How anxiety and eating disorders are connected

The relationship between anxiety and eating disorders (EDs) is complex and regularly overlooked or misunderstood. Many people who have an eating disorder also have an anxiety disorder. That’s largely because EDs involve anxiety about food and body image, and both types of conditions can be rooted in the same causes.

Recognizing the connection between these two conditions is vital. Gaining more knowledge about why you may be facing an anxiety-based eating disorder can help you better manage both conditions. This knowledge also plays a big role in getting the best support for your unique needs. 

The relationship between anxiety and eating disorders

Though eating disorders are not officially classified as anxiety disorders, the two frequently occur together. Nearly half of people with anorexia, most people with bulimia, and almost two-thirds of people with binge eating disorder also experience anxiety. 

Overlapping symptoms of both anxiety and EDs include:

• Excessive worry
• Fear of losing control
• Intrusive thoughts
• Compulsive behaviors
• Emotional distress
• Weight loss

Additionally, anxiety and EDs share common risk factors. These include:

• Genetic factors: More likely in people who have family with an eating disorder 
• Environmental factors: More likely in people who spend time around others with an eating disorder
• Psychological factors: More likely in people who experience stress, anxiety, or abuse 

It’s hard to deny the connection between anxiety and EDs, but can anxiety cause EDs? And can an ED cause anxiety? 

Which comes first, anxiety or an eating disorder?

The relationship between anxiety and eating disorders doesn’t provide a clear-cut answer as to which one is the cause and which one is the effect. However, the connection between the two can be cyclical — one condition can trigger the other, and vice versa.

In the case of food anxiety (characterized by excessive thoughts and worry about food), the anxiety comes first. Though not technically an ED itself, these anxious thoughts around food can contribute to the development of one.

Similarly, social anxiety can put you at risk of developing an ED. Concern about how others perceive you physically can negatively impact your experience in social situations. People with social anxiety may hyperfocus on food and eating as a way to manage their anxiety in social situations, which can turn into disordered eating.

Eating disorders can also lead to anxiety. For one thing, the psychological and physical effects of an ED can contribute to feelings of anxiety. EDs often involve forms of malnutrition, challenges with body image, and isolation. This physical and mental stress can create an environment that fosters anxiety. 

The cyclical relationship between anxiety and eating disorders may be partially because they’re both rooted in patterns of avoidance. People who face anxiety and EDs may show avoidant behaviors, like choosing not to eat in public. This avoidant behavior can reinforce anxiety, which can make it even harder to overcome. 

Six ways to manage anxiety and eating disorders

Your approach to managing anxiety and eating disorders is crucial for your success. Apart from receiving professional treatment, self-help strategies and lifestyle changes that can help you manage EDs, anxiety, or both include: 

1. Facing your negative thoughts

Anxiety and eating disorders both involve distressing thoughts. Aim to challenge those thoughts as they come in. When the thought “I shouldn’t eat this,” comes to mind, replace it with something like “My body deserves to enjoy this food.” By challenging your negativity, you open up the potential to replace the negative thoughts with healthier ones. 

2. Engaging in hobbies

Healthy distractions are a proven way to help break the cycle of negative thoughts and help you manage your anxiety. Note that these distractions are different from avoidance. Avoidance keeps you out of the discomfort and provides immediate gratification. It is also typically rooted in fear. 

Distraction, on the other hand, can help in times of overwhelm. It allows you an opportunity to take a step back and regulate your emotions. Healthy distractions include painting, dancing, walking, or any other hobbies that help slow you down and recenter your thoughts. 

3. Exercising

Healthy exercise can be a great way to reduce anxiety. However, the intention with which you exercise is key. Exercise is considered healthy if you’re doing it for the mental and physical health benefits — not as “punishment” for something you ate or in a compulsive manner. 

4. Practicing mindfulness

Anxiety takes you away from the present moment and causes you to worry excessively about the past or future. By practicing mindfulness throughout your day, you can learn to bring yourself to the present moment, which can help with rumination. Some people may find mindfulness through meditation, breathwork, or a walk. And if you’re living with an eating disorder, consider mindful eating as a way to be present with your food.  

5. Journaling

Writing in a journal can be a powerful tool for managing anxiety and negative thoughts about food and your body. This safe space allows you to explore your thoughts and feelings free from judgment. 

6. Building a support system

Sharing your anxiety and eating disorder challenges with a friend or loved one can be a helpful way to cope. It can ease feelings of loneliness and also provide you with support when you need it most. 

Treatment options for anxiety and eating disorders

If you have both anxiety and an eating disorder, it’s important to receive treatment for both conditions. Treating one without the other can lead to a worsening of the untreated condition. The primary ways to treat these two conditions are:

• Therapy: You can find a therapist who specializes in treating both conditions. Dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) are often used to treat anxiety and EDs. Treatment will likely involve focusing on stress reduction, challenging unhealthy thought patterns, and strengthening your coping skills.
• Medication: There are medications that can help treat both anxiety and EDs, but it’s best to discuss your options with your therapist or a psychiatric provider.

Find care with Rula

Anxiety and eating disorders often go hand in hand, and understanding the connection between the two is key to management. By addressing both conditions together, you can work toward recovery. Know that you are not alone, and support is available to help you on this journey. 

And thanks to Rula, getting support is easier than ever. Our therapist-matching program can help you find an in-network provider in a matter of minutes. And best of all, you can meet with them as soon as tomorrow from the comfort of your home.

Get started with Rula today