When someone keeps whispering in your ear constantly, can you focus on what you really want? The voice keeps telling you your hands are dirty, you need to check your calories, and other things. Despite being a whisper, this voice is demanding. This is the struggle of many people living with OCD and eating disorders. They cannot just ignore these voices. To them, it’s not an option, hence they obey the voice.

Obsessive-compulsive disorder (OCD) is a mental health condition in which certain uncontrollable thoughts keep occurring in the mind of an individual with OCD. These thoughts recur to the point where they make one feel anxious. OCD is more common than many realize. 1% to 3% of the world population was living with OCD in 2024, according to the National Center for Biotechnology Information.

Eating disorders, on the other hand, change the dynamics between you and food. It influences your eating habits. 16 million individuals in 2021, as per the World Health Organization (WHO), had eating disorders. Three million out of this were children and adolescents.

OCD and eating disorders, from the surface, seem like two entirely different conditions. One condition revolves around certain urges and rituals, whereas the other centers around food and body image issues. Once you look deeper, however, you will realize they have more in common than you might expect.

This blog aims to shed light on what OCD and eating disorders are, how they overlap, and how you can manage them to find your voice within the inner noise.

What do you mean by OCD?

According to the National Library of Medicine, obsessive-compulsive disorder is “characterized by intrusive thoughts known as obsessions and repetitive actions or compulsions.”

You could be obsessed with an intrusive and repetitive thought, urge or mental image that is difficult for you to control. The fact that you might not know why those thoughts come to your mind can be distressing.

You could be obsessed with:

• Fear of germs or contamination
• Afraid of forgetting or losing things
• Worries about losing control over others’ behavior
• Aggressive thoughts for oneself or towards others
• Unexplained need to have everything in symmetry or a perfect hierarchy

You feel compelled to repeat certain actions or the events in your mind to get rid of that distressing feeling. If you do not, you think that a consequence that you fear will happen. To prevent that, you feel like you have to do it.

Some compulsions could be, but are not limited to:

• Cleaning or washing hands excessively
• Repeatedly confirming things (example: windows are closed, the lights are off)
• Reciting or praying the words silently.

These actions end up taking a major portion of your time, and not just that, even when you perform the ‘rituals’, the distressing feeling still doesn’t go away. It lingers, and you find it difficult to function.

Understanding eating disorders

Eating disorders are a mental health condition where your relationship with food, what you think of it, and your eating behavior is somewhat unhealthy. You could eat less than you actually need or more than that.

Some may think it’s normal to worry about one’s weight or be conscious of one’s health. The case with eating disorders is, however, different. One could become fixated or even obsessed with one’s weight or shape.

How you behave with food can differ from others. Eating disorders have certain types:

• Binge eating: One keeps eating until they start to feel uncomfortable. This out-of-control behavior later makes them ashamed and distressed.
• Bulimia nervosa: The person first eats nonstop, but then compensates by vomiting or using laxatives. They can also exercise a lot or fast. Their weight is unpredictable. They could be underweight, normal weight, or overweight as well.
• Anorexia nervosa: Someone with anorexia nervosa avoids food or has strict restrictions regarding what to eat. Even within that, they eat only a small quantity. It is the least common type yet with the highest death rate of any mental health condition.

Eating disorders are not simply about the food or how one appears. They involve great emotional distress. Imagine being afraid of the food that you need to survive, having to check your weight after each meal.

How do OCD and eating disorders overlap?

The relationship between OCD and eating disorders is complex. Their symptoms and mechanisms often overlap. A person with OCD has a greater chance of being diagnosed with an eating disorder and vice versa.

The chances of developing both OCD and eating disorders simultaneously are as high as 41%. A study released in 2022 says the comorbidity could be due to a few shared mechanisms, including:

• Genetic and neurobiological mechanisms
• Anxiety
• Repetitive negative thinking
• Perfectionism
• Intolerance of uncertainty
• Impulsivity

Both OCD and eating disorders are driven by fear. With eating disorders, you could worry about your appearance. In the same way, someone with OCD may fear negative consequences if the rituals are not performed.

The ‘rules’ of an eating disorder, like weighing yourself after every meal, often function exactly like an OCD compulsion. They are repetitive actions you use to calm your anxious mind.

From the outside, this strictness can seem like a routine, but on the inside, it can be tiring. Knowing about these similarities is crucial so that you can identify these conditions early and seek help.

When to consider evaluation for OCD and eating disorders?

On some days, it is natural for one not to want to eat. They do not feel like eating and skip meals, but that’s not what eating disorders are. It’s more than that. You should consider seeking evaluation when:

• You have the urge to weigh yourself several times a day
• You obsessively count calories
• You feel dizzy, cold
• You compensate after eating by vomiting or heavily exercising
• You notice an unexpected change in your weight

For OCD, consider visiting a doctor when:

• You spend at least an hour on your uncontrolled thoughts and rituals
• You feel anxious because of those obsessions
• You struggle to do daily tasks
• You avoid social situations or meeting with families to hide your symptoms

It is not easy for everyone to know when they need professional help because they might not feel sick. They might not consider it a problem, but if you find yourself questioning whether you need help or not, that alone can be a sign that you should at least talk to your primary care doctor and see where it leads.

How is OCD diagnosed and treated?

Not everyone with obsessions or compulsions has OCD. It’s not always easy to diagnose OCD due to its symptoms being similar to other conditions, especially anxiety.

Generally, your doctor, like an OCD psychiatrist, could do a:

• Physical assessment: To rule out other underlying causes of your symptoms
• Clinical interview: The doctor asks about your medical history

If no physical issue is found, then an OCD test could be recommended. OCD treatment mainly involves changing how one reacts to unwanted thoughts and putting an end to the rituals. Your doctor could recommend therapy, medication, or both, depending on what’s better for you. Treatment options include:

• Cognitive Behavioral Therapy (CBT): You subtly change your thinking patterns and how you behave and react whenever you feel obsessed or compelled to do something.

• Exposure and response prevention (ERP): ERP, a type of CBT, encourages you to expose your obsessions or fears in a controlled environment. The purpose isn’t to overwhelm you but to let you manage your anxiety in healthy ways.

• Medications: Antidepressants like SSRIs are used to treat OCD. If they don’t work, some other psychiatric medication could be used. Medications are to relieve some OCD symptoms. They help you focus on your therapy.

OCD can seem like a lot, but it can be treated. Many people, with the right help, have improved their condition. Treating OCD is not about putting a stop to disturbing thoughts or urges, but about not letting them dictate your actions.

Diagnosing and treating eating disorders

Diagnosing eating disorders is somewhat similar to OCD diagnosis because the doctor first needs to know about your medical history, symptoms, your eating habits, and exercise behavior. Your doctor could recommend a physical examination to see if the symptoms are caused by some other issue or if the eating disorder has caused any other problems.

How eating disorders are treated varies depending on your needs and medical history. The doctor could be working with therapists and nutritionists to help you overall.

• Psychotherapy: Cognitive behavioral therapy for you and your family could help identify your negative thoughts and change them. You learn to cope with the not-so-helpful thoughts.

• Monitoring: Proper medical care and monitoring are important because you might have other problems that could be caused by eating disorders, like those related to the kidneys.

• Nutrition: A nutritionist will help you develop a proper diet so that you eat healthy and reach a healthy weight.

• Medications: Not only do they treat eating disorders, but they can also help with other conditions that often occur with them, like anxiety and depression. Some medications used are:

• Antidepressants
• Antipsychotics
• Mood stabilizers

Recovering from eating disorders is not just about improving your eating habits. You need to work on your relationship with food. You need to accept and be confident in how you look. A good treatment plan focuses on your complete health.

Turning down the inner noise

Living with OCD and eating disorders can be like living in your own home, but with no peace because somebody else is playing music at full volume. You find yourself doing things that you do not even wish to do, just to get through the day.

You might not know what it is that you’re going through or how to describe what you’re feeling, but that’s okay. You don’t have to know it all. That’s what the professionals are for. What you need to do is reach out to a psychiatrist or neurologist and speak up.

You can open up in a non-judgmental space like Gaba Telepsychiatry. Tell the psychiatrists from your comfort zone what you are feeling or not understanding. Together, figure out how to quiet the ‘whispers’ so that you have peace up there and can finally do what you want.