Link Between Anxiety and Eating Disorders

It’s not unusual for people with eating disorders like anorexia, bulimia, or binge-eating disorder to have a co-occurring mental health disorder. These co-occurring disorders may include depression, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), the last of which is the most common. People with OCD and anxiety often develop eating disorders because they create rituals or use food and eating behaviors to feel as though they have full control of this aspect of their life. But how are anxiety and eating disorders really linked?

Symptoms of Anxiety

Everyone feels anxious from time to time, but anxiety disorders are different. These are serious mental health disorders that can take over a person’s life, making tasks as simple as doing groceries, nearly impossible. Although many people have anxiety-related eating disorders, when the anxiety becomes debilitating, it could be an anxiety disorder.

Anxiety disorders can range in severity, and considering how common they are among people with eating disorders, understanding the symptoms of anxiety is important. These may include:

• Excessive worry
• Restlessness
• Agitation or irritability
• Rapid heartbeat
• Tense muscles
• Avoidance of social situations
• Sleep problems
• Irrational fears
• An intense, overwhelming fear

Eating Disorder Symptoms

The signs and symptoms of eating disorders may vary depending on the disorder itself. Eating disorders are a group of behavioral disorders that involve both emotional and behavioral symptoms. They have a high mortality rate compared to other mental illnesses, with anorexia nervosa at the top of the list.

Below are some general symptoms of eating disorders:

• Extreme weight loss or weight gain
• Difficulty gaining weight
• Fatigue and muscle weakness
• The absence of menstruation in or irregular menstruation in women
• Low blood pressure
• Nutritional deficiencies
• Preoccupation with body size or shape
• Frequently skipping meals or refusing to eat
• Refusing to eat in public or lying about how much food one has eaten
• Mood swings
• Rituals around food, such as eating foods in a certain order
• Dry skin and nails
• Imbalances in sodium, potassium, and other electrolytes
• Eating beyond the point of feeling full
• Using laxatives, self-induced vomiting, or other compensatory behaviors to try to lose weight
• Repeated episodes of fasting between binges
• Disappearing to the bathroom after eating
• Tooth decay and other dental problems
• Social withdrawal
• Bloating and stomach problems
• Low self-esteem and self-confidence
• Periods of eating more rapidly than normal
• Eating a greater amount of food than what most people would eat during the same time
• Hiding food and engaging in other secretive behaviors to hide binges

Because every eating disorder is different, finding individualized care for your condition or that of a loved one is important. Our center for eating disorders in Philadelphia offers various levels of eating disorder treatment, including care for anorexia, bulimia, binge eating disorder, and more. If you or someone you care about exhibits any of the signs above, don’t wait to get help.

What Role Does Anxiety Play in Eating Disorders?

According to a 2004 study, two-thirds of people had both anxiety and eating issues at some point in their lives, while around 42 percent had developed anxiety disorder during childhood, well before the usual onset of their eating disorders.¹ Other studies also confirm that anxiety disorders usually come before eating disorders, while panic disorders follow the latter.

Obsessive-compulsive disorder (OCD) is a form of anxiety and the most common among people with eating disorders. Many people with OCD develop an eating disorder because they create compulsive rituals connected to food, such as weighing every bit of food they’re going to eat, counting calories, cutting food into tiny pieces, or even binge eating. They perform these rituals to reduce the feeling of anxiety they get from intrusive thoughts (obsessions), and in the end, they end up developing an eating disorder, as well.

Additionally, disorders like binge eating disorder can reduce anxiety and improve a person’s mood due to increases in dopamine and serotonin from eating. Anxiety levels tend to be high right before binge eating episodes and decrease during a binge. Often, anxiety and depression return after a binge, along with shame and guilt related to the behavior.

Those with binge eating disorders may find that their anxiety is worse after a binge eating episode, which only adds fuel to the vicious cycle. Although an eating disorder caused by anxiety is more common among women and girls, men and boys make up 5% to 15% of people with anorexia or bulimia and about 35% of people with binge eating disorder.²

Can Anxiety Cause Eating Disorders?

Yes, anxiety can cause eating disorders. Anxiety and eating disorders are interlinked because food and eating-related behaviors are often a response to anxiety. As we mentioned before, people with OCD, for instance, may develop eating disorders because they develop food and eating-related compulsions to cope with their obsessions (intrusive thoughts). Individuals with anxiety may also feel as if food and behaviors, like counting calories, are the only ways to maintain control in their lives.

Finding Eating Disorder Support

Banyan Treatment Center offers eating disorder treatment in Philadelphia for disorders like anorexia nervosa, bulimia nervosa, binge eating disorder, and more. Our treatment includes nutritional management and counseling as well as individual and group therapy to help clients develop healthier ways to cope with their symptoms and live happier lives.

Whether it’s anorexia treatment or support for OSFED, Banyan Treatment Center Philadelphia is here to help. For more information about our center for eating disorders, contact Banyan at 888-280-4763.

1. NIH - Comorbidity of anxiety disorders with anorexia and bulimia nervosa
2. NIH - Eating disorders in males: a report on 135 patients