Eating Disorders

Eating Disorders are often mistakenly confused by some as a form of OCD, and whilst they are totally separate to OCD, there are overlaps and some similarities.  Anorexia nervosa and bulimia nervosa are serious eating disorders but some studies suggest a large number of people with these conditions perhaps also have OCD.

The intense determination to lose weight, and the sufferer's incessant preoccupations with food, weight, body size and shape, are all factors that lead experts to believe  the two disorders are related. Anorexics are commonly described as 'obsessed with thinness'. They are certainly preoccupied with their weight, size, and eating. However, anorexia nervosa is a separate disorder, not part of the OCD spectrum.  A sizeable sub-group of anorexic patients has obsessions and/or compulsions, some of them quite marked; the two disorders do co-exist. In fact many studies have reported this co-morbidity in a significant minority of anorexic patients.  Sometimes, the symptoms of the two disorders influence each other and get intertwined — i.e. certain behaviour assumes significance in both disorders.  For example: An adolescent girl had the compulsive behaviour of running up and down the stairs a certain number of times before every meal.  This had all the features of a compulsion, but it could equally be seen as anorexic behaviour, designed to lose weight —and it certainly had that effect.  She also had the compulsion to leave a quantity of food on her plate, arranged in a certain way, unconsumed. Her explanation was that she felt compelled to do this.  Although she denied that it had anything to do with restricting her eating, the behaviour clearly contributed to maintaining a lower weight.

Patients with both anorexia and obsessive-compulsive problems report that their latter difficulties tend to get worse when they are particularly unhappy with their weight and body size  It is also known that anorexics with obsessive-compulsive symptoms tend to display more severe anorexic disorders than those who do not have such symptoms.

In bulimia nervosa the patient has recurrent episodes of binge eating, followed by self-induced vomiting and/or laxative abuse.  The urge to engage in binge eating is described by some of these patients as having a compulsive quality, although the nature of the behaviour is by no means senseless.  As with anorexics, some bulimics also have accompanying obsessive-compulsive problems, some features of which may become closely related to the eating disorder.  For example, a young woman with a history of both disorders reported that when she binged on chocolate bars she felt compelled to eat 24 bars at a time, neither more or less, and the binge had to be uninterrupted.  If the chocolate bars got 'contaminated' by the smell of another food, then the binging episode had to be restarted.

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