The overlapping of OCD and a range of eating disorders
It is common for eating disorders to be confused with a branch of OCD, when it can be important to recognise that although recognised as completely separate, there are many overlaps between the two conditions. There is evidence to suggest that people experiencing both anorexia nervosa and bulimia often also have many OCD symptoms, such as intrusive thoughts and a need to act in certain ways to make themselves feel better. Intense feelings around body image, shape and obsessions with food are what lead many of the world’s leading experts to believe that both anorexia nervosa and OCD to be related. The evidence to suggest that eating disorders and OCD are often experienced together largely relate to the person’s inability to think about anything other than their obsession, i.e. losing weight or attaining a certain body image. Anorexics are often described as being obsessed with becoming thin, and performing ritualistic behaviour that helps them to take steps to attaining the body that they desire.
Many experts claim that the symptoms of anorexic nervosa and Obsessive Compulsive Disorder become largely linked where certain behaviours assume significance in both of the disorders. An example could be that a young girl feels that she needs to run around the block for exactly 20 minutes before every meal. This act is indeed a compulsive behaviour, whilst also purposefully acting in a way that is going to help to lose weight. Those that suffer from bulimia nervosa experience recurrent episodes where they partake in binge eating, followed by vomiting, laxative abuse or both. The urge to perform such acts have noticeably been described as feeling like a compulsive act. Similar to the example of the girl that feels compelled to run around the block for a set amount of time, sufferers of bulimia nervosa can also display some behaviours which fall into both Obsessive Compulsive Disorder and that of bulimics. An example would be a person that believes in eating for a set period of time, let’s say 30 minutes, uninterrupted. However, if the person is disturbed or distracted during that time, then the binging episode feels ‘ruined’ and so they have to start all over again.
General information about eating disorders
Often those experiencing eating disorders have placed their happiness in something external, that being their weight. They genuinely believe that once they are just the right amount of ‘thinness’, they will finally be happy, although this is never the case. Self-acceptance is the key to being truly happy. When we accept ourselves for who we are, wholeheartedly, then we can set ourselves free from suffering. People who start to accept themselves report feelings of prolonged calmness, mental wellbeing and feelings of happiness. Many of the treatments known for eating disorders encompass this self-accepting attitude, discovering who we are without all of these conditions, that are often created by our own minds. On many occasions clients claim that the number one reason for their eating disorder is to make themselves feel better. Positive feelings and happiness are often wrongly associated with diet and nutrition. Whether it be obsessing about food, over or under eating, avoidance or performing compulsions that are linked with food, all are to seek safety, control and feelings of self-gratification in some way.
Types of eating disorders
- Anorexic Nervosa
- Bulimia Nervosa
- Binge Eating Disorder
Most, if not all human beings wish they could change something about themselves. However, for someone that develops anorexia nervosa, the want to physically alter one’s appearance can become nothing shy of an obsession. More often than not, the effects of developing such a disorder mean that thoughts, feelings, and eating habits are largely affected, fuelling an obsession to want to lose weight. When in the grips of anorexia nervosa, it can become very difficult to think rationally about body weight or image, whereby even seeing one’s own body accurately can become difficult and clouded. Anorexia nervosa affects all people, regardless of sex, religion or race. At its worst, it can make the sufferer seriously question whether they will ever be able to live a happy life again, which in turn can increase negative and suicidal thoughts. Many people suffer from this condition, so please know that you are not alone. Although at times recovery from anorexia nervosa can seem hopeless, we want you to know that there is hope. Lots of people have overcome the condition, you can too.
What is Anorexia Nervosa?
There are 3 main features that make up anorexia nervosa. These are:
- Refusing to maintain a healthy body weight
- An obsession and intense fear around gaining weight
- A distorted view of themselves and their own body
Often those that suffer from anorexia nervosa also experience bouts of depression, low self-esteem and self-doubt. The idea around losing weight can become an obsession, with things like the monitoring of diet, checking of body image in mirrors, having thoughts about anything relating to diet and body image as well as a deep desire to become thin can take up most of the persons day. Similar to some of the symptoms of Obsessive Compulsive Disorder, the person will not only become obsessed, but no matter how hard they try to get to where they need to be, such as a certain body weight, it is never enough. It is this desperation, this idea that no matter what, the condition is never satisfied that can cause the sudden onset of depression.
How to recognise if you have Anorexia Nervosa
- Are you obsessed with trying to become ‘thin’?
- Do you feel that your body image is different to others perception about your body?
- Do you accept yourself for all your flaws? Is your love for yourself unconditional, or is it dependent on diet and body image?
- Do you hide from others the truth about your eating habits?
- Does controlling your food intake make you feel safe, or more in control?
- Do you fear gaining weight?
Restrictive anorexia is where the person may avoid eating certain foods, or strictly control their calorie intake with the intention of losing weight. These behaviours are normally beyond what the average person will do, and can include anything from working out for several hours a day to fasting dramatically. On the other, purging anorexia relates to achieving weight loss by abusing laxatives or deliberately causing one’s self to vomit.
Anorexia is often the act replacing some other need that hasn’t been met in your personal life. Used as a form of control, or to feel safe, the underlying causes of the condition are much less likely to be about food or body image, and rather about making the person feel a certain way about themselves. Often anorexia nervosa is spoken in relation to power, or provides a distraction from other, unwanted, intrusive and difficult emotions. Again similar to Obsessive Compulsive Disorder, the very act of trying to stay or achieve ‘thinness’ becomes the very problem itself, and it is in breaking this negative cycle where true freedom and self- acceptance lies.
Turning to food to make ourselves feel better can often be a natural process that many of us relate to. However, with bulimia nervosa, the act of overeating becomes an obsession. The compulsion of eating too much food can become a daily activity whereby you could feel out of control. Overeating is then followed by punishing yourself in some way, usually via intense exercise, purging or fasting. Often feelings of guilt, shame and self-loathing accompany bulimia nervosa. Linked to low self esteem and depression, being caught in this unhealthy cycle can have large negative impacts on your emotional and physical wellbeing. Similar to Obsessive Compulsive Disorder, someone experiencing bulimia nervosa will feel an overriding urge to perform a particular compulsion which temporary makes them feel better, although the relief from emotional turmoil is never long lasting.
What is Bulimia?
Bulimia nervosa relates to episodes of binge eating, followed by counter-productive and unhelpful ways to avoid gaining weight. A condition that can affect anyone, it is believed that up to 1 in 100 people currently live with the condition. Whilst suffering from bulimia nervosa, your quality of life is likely to be diminished. Often you may feel extremely torn between the feeling of desperately wanting to lose weight and get that body you so desire, and the urge to binge eat. Although the act of binging will undoubtedly cause feelings of shame and disgust, you just cant help yourself, and fall back into this cycle time and time again. The average binge can mount to the consumtion of anywhere between 2,500 up to 6,000 calories in minutes. Afterwards, the need to reverse and neutralise the binging episode is overwhelming, which can lead to extreme behaviours. Laxative abuse, deliberate vomiting, fasting or unreasonable and intense amounts of exercises are common examples.
Do I have Bulimia?
If you can answer yes to several of the questions below, then you may be suffering from bulimia nervosa.
- Seemingly over obsessed with your image, weight or shape of your body?
- Do you feel negative feelings after you eat, such as intense shame, regret and guilt?
- Do you ever eat so quickly, and such vast amounts that you feel like you may be sick?
- Do you ever use laxatives or vomit deliberately as an attempt to gain some control over your own weight?
- Have you noticed more persistent and intrusive thoughts around food, weight and exercise?
- Would you say that an abnormal amount of your day is spent thinking about nutrition and body image?
Bulimia is largely related to being ‘stuck’ in an unhealthy cycle that you find extremely difficult to break out of. What feels like the solution, or at least brings about a temporary feeling of relief from the guilt, is what can becomes the very problem itself. The counter- productive behaviour largely centres around trying to attain a more strict and rigid diet, as this is likely to in turn make you even more obsessed with food and body image. As you become more obsessed about food, feelings of hunger and stress on the body make you want to eat. The act of eating o ‘forbidden food’ all becomes too tempting, and once eaten all those cravings disappear. However, it is likely that you then fall into black and white thinking, and feel that you have started eating this ‘junk’, so what’s the point, you might as well continue. However, the effects of this binge last a very short period of time, and then negative and intense feelings of guilt, regret and shame set in. The urge to undo that purge becomes all consuming, and an act such as exercising for an unhealthy amount of time, or abusing laxatives is too tempting to resist. Unfortunately this behaviour not only makes you then more likely to binge eat again, but also supports the mind-set that it’s ok, after all you can just purge to undo everything next time too. These behaviours are what fuel this unhealthy cycle, and the effects on the body can be damaging and potentially long lasting.
Binge eating disorder is characterized by the urge to compulsively overeat, whereby you feel over riding feelings to eat large quantities of food whilst feeling like you have little or no control over whether you do so or not. An binge eating episode can last anywhere between 1-3 hours, although some people experience intermittent binging in that they binge eat for small periods over a longer period of time, say an entire day for example. At times someone that is binge eating will pay little attention to the actual taste of the food, often eating for periods of time when are they not in fact hungry, but the act has become compulsive.
What are the main features of binge eating disorder?
- Lack of control over eating binges
- Experiencing intense emotions such as shame, guilt or regret after a binge eating episode
- There are no attempts to neutralise or undo the binge eating episode. This is a key different between bulimia nervosa and binge eating disorder
The main compulsion for binge eating disorder is the act of eating itself. There are little or no acts which make the person feel better, but there is an overwhelming urge to partake in consuming large amounts of food to make yourself feel better. Often replacing emotions like feeling out of control, or large amounts of pain in your life, binge eating can be a good distraction and a means of trying to gain some control unwanted and negative emotions. The urge to binge eat normally replaces unwanted emotions, and although temporarily eating vast amounts of food may make you feel better, the relief is short lived, and feelings of disgust and self-criticism are likely to set in. This then leads to further binge eating, and so the cycle continues. Similar to Obsessive Compulsive Disorder, any control over intrusive thoughts and emotions by performing some act or compulsion, in this case the act of eating, only serves to temporarily make the person feel better. As with many anxiety conditions, it is in trying to grasp at this control, where the true problem lies, which only strengthens the habitual cycle further.
How can our treatment help?
Like OCD, anorexia nervosa, bulimia nervosa and binge eating disorder largely relate to the person using some external behaviour or compulsion to gain feelings of safety, control or distraction from other unwanted feelings. Like more traditional Obsessive Compulsive Disorder, there tends to be some habitual cycle that is taking place. Firstly there is that negative unwanted thought, or feeling that the individual gives too much attention to, and rather than accepting it performs some act to take those intrusions away. Although this may temporarily give the sufferer some short term relief, the effects are not very long lasting, and before the person knows it they are caught up in the same unhelpful, ritualistic behaviour day in day out. Our treatment can show you ways of clearly identifying what is going on underneath the surface. Although we appreciate how debilitating these conditions can be, we assure you that there is hope. As well as educating you around exactly what is going on for you, both mentally and physically, we can show you simple and effective ways to positively gain control back into your life, and break these negative self-perpetuating cycles. The intensive method has been known to be extremely effective when treating a wide array of anxiety disorders, as the very nature of the condition is an habitual one. Therefore working in ‘blocks’ of therapy can aid a quick and effective process, and deeply challenge what is driving your condition and your continual suffering.