Eating Disorders & Co-Occurring Disorders

Eating disorders present plenty of challenges on their own.  Further complicating recovery are co-occurring disorders; other mental health conditions that exist along with the eating disorder.  These conditions may exist prior to the eating disorder, start along with the eating disorder, or begin because of the psychological distress of eating disorder.  Let’s look at some common examples.


Anxiety is the most common co-occurring disorder, perhaps due to overlapping risk factors:  rigid beliefs and behaviors, and perfectionist tendencies.  Anxiety can present mentally, such as overwhelming nervousness or irritability, or physically, such as difficulty concentrating and GI issues.

Mood Disorders

Eating disorder co-occurrence is high with bipolar disorder and depression.  Often the eating disorder is developed as a coping mechanism for symptoms of the mood disorder but can also occur due to malnourishment and side effects of the eating disorder.


Symptoms of OCD and eating disorders are similar:  rigidity, meticulousness, perfectionism, difficulty coping with changes to daily life.  Additionally, intrusive thoughts often followed by ritualistic behaviors (compulsions) can occur.  As such, eating disorders can become a manifestation of these thoughts and compulsions.

Substance Use Disorder

Substance use disorder and eating disorders often feed off one another, as they are both used as a method of coping.  They also share risk factors including family history, low self-esteem, social pressures, and anxiety/depression.


Many individuals with eating disorders also meet criteria for PTSD.  Many more have some level of trauma that causes a disconnect from the body and emotions.    Purging behaviors are more likely in those with PTSD, as it often numbs the hyperarousal and flood of emotions associated with traumatic flashbacks.

This co-occurrence stresses the need for multidisciplinary teams in eating disorder care.  At minimum a therapist, dietitian, and primary care provider are recommended to address the emotional, behavioral, and medical needs of the disorders.  Please reach out to discuss how we can help you fill out your team and continue your journey to recovery.

References (Accessed 6/2/23) (Accessed 6/2/23)

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