Obsessive Compulsive Disorder (OCD) as a risk factor for eating disorders

A research collaboration between the Institute of Psychiatry (IoP) and the South London Maudsley NHS foundation Trust’s OCD Service for young people has identified a link between eating disorders and Obsessive Compulsive Disorder (OCD), with childhood OCD shown to be a risk factor for the development of a teenage eating disorder.

This finding echoes our experience at Life Works, where many of our eating disorder clients, present with the co-occurring disorder of OCD.

What is Obsessive Compulsive Disorder

OCD is a mental disorder with symptoms varying from mildly to severely disabling. OCD tends to develop in childhood and may affect the person throughout life with the sufferer often having unrealistic and illogical worries.

A key aspect of the disorder is a compulsion to engage in repetitive behaviours such as:

• Checking something over and over
• Hoarding
• Keeping things in order

Children that suffer with OCD are highly distressed and anxious and the compulsive behaviours interfere with normal living, impacting on academic performance, social relationships, and healthy development.

What causes Obsessive Compulsive Disorder

A recent study has found that contrary to what was previously believed, OCD begins with compulsions, which leads to obsessions, not the other way around.

Obsessions are therefore believed to be the brain’s way of making sense of the compulsive behaviours, by instilling a very real obsessive fear in order to justify and explain what would otherwise make little sense. The fact that the obsession tends to cease with the cessation of the compulsive behaviours, reveals something central about the development of the disorder.

Viewing compulsive behaviours as a pre-cursor to OCD allows earlier detection and better screening tools.

Why there is a link between eating disorders and OCD

It has long been recognized that the clinical presentation of eating disorders and OCD is quite similar and that many eating disorder sufferers also suffer from OCD. The core abnormal thoughts and behaviours about food and eating associated with eating disorders have obsessional and compulsive features.

Patients with eating disorders will often perform specific rituals in their pursuit of weight loss, binge eating and purging which resembles the ritualistic nature of OCD behaviours. Yet because the two disorders share some central features it can be difficult to determine whether an eating disorder patient whose behaviours have an OCD component has an underlying OCD until the eating disorder has been successfully treated. What we often find is that the OCD behaviours are part of the eating disorder.

On a positive note

Identifying childhood OCD as a contributing factor to developing an eating disorder in adolescence allows professionals to recognize higher risk individuals and administer early treatment and potentially even prevention.