Understanding the Overlap Between OCD &
Eating Disorders
Eating disorders and Obsessive-Compulsive Disorder (OCD) often coexist, and at Recovered & Restored, we believe it’s essential to understand how these conditions may interact so that clients can receive the most effective, individualized care. If you’ve ever wondered why you or someone you love struggles with both food and intrusive thoughts, this page is here to help you understand the connection.
What Is an Eating Disorder?
According to the American Psychological Association, an eating disorder is "any disorder characterized primarily by a pathological disturbance of attitudes and behaviors related to food." Common diagnoses include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder (ARFID), and other specified feeding and eating disorders (OSFED). Check out a recent blog from our registered dietitian that explores the definition of eating disorders in great depth.
These conditions are complex and impact both mental and physical health. While every individual is different, common signs of an eating disorder include food restriction, binge eating, compensatory behaviors like purging or over-exercising, extreme concern about body weight or shape, and emotional distress around eating.
Eating disorders are best treated through a multidisciplinary team approach that may include an eating disorder therapist, dietitian, psychiatrist, medical provider, and family support.
Overview of Common Eating Disorders
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Anorexia Nervosa: Characterized by food restriction, fear of gaining weight, and body image distortion.
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Bulimia Nervosa: Involves cycles of binge eating followed by purging.
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Binge Eating Disorder: Marked by recurring episodes of eating large amounts of food with feelings of loss of control.
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ARFID: A persistent disturbance in eating due to sensory issues, fear of adverse consequences, or lack of interest in food, without body image concerns.
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OSFED: Includes variations of eating disorders that don’t meet full criteria for the above diagnoses, such as purging disorder or atypical anorexia.
What Is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health condition involving intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that individuals perform to relieve anxiety. These thoughts are not simply preferences or interests; they are unwanted and distressing, often leading to significant emotional turmoil and life disruption.
Compulsions might look like excessive checking, cleaning, reassurance-seeking, or rigid routines. While these behaviors can provide temporary relief, they reinforce the anxiety long-term.
How OCD and Eating Disorders Overlap
According to the International OCD Foundation, up to 69% of individuals with an eating disorder also experience OCD symptoms, and 41% are formally diagnosed with both. In our experience, the overlap is often even higher, especially when we consider how underreported these symptoms are due to stigma and shame.
One of the most significant areas of overlap is ritualistic behavior. For example, both individuals with OCD and those with eating disorders may develop strict routines around food. However, when both conditions are present, these routines become deeply rooted in fear-based compulsions:
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A person may feel the need to eat in a certain order or arrange food symmetrically.
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Body checking may become a compulsive ritual (e.g., weighing oneself multiple times or checking a specific body part).
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Food restrictions might be linked to intrusive thoughts about contamination or safety.
The "just right" feeling is another hallmark of both conditions. Someone may cut their food into precise shapes or engage in repetitive exercise rituals until things feel balanced or correct. While people without OCD may have preferences, individuals with OCD and eating disorders experience extreme anxiety if their routine is disrupted. Learn about the 10 different types of OCD here.
Why Does It Matter?
Treatment: How We Help
At Recovered & Restored Eating Disorder Therapy Center, we specialize in treating both eating disorders and co-occurring conditions like OCD. One of the most effective treatments for OCD is Exposure and Response Prevention (ERP), and we often integrate this into treatment plans when needed.
ERP works by gently exposing a person to their fear and helping them learn to tolerate the anxiety without engaging in compulsions. For example, a client might be supported in resisting the urge to recheck their weight or eat a fear food without engaging in body-checking rituals afterward.
Here’s how ERP might look when addressing OCD + ED overlap:
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Supporting a client in eating a food that triggers obsessive thoughts without cutting it into perfect pieces.
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Guiding someone through a body image trigger without reassurance or checking.
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Practicing tolerating uncertainty (e.g., "maybe I gained weight, maybe I didn’t") without engaging in ritual behavior.
We also use other evidence-based modalities such as:
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CBT (Cognitive Behavioral Therapy)
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DBT (Dialectical Behavior Therapy)
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ACT (Acceptance and Commitment Therapy)
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Trauma-informed care
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Nutritional counseling
You Are Not Alone
We know how exhausting it can be to live with both OCD and an eating disorder. These conditions can create a loop of anxiety, shame, and ritual that makes daily life feel overwhelming. But we want you to know: that healing is possible. With the right support, treatment, and tools, you can break free from the cycle and reclaim your life.
Our compassionate team serves women and girls ages 12 and up through virtual therapy in Pennsylvania, New Jersey, Maryland, Delaware, Florida, Connecticut, Vermont, and South Carolina. Whether you’re looking for an eating disorder therapist near you or support for OCD, we are here to walk alongside you.
We proudly serve clients in areas including Berwyn, Philadelphia, West Chester, Morristown, Essex County, Bergen County, Princeton, Chevy Chase, Charleston, Columbia, Stamford, Burlington, Fort Lauderdale, Orlando, and Wilmington.
Some of the services we offer include individual therapy, group therapy, nutritional counseling, EMDR, ERP, DBT skills, athlete therapy, Christian counseling, parent coaching, nutritional counseling, body image support, and maternal mental health therapy.
Ready to Take the First Step?
If you or someone you love is struggling with OCD and an eating disorder, we’re here to help. Fill out our contact form today and a member of our team will reach out to you within 24 hours. You don’t have to have all the answers - you just have to take the first step.
Recovery is possible. Let’s take that step together.