Making the connection
Anxiety disorders are the most common “comorbid disorder” found with eating disorders. A 2007 national survey found that 80.6 percent of people suffering from bulimia suffered from an anxiety disorder at one point. Depression is another commonly seen disorder among bulimics. Both anxiety and depression are frequent comorbid conditions among those suffering from anorexia as well.
A 2004 study found that two-thirds of people with eating disorders suffer from an anxiety disorder at some point in their lives and that around 42 percent had developed an anxiety disorder during childhood, well before the onset of their eating disorder. Other studies also confirm that an anxiety disorder usually the onset of an eating disorder, but panic disorder often follows.
Obsessive-compulsive disorder (OCD) is the most common anxiety disorder to co-occur with an eating disorder. Those who have both disorders often develop compulsive rituals connected to food, such as weighing every bit of food or cutting it into tiny pieces, or even binge eating.
Anxiety and eating disorders may be treated at the same time and in the same manner. Even so, recovery from one disorder does not ensure recovery from another, so it is necessary to seek help for both.
A well-established, highly effective, and lasting treatment is Cognitive-Behavioral Therapy, or CBT, which focuses on identifying, understanding, and changing thinking and behavior patterns. Benefits are usually seen in 12 to 16 weeks, depending on the individual.
The research shows that anxiety disorders tend to precede eating disorders and that specific anxiety disorders seem to be more likely to occur with either anorexia nervosa or bulimia nervosa.
In an article for the winter 2011 edition of The Renfrew Center Foundation’s professional journal “Perspectives,” David Barlow, PhD and Christina Boisseau, PhD., discuss a “transdiagnostic” treatment protocol they’ve developed called UP, for Unified Treatment Protocol, designed for use with eating disorders and anxiety and depressive disorders. What makes it unique, they explain, is the emphasis it places on how patients experience and respond to their emotions. This treatment incorporates the following therapeutic techniques:
- Brining attention to emotional awareness of experiences as well as secondary judgments
- “Cognitive reappraisal” that involves challenging core beliefs
- Increased awareness and understanding of “emotion-driven behaviors” such as avoidance and bingeing and purging
- Engaging in therapeutic exercises that evoke the intense emotions he might feel along with social anxiety
- Exposure to internal and external emotional triggers in an attempt to increase emotional tolerance
Online and research references
- Comorbidity between eating disorders and anxiety disorders: A review N. T. Godart,, M. F. Flament, F. Perdereau, P. Jeammet, 23 AUG 2002
About Lindsay Brady, LICSW: Lindsay is a licensed independent clinical social worker with a private practice in Framingham, MA. Lindsay’s passion for helping individuals, families, and organizations reach their full potential for meaningful change has been the greatest motivator in her work to develop the Metrowest Clinical Collaborative.