OCD and Eating Disorder?

By Kristina Randle, Ph.D., LCSW

I am 23 year old woman who is underweight and having food issues. My height is about 4’10ft and my weight is around 66lbs.

In the last 8 months I have lost over 30lbs. It all started with me wanting to be healthy. I wanted to make my husband proud of my food choices so I started cutting my portion size. After a few months, A relative commented on how many carbohydrates I eat and my husband also commented on the amount of bread I have so I started limiting carbohydrates to a slice of bread every few days.

I then stopped eating all foods besides steamed veggies, coffee, herbal tea, Dark Chocolate, and oatmeal. Mainly because I wanted to lose weight. My calorie intake is always 800 or lower. What I consider a good day is if I eat around 400-500 calories. I consider days when I eat around 600-800 fat days.

One major trigger for me was looking at my husband’s ex girlfriend picture. She looked so skinny and ever since I saw her picture, I felt like he settled with me looks wise. In our first few months after meeting, my husband made a comment on liking well toned girls, and I wasn’t exactly well toned. Plus I have a few disabilities and most doctors say it good that I am not overweight.

I then started obsessing over food and calories whenever something horrible happened. I become more eager to lose weight. I sometimes feel that all that I am good at. After a while I started doing a routine. I plan my activities for the next day including my meals. I started paying more attention to things being out of place, washing dishes even if it just a spoon is in the sink; separating food, cutting it into pieces, chewing it about 30 times,

Now that I lost weight, I find comfort in my appearance in a way, like seeing the bones in my hand, the lack of muscle in my legs but I still feel the need to lose weight. I get anxious whenever I see a woman that is petite or skinny and I feel like a failure. Though I also feel proud when I weigh less than someone else or if I lost weight.

I wrote an e-mail to another expect on a site and they thought I have OCD. I also think I have OCD. I just want to know if it just OCD or do I have an eating disorder.

A. Having never had the opportunity to interview you in person makes it difficult for me to provide a diagnosis over the Internet. My recommendation would be to have an in-person psychiatric evaluation to determine if you have a mental health disorder. Having said that, it is reasonable to believe that you may have an eating disorder. In addition to an eating disorder, you may also have OCD.

It makes sense that eating disorders and OCD would co-occur. Both disorders are fundamentally about control. Symptoms of eating disorders and OCD are external manifestations showing an attempt to gain additional control. The individual is actually losing control because the process to gain control becomes obsessive and eventually denies the individual the freedom to make rational, healthy choices.

Your story is a common one. An individual begins to diet and loses a few pounds. Others begin to notice the weight loss and compliment them. It is reinforcing. They like the compliments and figure “five pounds was good but 15 would be better.” They begin restricting more and eating less. For some people, they lose the weight they want and are able to maintain that weight. For others, they can’t stop. Some have described it as an addiction that overtakes them. Each pound they lose makes them feel better about themselves. It gives them a sense of power and control that they may never have felt before. These are the people who often develop eating disorders. The problem is that no amount of weight loss will ever be able to make them feel “good enough.” They may think “five more pounds and I will feel really good about myself; then I will be happy” but it doesn’t work that way. It is an illusion.

There are other causes of eating disorders and they can be found in the many, many books written specifically on this complex subject.

The reality of your situation is that you are heading down a dangerous path. You’ve lost a significant amount of weight and it doesn’t seem as though you can stop yourself from continuing to engage in destructive weight loss behavior. Eating disorders are very dangerous. People die from eating disorders for a number of reasons but primarily because they starve their bodies of the vital food and nutrients that it needs to function properly. It is imperative that you seek help as soon as possible. The longer that you wait to seek help the more your body will suffer. Please get help. I wish you the best.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 12 Jul 2011

APA Reference
Randle, K. (2011). OCD and Eating Disorder?. Psych Central. Retrieved on September 18, 2014, from http://psychcentral.com/ask-the-therapist/2011/07/12/ocd-and-eating-disorder/