practitioner to begin using evidence-based therapies and tools that have been proven effective for your specific condition. 

But what if the signs and symptoms of one condition overlap with those of another and even the best therapist is unsure of the correct diagnosis, or mistakenly misdiagnoses you? Such can be the case with an eating disorder like anorexia or bulimia and obsessive-compulsive disorder (OCD).

Overlapping Symptoms and Traits

One personality trait seen in both conditions is extreme or dysfunctional perfectionism. If you suffer from anorexia or OCD, you may agonize over every mistake you make or every little thing that is out of order. Your thought patterns are repetitive and intrusive. In both conditions, repetitive thinking leads to ritualistic behaviors, such as routinely checking, double-checking and triple-checking that you’ve turned off the lights, or that everything in your kitchen cabinet is lined up neatly and in its place, or that nothing about your body has changed since the last time you checked, even if you just checked ten minutes ago. Much of this repetitive and ritualistic behavior is actually your mind’s attempt to cut back on the anxiety that comes with your perfectionist beliefs. 

With OCD, you may repeatedly check your hands for signs of dirt or germs, obsessively washing them throughout the day, or repeatedly check a light switch to be sure you turned it off; with anorexia, bulimia, or body dysmorphic disorder, you may repeatedly and obsessively check your body in the mirror or on a scale throughout each day, looking for signs of fat or weight gain. If you suffer from OCD, you may avoid certain tasks at work or school, in order to avoid the anxiety that comes with that particular job; with an eating disorder, you may avoid eating or overexercise, in order to avoid the anxiety provoked by your fear of gaining weight. 

Symptoms of both conditions can overlap if, for instance, you have an unfounded fear of contamination from certain foods, such as meat, and therefore avoid all meat products and any other food that might come in contact with meat. In both cases, everyday concerns about choices that lead to health, weight control, and maintaining an orderly life are greatly exaggerated beyond that of a perfectionist who feels strongly that life must be organized in a specific way. The obsessions and compulsions associated with OCD or an eating disorder are so excessive, they become disabling and interfere with your relationships, your education or career, your health, and just about every other aspect of your life.

Causes and Motivations

In addition to similar thinking and behavior patterns, researchers suspect a shared genetic basis for OCD and eating disorders, especially when it comes to anorexia. Shared genetic backgrounds may help explain the overlapping traits in the two disorders, including repetitive behaviors, extreme habit formation, and rigid thinking, as well as why both OCD and anorexia often manifest at an early age. If you have an immediate relative (mother, father, sister, or brother) with an eating disorder, you are at 10 times higher risk than the average person of developing one yourself. Among those diagnosed with OCD, approximately 25% also have a first-degree relative with the disorder.

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While no absolute or specific causes have been found for either OCD or eating disorders, both appear to result from a combination of genetic, neurobiological, behavioral, environmental, and cognitive factors that come together and trigger disordered thinking and behavior patterns. Some of the factors thought to play into the development of both conditions include obsessive, compulsive, and impulsive personality traits and abnormal brain chemistry.  

Additional factors that are thought to trigger eating disorders include a history of sexual abuse and an overwhelming social or cultural pressure to be thin from families, peers, media outlets and social media. OCD symptoms, on the other hand, maybe triggered by a brain injury or conditions of severe stress.

If you have an eating disorder, you are most likely motivated by a desire for a perfect body and a preoccupation with body image. If you have OCD, you are generally motivated by something other than your physical appearance. But it is easy to see how the symptoms of both conditions can overlap, and that you could suffer from both conditions at the same time, particularly if your OCD symptoms are associated in any way with food.

Successful Treatment Plans

Perhaps the only good news about overlapping OCD and eating disorder symptoms, and the fact that one could be mistaken for the other, is that treatment and therapies for both conditions are similar. Both conditions are most often treated with cognitive-behavioral therapy (CBT). One CBT technique your therapist may use is increasing your exposure to what you fear, in order to challenge specific behaviors and thinking patterns associated with your condition. CBT can also include goal-setting, motivational techniques, and strategies for coping and responding to trigger situations in more effective ways. In both cases, group therapy can also be beneficial and counseling may extend to families. When drug therapy is required, antidepressants and anti-anxiety medications are often prescribed for both conditions.

For severe cases of OCD and eating disorders, there are other treatment options. In residential treatment, for instance, you may live in a specialized treatment center or hospital for however long you need intensive treatment. If an even higher level of care is needed to protect your well-being, you could be confined to a treatment center for a brief period of time, until you are stabilized and able to transition back to a lower level of care. 

Both OCD and eating disorders are difficult conditions to treat. In fact, while OCD can be well-managed, and most people will benefit from treatment, it can be a lifelong condition. Eating disorders, on the other hand, while equally complicated, are more successfully treated. Early intervention greatly increases the chance of successful treatment and management of symptoms in either case.

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Last Updated: May 21, 2021