D'Amore is now in-Network with United Health Group
We are proud to announce the opening of our fourth Residential Facility: Cheyenne House
D'Amore is now in Network with MHN Health Net Insurance
We are proud to announce the opening of our fourth Residential Facility: Cheyenne House
D'Amore is now in Network with MHN Health Net Insurance
D'Amore is now in Network with MHN Health Net Insurance

Anxiety & Eating Disorders

Examining The Complex Relationship Between Disordered Eating and Anxiety Disorders

Table of Contents

The number of people suffering from some form of anxiety is climbing rapidly, especially in recent years. More concerning is the fact that anxiety and eating disorders go hand in hand. It’s almost as if the presence of one invites the other.

But how does one go from feeling nervous to experiencing the onset of anxiety eating disorders? Well, it’s quite complicated and requires some digging before finding an answer. The truth is, anxiety disorders and eating disorders are umbrella terms for a myriad of different signs and symptoms that can appear.

To fully understand how both conditions relate, it’s a good idea to break them down individually first. Comprehending how each one functions lays the foundation for taking the first steps to recovery. 

Understanding Anxiety

Anxiety is a term used to describe what many consider a form of restlessness. More often than not, it’s considered pent-up emotions manifesting in a passive form. That is, feeling a need to react to some kind of stressor, but being unable to take action and resolve or remove the stressor, either literally or metaphorically.

Common examples include a feeling of impending danger or doom, sweating, an increased heart rate, weakness or lethargy, difficulty sleeping, and deep worry. It’s important to note that many view these symptoms as normal for the average person, so it’s worth clarifying that anxiety, as a disorder, exists when the symptoms are chronic or overly intense.

People should seek medical assistance immediately if they notice that their anxiety interferes with parts of their lives, feel depressed, find themselves abusing substances, or have thoughts of self-harm. If these signs aren’t present, it’s more than likely a person can find ways to resolve their anxiety without professional assistance.

Types of Anxiety Disorders

While anxiety disorders can be viewed as similar in a few aspects, there are subdivisions that are more specific to certain feelings. This is especially true when considering the context. Here are some of the most common examples.

Social anxiety disorder, otherwise known as social phobia, refers to feelings of fear and nervousness surrounding social situations. It’s associated with internal thoughts regarding self-image, self-esteem, and excessive concern about what others might think of the individual.

Anxiety, in the form of panic disorder, appears in the form of sudden outbursts along with feelings of intense fear. Typically known as panic attacks, these can also evoke physical symptoms like chest pain, a headache, or heart palpitations. Unfortunately, these can create a vicious cycle. That is, a person might suffer from panic attacks at the thought of suffering from a panic attack.

Generalized anxiety disorder refers to the presence of nervousness for various types of activities, gatherings, and events. This is quite broad and can include examples like brushing your teeth, using a certain type of clothing, and reading your emails. This comes in stark contrast to anxiety regarding events that would otherwise normally cause nervous feelings in most people.

Some individuals might not fit under one of the classifications of anxiety disorders. It’s still possible to determine whether someone might suffer from an anxiety disorder by checking if they suffer from any number of the following symptoms:

  • Restlessness
  • Bursts of anger
  • Isolation
  • Troubles sleeping
  • Nonsensical phobias
  • Panic attacks

Understanding Eating Disorders

Eating disorders involve a complex set of factors that, when combined, alter the way a person consumes food on a daily basis. They can appear due to social contexts, cultural traditions, genetics, biology, and mental health issues. There’s usually a change in the relationship between a person and the food they consume. This then alters a person’s physical appearance, this often results in feelings of shame and guilt or satisfaction which in turn can worsen the eating disorder.

Types of Eating Disorders

Eating disorders come in many forms, although all involve an abnormal relationship with food. Eating disorders are such a broad diagnosis that they are often subcategorized to understand specific symptoms and receive a separate diagnosis. Although an individual may be diagnosed with a specific type of eating disorder, symptoms and patterns of behavior can change over time. 

An individual with Anorexia Nervosa restricts their intake of food which leads to a low body weight based on their age, sex, developmental trajectory, and physical health. Anorexic individuals have an intense fear of gaining weight or becoming fat despite being underweight. Due to individuals with this disorder having an extremely low BMI and many physical health complications, Anorexia is the most deadly mental health disorder.  

Anorexia Nervosa is further subcategorized into a restrictive type and binge-eating and purging subtype. The binge-eating and purging subtype is characterized by both overeating and participating in behaviors like self-induced vomiting or the misuse of laxatives or diuretics The restrictive type of anorexia focuses on low intake of food without the behaviors of binging and purging.

Bulimia Nervosa is an eating disorder that consists of two different kinds of behavior. The individual with the disorder cycles through periods of binge eating and behaviors to get rid of the food they have consumed. The binge eating cycle includes eating amounts of food larger than what a normal person would consume and having a lack of control over eating during this part of the cycle. 

In order to get rid of the food they have consumed during a binge and prevent weight gain, a person with bulimia may self-induce vomiting, take laxatives, diuretics, or overexercise. This cycle of behaviors occurs at least once a week for three months in order to be diagnosed with bulimia.

Binge Eating Disorders are characterized by recurrent episodes of eating an amount of food that is larger than what most people would intake in a similar period of time and a lack of control over eating during the episode. These individuals may consume food until they are uncomfortably full or when they are not physically hungry. To be diagnosed with BED, you must binge eat at least once a week for three months. 

Often after the binge episode, a person with BED may feel ashamed and want to keep their eating behaviors a secret. Individuals with BED do not have any behaviors to get rid of the food they have consumed. Binge Eating Disorder can occur in people of any BMI, but it is often seen in overweight individuals. 

To be diagnosed with OSFED, an individual meets some, but not all of the criteria for a subtype of an eating disorder. People with Atypical Anorexia Nervosa, fit all the criteria for Anorexia Nervosa but are within a normal weight range. People who fit all the criteria for binge eating disorder or bulimia nervosa but the symptoms of their disorder are not frequent enough to fit the criteria may be diagnosed with OSFED instead. 

A person who purges without binge eating does not meet the criteria for the other subcategories of eating disorders and will often be diagnosed with Purging Disorder OSFED type. Night Eating Syndrome is another Other Specified Feeding and Eating Disorder that occurs in individuals who repeatedly eat after waking up from sleep or eat large amounts of food after dinner.

ARFID, previously known as “Selective Eating Disorder” occurs in individuals who limit the amount or types of food, but is not based on fear of gaining weight. People with ARFID may be confused with picky eaters, but their relationship with food may be caused by anxiety or phobias. This may materialize by a lack of interest in eating or food or repulsion of food based on texture or other senses. 

Symptoms of Disordered Eating

While there are many more eating disorders, there are symptoms that are common amongst them. These are a few examples of common and broad symptoms related to eating disorders:

Anxiety and Eating Disorders

Eating disorders and anxiety, more often than not, go hand in hand. This is similar to the connection between anxiety and substance abuse. In many cases, one leads to the other. Additionally, people often fall into a vicious cycle where their anxiety will contribute to their eating disorder, which then produces more feelings of anxiety.

Medical research has yet to determine the specifics regarding the connection between anxiety and eating disorders, but the connection is very apparent among patients. There are, of course, common conclusions that provide some explanation.

One conclusion involves dopaminergic activity. In some patients that have PTSD and eating disorders, consuming fatty foods with high-calorie content helped them relax and reduce stress. However, an anxiety disorder like social anxiety disorder would then prevent them from attending events, as they feel embarrassed due to weight gain.

Another conclusion considers the fact that some patients look to food for comfort. In this case, a person diagnosed with an anxiety disorder would relieve their symptoms, not to be confused with a dopaminergic “fix,” through eating. They would then be able to, for example, attend social events and feel completely fine. So, the person in this example has an anxiety disorder that leads to an eating disorder.

Symptoms of Anxiety Eating Disorders

Identifying patients with anxiety eating disorders seems simple at first glance, but it’s more in-depth than many might consider. Dietary changes are commonplace and, in some cases, people that suffer from a change that lasts months would be fit for diagnosis.

Some individuals, to use another example, gain weight intentionally to later build muscle during a “cutting phase.” This is very intentional in the world of bodybuilding. Others might seek to lose as much weight as possible for a position at a modeling agency. In both cases, unless overseen by a medical professional, there’s a chance for an eating disorder to appear. It’s also situations like these that make it so difficult to spot anxiety eating disorders.

Sticking to the two aforementioned examples, we can look for the connection between anxiety and eating disorders. The person seeking to gain weight and “cut” for muscle gain at a later date might have a social anxiety disorder. This would mean that they’re trying to build their self-image and self-esteem to feel more comfortable at social gatherings, for example.

The person in the second example seeking to fill a position at a modeling agency might find themselves suffering from Anorexia nervosa or Bulimia nervosa. Both would usually lead to weight loss. And, while it might seem silly, another reason they seek to lose weight could come from generalized anxiety disorder, where they get very anxious when they know that they’re overweight.

Detangling The Relationship

Anxiety eating disorders are, essentially, a combination of symptoms that feed off of each other. In most cases, anxiety will push a person into an eating disorder. People usually start small and develop eating habits over time that are especially hard to break due to their capacity to alleviate anxiety symptoms.

While the examples may seem hard to understand, the physiological nature of both disorders intertwined can feel impossible to follow. For simplicity’s sake, there’s a counterintuitive reaction to elevated levels of dopamine and serotonin after eating foods in varying amounts.

In people with Anorexia, this results in high levels of tension and anxiety, resulting in what you could consider a “fear” of eating. Bulimics have an opposite reaction to the uptick in dopamine and serotonin, instead of seeing relief of anxiety symptoms. The truth is, it’s very difficult to properly diagnose, treat, and accompany individuals with anxiety eating disorders. It requires a lot of care and patience.

Treating Anxiety and Eating Disorders

If you suspect you or someone you know may have an anxiety eating disorder, seek help as soon as possible. If necessary, set up an intervention. The sooner an individual receives assistance and treatment, the sooner and more likely they are to recover. The best treatment for any disease is prevention.

Dealing with anxiety eating disorders can prove quite difficult. Many consider it a vicious cycle and refer to it as a “nightmare.” But, reaching out to the right professionals and help can yield amazing results. Treatment involves a mix of psychological therapy, nutritional counseling, and medical assistance via medication.

The first step usually involves psychological therapy, first and foremost to intervene and deal with any present life-threatening behaviors. Many also aim to achieve acceptance before moving forward. That is, for the patient to feel comfortable with who they are, and to understand that they’re not “broken” or “odd.” Shortly after, a nutritionist steps in for educational and guidance purposes.

Psychological therapy and nutritional guidance attack the anxiety and eating disorder separately, with an approach similar to addiction recovery. When progress is made, the recommended follow-up is a consultation with a medical doctor that can prescribe medication. The type of meds varies greatly depending on the present disorder or disorders.

Life After Treatment

While it’s very possible to treat anxiety eating disorders, it’s important that patients, and their respective friends and family, follow their case. A major problem that individuals suffering from anxiety and eating disorders have to face involves self-control when alone. And, because isolation is often where symptoms can appear, having peers monitor the individual can keep them on the right track.

Anxiety and eating disorders can exist separately. Even on their own, they can be crippling. When anxiety and eating disorders combine, however, things can get much worse. The combination of anxiety symptoms with a profound alteration to eating habits makes it seem impossible to get better.

Some people turn to food to solve their anxiety problems, while others stumble into an anxiety disorder due to their eating habits. Either way, in the end, they have to deal with a vicious cycle. It’s still possible to recover, though.

Whether it’s a combination of BED and panic disorder, or social anxiety disorder and Anorexia, the right professionals can find a solution. A lot of the responsibility falls on the shoulders of the patient, though, making success more likely if they have friends and family to help.

It all starts with a proper diagnosis by a medical professional. After that, a psychologist and nutritionist help inform, correct, and guide the patient. Once progress is made, the patient is ready for the potential addition of medication. Finally, though, the patient has to follow instructions while on their own. The potential to fall back into prior habits is quite high, so monitoring the case is essential.