Understanding the Relationship Between Eating Disorders and OCD

October 26, 2023

Almost all types of mental health conditions are more common among people who have an eating disorder. These conditions are often referred to as “co-occurring disorders.” One co-occurring disorder that has drawn a lot of attention from researchers and the public is obsessive-compulsive disorder. The relationship between eating disorders and OCD can be complicated, making it more difficult to treat both conditions. However, with the right program, these conditions can be addressed effectively.

What is an Eating Disorder?

Eating disorders are mental health conditions that involve an intense focus on body shape, weight, and a preoccupation with food. Individuals with eating disorders typically engage in dangerous behaviors surrounding food and exercise to manipulate their weight and body size.

The most common examples of eating disorders are bulimia nervosa, anorexia nervosa, and binge eating disorder. Eating disorders can have severe emotional and physical ramifications, and early intervention is key.

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder, which may also be called “OCD,” is a common mental health condition that can seriously interfere with a person’s daily life. People who have OCD struggle with obsessions, which are intrusive, uncontrollable thoughts that continue to come back over and over. These thoughts lead the individual to engage in rituals designed to alleviate the associated distress. These behaviors are known as “compulsions.”

Obsessions can be focused on almost any topic, but some of the most common focuses include fear of germs, having things in perfect order, and thoughts of harm. In the case of someone with an eating disorder, obsessions may be related to food or body shape. People who suffer from OCD have difficulties controlling their compulsive thoughts or the ritualistic behaviors that accompany them. The behaviors performed to alleviate the discomfort of obsessions may relieve stress or anxiety, but are still a symptom and sign that the individual is struggling.

Common underlying factors for OCD and Eating Disorders

There is a high likelihood of eating disorders and OCD developing simultaneously due to commonalities in underlying factors. Both OCD and eating disorders are tied to comorbidities such as anxiety and trauma. Identifying and addressing these common underlying factors is typically an important component of any treatment program designed for people with both an eating disorder and OCD.

According to the International OCD Foundation, as many as 69% of people with eating disorders may also experience symptoms of OCD. Among people who have OCD, the rates of eating disorders may be as high as 17%.

OCD and Anorexia Nervosa and Bulimia Nervosa

OCD is a common co-occurring illness among individuals who struggle with all eating disorders, especially anorexia nervosa and bulimia nervosa. Anorexia nervosa involves an overwhelming concern with manipulating weight by restricting calories. Those with anorexia nervosa and OCD may engage in specific disordered eating behaviors, such as counting bites of food or arranging food in specific ways.

Individuals with bulimia nervosa experience a similar preoccupation with obsessions and disordered behaviors around food, however, it is characterized by bingeing and purging.

When OCD and Eating Disorders are Mutually Exclusive

In some cases, a client may have both OCD and an eating disorder but without an interaction between the two disorders. For example, the individual’s OCD may be focused on contamination and/or germs without any consideration for body shape, food, or weight. In these cases, the two disorders co-occur together because they stem from similar underlying causes, such as a history of trauma and/or a tendency toward perfectionism.

It is important to note that even if a person has OCD and an eating disorder that seems to be mutually exclusive, treating both disorders at the same time is still recommended. The goal of any eating disorder treatment program should be to help the person heal in all aspects of their life and build the healthiest future possible.

In addition, failing to treat OCD during the eating disorder treatment program may make the client more vulnerable to stress and triggers after discharge, which may raise the chances of relapse.

Treatment for people with OCD and an Eating Disorder

When someone has both an eating disorder and OCD, it is best they seek specialized treatment. Without the proper treatment plan to address both diagnoses simultaneously, the chance of a full recovery is not as high.

To effectively treat both the eating disorder and co-occurring OCD, a treatment program should:

1. Formally diagnose both the eating disorder and OCD.
In some cases, a person who has an eating disorder and OCD may be unaware of one or both conditions. The best programs will include a thorough assessment designed to identify the client’s eating disorder and consider the presence of any other mental health condition, including OCD. These conditions cannot be treated effectively unless they have been properly diagnosed. Making the individual aware of these issues can also help with the effectiveness of the treatment program.

2. Incorporate OCD treatment into the eating disorder treatment plan.
OCD is a difficult disorder to treat. However, if this disorder is not treated, obsessions and associated rituals will make it difficult for someone to maintain recovery even after receiving treatment for an eating disorder. Examples of treatments that can be effective for patients with OCD include psychotherapy, behavioral therapy, and medication.

3. Customize treatment based on the client’s individual needs.
Every person is unique. While some patients have eating disorders and OCD that are deeply intertwined and related to one another, others may deal with each condition separately. Likewise, some people may respond to certain treatment approaches better than others. For this reason, treatment programs need to be tailored to the individual. The best eating disorder treatment programs will involve a thorough assessment and careful, customized treatment planning.

4. Have an aftercare plan.
Everyone who enters treatment for an eating disorder should have a plan for aftercare before being discharged from the program. Aftercare planning is even more important for someone who also has OCD.

On its own, OCD is a pervasive condition that can dramatically decrease quality of life. Whether or not a person’s OCD is intertwined with their eating disorder, having the condition makes eating disorder treatment more complicated. Ongoing treatment after discharge that focuses on both the OCD and the eating disorder is the best way to reduce the chance of relapse and give the individual the best chance of embracing a healthier life and remaining fully recovered.

Treating Eating Disorders and Obsessive-Compulsive Disorder at Monte Nido

If you or someone you love is showing the signs of an eating disorder complicated by OCD, getting the right treatment is essential. At Monte Nido & Affiliates, we understand the complexities of treating eating disorders with co-occurring disorders, including OCD.

If you’re interested in learning more about our programs, please visit www.MonteNidoAffiliates.com or email Admissions@MonteNidoAffiliates.com to connect with a member of our Admissions Team.


Monte Nido & Affiliates delivers clinically comprehensive, research-backed treatment to adults and adolescents with eating and co-occurring disorders, within a healing environment. As a Miami, FL-based company, Monte Nido & Affiliates has over 50 programs, offering a full continuum of care. Founded in 1996, Monte Nido & Affiliates specializes in the treatment of eating disorders for all genders and includes four distinct clinical programs: Monte Nido, Walden Behavioral Care, Clementine, and Rosewood Centers. For over two decades, our tenured and expert staff — which includes recovered professionals — has delivered treatment that leads to full recovery. For more information, please visit: montenidoaffiliates.com.