Anxiety Eating Disorder: Feasting on Fear

by | May 24, 2024 | Anxiety

Imagine this: every meal is a battle, not just with the food on your plate, but with fear gripping your heart. Or picture a constant, nagging worry that you’re never quite good enough. If this sounds familiar, you’re not alone. 

Shockingly, the Price Foundation study found that roughly 2/3 of individuals with anorexia or bulimia have at least one-lifetime anxiety disorder, such as obsessive-compulsive disorder (41%) or social phobia (20%), often beginning in childhood before the eating disorder develops.¹ These aren’t just statistics; they reflect real experiences like yours. Understanding and treating these issues is important for your recovery and reclaiming the peace you deserve.

Our focus is on understanding the human experience of these conditions—from the psychological distress of anxiety symptoms to the disordered eating behaviors that characterize many eating disorders. By highlighting effective treatments and the importance of nutritional counseling and psychiatric medications, we aim to illuminate the paths toward managing and overcoming these complex disorders.

Join us as we connect the dots between anxiety and eating disorders to understand better and support those affected by these challenges.

Understanding Anxiety and Eating Disorders

What are Anxiety and Eating Disorders?

Anxiety disorders are mental health conditions that involve excessive fear and anxiety. These fears can interfere with daily activities and greatly disrupt a person’s life. Eating disorders, on the other hand, consist of unhealthy eating habits that harm both physical and emotional health. Both of these disorders require professional treatment in order to be effectively managed.

  • Anxiety Disorders: You might experience overwhelming feelings of fear, nervousness, and constant unease due to conditions like generalized anxiety disorder, obsessive-compulsive disorder, or post-traumatic stress disorder.
  • Eating Disorders: Disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder cause disturbances in your eating habits, accompanied by distressing thoughts and emotions about food and your body image.

Anxiety and eating disorders are deeply intertwined, complicating each other’s management and treatment, but understanding this connection is a step towards finding the right support and beginning to heal.

How Do Anxiety and Eating Disorders Connect?

1. Anxiety Leading to Eating Disorders:

  • Someone with social anxiety might start excessively controlling their food intake (anorexia nervosa) to manage fears of negative social evaluation, seeing this as a way to cope with or control their anxiety symptoms.

2. Eating Disorders Leading to Anxiety:

  • A person with bulimia nervosa experiences intense episodes of binge eating followed by purging. The shame and secrecy surrounding these behaviors trigger severe anxiety and distress.

Treatment and Support:

  • Combined Approaches: Effective treatment often includes a mix of psychiatric medications (e.g., Selective Serotonin Reuptake Inhibitors SSRIs or Serotonin-Norepinephrine Reuptake Inhibitors SNRIs), behavioral therapy, and nutritional counseling.

Focus on Both Disorders: Addressing the anxiety and eating disorder symptoms is important, as they are often interconnected.

These disorders are complex and interlinked, making personalized and thorough treatment essential. Seeking help is a strong step towards recovery, reducing symptoms, and improving overall mental health.

Deep Dive: Specific Disorders

Anxiety Leading to Anorexia

If you’re experiencing anorexia nervosa, it’s important to understand that it often doesn’t start with a choice to lose weight. Instead, it may stem from underlying anxiety and a pursuit of perfection. You might find yourself constantly worried about meeting impossibly high standards, a concern that seeps into every part of your life, including how you perceive and manage your body image.

This intense pressure can show as severe anxiety, leading to restrictive eating behaviors as a way to have control over an aspect of your life that feels manageable. Recognizing this pattern is an important step toward seeking help and understanding the deeper emotional drivers behind your eating habits. Treating this form involves 2 approaches:

  1. Nutritional counseling to fix disordered eating.
  2. Psychological support for managing anxiety and perfectionism.

Bulimia and Anxiety

If you’re struggling with bulimia nervosa, you might find yourself in a tough cycle. Binge eating leads to distress and then to purging or excessive exercise to compensate. Anxiety disorders, like social anxiety or panic disorder, worsen this cycle. They exacerbate low self-esteem and concerns about body image.

Effective treatment for bulimia involves addressing 2 problems. The problems are the eating disorder and co-occurring anxiety. This is usually done with a mix of therapy and medications. This approach helps manage the symptoms and the underlying anxieties.

Binge eating disorder involves eating too much without compensating. Treatment should focus on mental distress and eating habits.

Understanding the link between anxiety and eating behaviors is important. Managing these conditions takes: 

  • Compassion
  • Patience
  • Professional care

Symptoms, Diagnosing, and Treatment

Identifying Symptoms

If you’re feeling overwhelmed by anxiety and struggling with your relationship to food, you’re not alone. Many who grapple with anxiety disorders find that these issues deeply influence eating behaviors. Here are some ways this might manifest:

Common Anxiety Disorders Influencing Eating Behaviors:

1. Generalized Anxiety Disorder:

  • Constant worry about gaining weight or not eating certain types of food may lead to restrictive eating habits.

2. Social Anxiety Disorder:

  • Fear of eating in front of others, potentially leading to skipping meals or restricting food intake in social settings.

3. Post-Traumatic Stress Disorder:

  • Flashbacks or distressing memories triggered by specific foods or the act of eating, which can disrupt normal eating patterns.

Symptoms of Anxiety Eating Disorders:

1. Obsessive Compulsive Thoughts:

  • About Food Intake: Excessively persistent thoughts about the calories, nutritional content, and purity of foods eaten.
  • About Body Weight: Continual fear of weight gain leads to frequent weight checks.

2. Binge Eating Episodes:

  • Consuming large amounts of food in a short period, often in response to a spike in anxiety or stress, followed by feelings of loss of control.

Common Experiences in Anxiety Eating Disorder and Bulimia Nervosa:

1. Significant Distress:

  • About Eating Habits: Extreme anxiety when deviating from planned diets or when forced to eat feared foods.
  • About Body Image: Intense dissatisfaction with body shape or weight, regardless of reality.

2. Disordered Eating Behaviors:

  • Severe Restriction: Drastically limiting food intake, often far below nutritional needs.
  • Excessive Exercise: Engaging in intense exercise regimes to ‘burn off’ calories consumed, even when physically exhausted.

3. Compensatory Behaviors:

  • Purging: Force vomiting after meals or using laxatives to control weight.
  • Other Methods: Fasting or restricting even more severely after perceived overeating.

These symptoms and behaviors don’t just affect physical health but deeply impact mental health, leading to a heightened state of psychological distress.

How Disorders are Diagnosed

Diagnosing an eating disorder with an anxiety disorder involves understanding how these conditions interact. It’s common for one to mask or intensify the other, making separating the symptoms challenging. Therapists use the Statistical Manual of Mental Disorders (DSM) diagnostic criteria, which help them diagnose eating and anxiety symptoms.

The process starts with a full assessment. It includes discussing your history of anxiety, eating, body image, and any compulsions. This might also involve discussing weight gain or loss. It could include excessive worry about body image and episodes of distress related to eating or social situations. It’s important to identify when someone has more than one mental health condition at the same time. It guides the effective treatment of both disorders at the same time.

Approaches to Treatment

Treating co-occurring anxiety and eating disorders involves a holistic approach that addresses the mind and body. Here’s a list of treatments and support strategies:

Integrated Treatment Approaches:

  • Cognitive Behavioral Therapy (CBT): Targets negative thought patterns and behaviors related to food and anxiety.
  • Nutritional Counseling: Aims to establish healthy eating habits and repair one’s relationship with food.
  • Medication: SSRIs and SNRIs help manage symptoms of anxiety and depression.

Additional Support Options:

  • Support Groups: Provide emotional and experiential support from peers facing similar challenges.
  • Regular Sessions with Mental Health Professionals: Ongoing therapy to monitor progress and adapt treatment plans.
  • Inpatient Treatment: Intensive care option for severe cases, providing structured treatment environments.

Recovery Journey:

  • Acknowledging Challenges: Recognizing the potential for relapses and the need for continued effort.
  • Empowerment: Understanding that recovery is a progressive journey towards improving quality of life.
  • Seeking Help: Encouraging reaching out for professional assistance is important in managing health.

Remember, your disorders do not define you. With the right support and comprehensive treatment, managing the symptoms of anxiety and eating disorders is achievable, paving the way to a healthier, more fulfilling life.

Living with the Disorders

Day-to-Day Management: Handling food intake during anxious times

When you’re grappling with an anxiety eating disorder, each day feels like a new challenge, particularly when it comes to managing your food intake. It’s common to experience heightened anxiety symptoms that disrupt normal eating patterns, leading to disordered eating behaviors such as restrictive eating or binge eating. Here are some gentle strategies to help you manage these difficult moments:

  1. Mindful Eating: Focus on being present while you eat. Try to eat slowly and savor each bite, which helps you become more attuned to your body’s hunger and fullness signals. Mindful eating acts as a form of behavioral therapy that helps reduce binge eating and compensatory behaviors.
  2. Structured Meal Times: Keeping a regular eating schedule provides a sense of normalcy. Plan your meals and snacks for the same time each day. This will stabilize your mood and blood sugar levels. It will cut binge eating and the risk of getting bulimic symptoms.
  3. Nutritional Counseling: Engaging with a professional for nutritional counseling is an effective treatment component. They provide tailored advice that respects your body’s needs without triggering anxiety around food intake.
  4. Comfort Foods: Allow yourself to enjoy comfort foods in moderation. These should be foods that you enjoy but don’t cause guilt or anxiety post-consumption. This practice helps build healthier relationships with food and improves self-esteem.
  5. Avoidance of Trigger Foods: If certain foods trigger compulsive behaviors or severe anxiety, it may be wise to avoid them as you work on recovery. To ensure your diet remains balanced, a healthcare professional should guide you in doing this.

Support and Relapse: Embracing the Journey

Recovery from an anxiety eating disorder is rarely linear. It often involves periods of progress and the possibility of relapse. Understanding and accepting the cyclical nature of recovery can ease some of the distress from setbacks.

  1. External Support: Building a support system of friends, family, and mental health professionals is essential. Family is synonymous with emotional support. They can help monitor your eating disorder symptoms and keep you motivated on the recovery path. Group therapy can also help. It offers a space to share experiences and strategies with others who face similar struggles.
  2. Recognizing Signs of Relapse: Educate yourself and your support network about the signs of relapse, which might include increased anxiety, returning to old eating habits, or using food to cope with stress. Early recognition of these signs can lead to prompt intervention, reducing the severity of a relapse.
  3. Coping Strategies: Develop personalized strategies to manage stress and anxiety that do not involve food. These might include exercises like yoga and meditation. They are activities that promote relaxation and reduce stress.
  4. Continuous Treatment: Stick with your treatment plan, including regular sessions with mental health professionals. You might need to adjust therapy or medications. This will happen as you move through different stages of recovery.
  5. Self-Compassion: Practice self-compassion. Remind yourself that recovery is a journey, and it’s okay to have setbacks. Treat yourself with the same kindness and patience you would offer a good friend.

Facing anxiety and eating disorders can feel hard. But, with the right strategies and support, you can manage your symptoms. You can also work towards a healthier, more balanced life. Each step you take is a move toward regaining control. Helping you improve your mental health and leads to a fulfilling life free from anxiety and disordered eating.


Firstly, you or your loved one aren’t the only person struggling with anxiety and eating. These conditions are complex and, unfortunately, more frequent than they ought to be. But effective treatments help. 

Cognitive behavioral therapy, nutrition counseling, and medications are all options to help combat co-occurring disorders. No matter the eating disorder or anxiety disorder you have, there is hope and help. These are not just personal struggles but common mental illnesses that respond well to professional care.

Reaching out for help is a courageous step towards reclaiming your life and well-being. Talking to mental health professionals will bring relief. We specialize in anxiety and eating disorders and can lead you to recovery. You don’t have to face this alone. Support from trained experts and loved ones can empower you to overcome these challenges and move to a healthier future. Remember, every step forward, no matter how small, is a step towards recovery.


What exactly are anxiety eating disorders?

Anxiety eating disorders are not a specific diagnosis. They are a descriptive term. It captures how closely anxiety disorders and eating disorders can be linked. This can include cases where severe anxiety causes or worsens eating disorders. These disorders include anorexia nervosa, bulimia nervosa, or binge eating disorder.

How do I know if my eating habits are linked to anxiety?

You often overeat or undereat. This is often triggered by anxiety, stress, or emotional distress. This link between your eating habits and anxiety may be the cause. Watch for symptoms. They include much distress about eating decisions. They cover compulsive eating and excessive worry about body weight or appearance.

What treatments are available for someone with an anxiety disorder and an eating disorder?

Treatment for a co-occurring anxiety disorder involves a comprehensive approach. The approach addresses both conditions. This may include psychological therapy. For example, cognitive behavioral therapy modifies negative thoughts and behaviors. It also includes nutritional counseling. This helps establish healthy eating patterns. Doctors might also prescribe medications. These include selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors.

I’m struggling with body image concerns due to my disorders. How can I improve my self-esteem?

Improving self-esteem when dealing with body image concerns takes time. It often involves many strategies. Behavioral therapy is useful for addressing negative social evaluation and body image distortions. It can be particularly helpful for these issues.

What should I do if I feel like I’m relapsing?

Relapse can be a common part of recovery from mental disorders. If you feel a recurrence of eating disorder or anxiety symptoms, reach out to your treatment provider right away. Early intervention can prevent a full relapse and help you regain control.

  1. Comorbidity of anxiety disorders with anorexia and bulimia nervosa,
Anastasiya Palopoli
Written by Anastasiya Palopoli

Anastasiya Palopoli, a board-certified Psychiatric Nurse Practitioner, has extensive experience in nursing and psychiatric care, with degrees in Nursing from UCF and Psychiatric Mental Health from the University of Cincinnati. Following a residency in General and Child Psychiatry in Florida, she specializes in treating Dementia, psychosis, depression, and anxiety through holistic approaches. Beyond her professional life, she enjoys hiking, tennis, and traveling with her family.