The Overlap Between Anxiety and Eating Disorders

The Overlap Between Anxiety and Eating Disorders

What is anxiety?

Many people who have experienced an eating disorder or disordered eating are familiar with anxiety. It’s common to feel stuck in your head when you’re anxious and worried. In addition to worried thoughts, anxiety can show up as physical sensations in the body, including faster breathing, lightheadedness, sweating, upset stomach/nausea, and tightness in the chest.

Anxiety is our body’s ‘alarm system’ to warn us of potential danger in our environment. Everyone experiences anxiety sometimes. It’s important to remember that our body evolved this reaction to protect us from things that can threaten our survival. However, our world is much less dangerous than it once was. This means that a lot of the time our body and brain are making us think there is a serious threat when in reality there is none (or very little). 

When does anxiety become a problem?

Anxiety becomes a problem when it continues to show up when there is no real danger (e.g., when your fire alarm goes off after burning toast). When anxiety happens often and is felt so strongly that it gets in the way of doing things that matter to you (e.g., getting your homework or job tasks done, socializing, making friends), it is likely there is more anxiety present than typical levels of fear and worry. 

What are eating and feeding disorders?

Eating disorders are complex mental illnesses that also have a physical impact on the body. They include a range of thoughts and behaviours that negatively affect a person’s health and quality of life. Worry about the size and shape of one’s body is one of the most common features of eating disorders. 

Feeding disorders are similar to eating disorders in that they affect a person’s thoughts and behaviours around food and can have serious negative consequences on a person’s health and quality of life. Unlike eating disorders, feeding disorder behaviours are not related to a person’s desire to change their body shape or weight. For example, someone with Avoidant Restrictive Food Intake Disorder (ARFID) may experience such an intense fear of choking that they find it difficult to eat enough food to maintain health and lose weight as a result. 

How do anxiety, eating, and feeding disorders overlap? 

  • Eating and feeding disorder behaviours often develop when life challenges or struggles exceed a person’s ability to cope. During this time, feelings of stress and anxiety are common. 
  • In most cases (47-94% of the time), symptoms of anxiety develop before disordered eating or eating disorder symptoms show up.1
  • Anxiety symptoms may be directly related to worries about food intake and/or body shape and weight but don’t have to be. 
  • Some common features of eating disorders that are related to anxiety symptoms include:
    • Fear/worry about weight gain (common in Anorexia and Bulimia Nervosa)
    • Sensitivity to physical sensations (common in Bulimia Nervosa and Feeding Disorders)
    • Difficulty tolerating uncertainty (e.g., having a hard time coping when we can’t predict with a higher degree of certainty what will happen in a certain situation, or doing whatever we can to get reassurance or reduce the risk of the unwanted scenario from occurring)
    • Difficulty tolerating intense emotions
    • Perfectionism (e.g., the desire to do or say things perfectly, to try to make your appearance or body ‘perfect’, and experiencing stress or worry if you make a mistake or cannot reach the high standards you set for yourself.)

How common is anxiety among individuals with eating and feeding disorders?

  • Studies estimate that 24-65% of individuals with an eating disorder also have an anxiety disorder.2-5
  • Anxiety is very common among people with feeding disorders. For example, more than half of people with an ARFID diagnosis (avoidant and restrictive food intake disorder) also have an anxiety disorder diagnosis.6
  • 13.5% of women in treatment for an eating disorder meet the requirements for an anxiety disorder.

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