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  • Writer's pictureCatherine Lott

Eating disorders and Co-Occurring disorders





Eating disorders are complex mental health conditions that often occur in combination with other psychiatric disorders. The direction of this relationship is unclear and depends on each individual; Eating disorders may develop as maladaptive coping skills for mental health diagnoses, however, mental health issues may also develop as a result of eating disorder behaviours. According to research, individuals with eating disorders frequently have co-occurring conditions, which can complicate treatment and recovery.


Understanding the relationship between eating disorders and co-occurring mental health issues is key to effective diagnosis and treatment of the individual.


WHAT IS A CO- OCCURRING DISORDER?


Co-occurring disorders refer to individuals that struggle with two or more mental health diagnoses at once. For those with eating disorders, this means that they engage in and struggle to overcome eating disorder behaviours in addition to other existing mental health disorder(s).


Approximately 56.2% of those with Anorexia Nervosa, 94.5% of those with Bulimia Nervosa, and 78.9%

of those with Binge Eating Disorder (BED) meet criteria for at least one other mental health diagnosis.

One study that looked at 2400 individuals found that 94% of those hospitalized for eating disorders also had a mental health mood disorder



Here are some of the most common co-occurring disorders found in individuals with eating disorders and how they can be treated:



How the existence of each of these disorders impact eating disorder symptoms and treatment differs depending on diagnosis and presentation.



  1. Anxiety Disorders: People with eating disorders often struggle with anxiety, including generalized anxiety disorder, panic disorder, and social anxiety disorder. Treatment options for anxiety include cognitive-behavioural therapy (CBT), exposure therapy, and medication, such as selective serotonin reuptake inhibitors (SSRIs).

  2. Mood Disorders: Depression is a common co-occurring condition for individuals with eating disorders. These disorders often lead to the development of eating disorders as an ineffective method of coping, occur due to malnourishment and the impact of eating disorders, and/or both. 42.1% of those with Anorexia Nervosa, 70.7% of those with Bulimia Nervosa, and 46.4% of those with BED also have a diagnosis of a depressive disorder. Other mood disorders, such as bipolar disorder, may also be present. Treatment for mood disorders may include a combination of psychotherapy, such as dialectical behaviour therapy (DBT) or interpersonal therapy (IPT), and medication, such as antidepressants.

  3. Substance Abuse Disorders: Eating disorders and substance abuse disorders frequently occur together. Treatment for substance abuse disorders may include detoxification, behavioural therapies such as motivational interviewing, and medication-assisted treatment (MAT) with drugs like methadone or buprenorphine.

  4. Obsessive-Compulsive Disorder (OCD): Individuals with eating disorders may also experience OCD symptoms, such as intrusive thoughts and repetitive behaviours. Treatment for OCD typically involves exposure and response prevention (ERP) therapy, a form of CBT, and medication, such as selective serotonin reuptake inhibitors (SSRIs).

  5. Personality Disorders: Personality disorders, including borderline personality disorder, are often found in individuals with eating disorders. Treatment for personality disorders may include DBT, IPT, and medication, such as atypical antipsychotics.

  6. Post Traumatic Stress Disorder: Trauma severely impacts the psychological, neurological, and sociological functioning of individuals that experience it. The relationship between trauma experiences are linked with all eating disorder diagnoses, yet, appears particularly significant in those with Bulimia Nervosa. One study noted that “eating disordered behaviours, particularly purging behaviours, serve to facilitate avoidance of traumatic material and to numb the hyperarousal and emotional pain associated with traumatic memories and thoughts.” (Brewerton, T. D. (2008). The links between PTSD and eating disorders. Psychiatric Times.)

Additionally, those with a PTSD diagnosis tend to experience an increased disconnectedness from the body and emotions as well as dissociative states, all of which can also contribute to eating disorder development.




*original image source Rogers Behavioral Health




TREATMENT


It's important to note that each person's experience with co-occurring disorders and treatment is unique, and the best course of action will vary based on the individual's specific needs and circumstances. Depending on the individual, symptoms and the diagnoses, a specialist or a multidisciplinary team of mental health professionals, can develop an effective treatment plan to help you reach recovery.








  • Unknown (2017). Eating disorders. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/statistics/eating-disorders#part_155062.

  • NEDA (2022) Anxiety, Depression, and Obsessive Compulsive Disorder.



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