Co-Occurring Disorders and How They Affect Eating Disorders

Updated on April 10, 2020

Far more common in people suffering from eating disorders than in the general public, co-occurring mental health conditions can exacerbate the eating disorder and make it more difficult to treat. This grim reality has led eating disorder treatment centers to ensure their services include not only the medical treatments necessary but a variety of psychiatric and psychological therapy programs for their clients. 

When anorexia nervosa or another form of eating disorder occurs alongside another mental health condition, and that condition is not addressed, there is a good chance that it will interfere with an individual’s chances of enjoying a long-term recovery. Here, we’ll examine some of the most common types of mental health disorders that appear alongside eating disorders, how they interact with each other, and how they can be treated.

A dual diagnosis (another term for co-occurring disorders) can complicate the life of the individual dealing with it, as well as making the treatment more complex, but don’t lose hope.  For all the very real risks of eating disorders and their co-occurring complications, they are quite treatable. Let’s take a closer look at the most common co-occurring disorders that accompany eating disorders.

Common Disorders Found in a Dual Diagnosis

It’s difficult to determine whether another condition can cause or trigger an eating disorder, or the co-occurring disorder is a result of emotions and thoughts stemming from the eating disorder. In most cases, it’s likely a combination of the two – the eating disorder influences the other condition and vice versa. When a person has symptoms of more than one mental health disorder, they may receive a dual diagnosis for co-occurring disorders. 

As individuals or their families search for help from treatment centers and other resources, it’s important they understand another type of disorder may be present and can relay that information to the doctor or counselor who’s making the diagnosis. This will greatly influence the type of program that will be most effective in treating both conditions.

Some of the most common co-occurring disorders coinciding with eating disorders include:


Anxiety disorders are very common in America and can range from mild nervousness or worry at all times (as in Generalized Anxiety Disorder) to more acute cases involving panic attacks and other more severe symptoms. Additionally, anxiety disorders may be characterized as phobias, panic disorders, social anxiety disorder and more. In relation to anorexia nervosa, bulimia nervosa, BED, and other common eating disorders, anxiety about weight and body image can trigger disordered behavior.

Substance Abuse

Addiction often interacts with an eating disorder in two frequent guises. First, long-term disordered eating actions like purging or binge eating can release dopamine into the brain, just like using drugs. These actions can become compulsive – just like the dependency a person might develop after using drugs or alcohol over a period of time. Second, certain drugs like cocaine and amphetamines can speed the metabolism and reduce appetite, making them power weight-loss agents. People who abuse these drugs to avoid gaining weight are at high risk to become addicted.


Depression is a mood disorder that is characterized by chronic feelings of sadness, shame, low self-esteem, and a lack of motivation. This serious and widespread mental health condition can result in low energy levels, fluctuations in appetite, sleeping problems, suicidal thoughts and more.  Eating disorder patients are already at greater risk of suicide than the general population, and the frequency of depression as a co-occurring disorder increases that risk. Therapy and sometimes medication can be useful in treating depression.

Obsessive-Compulsive Disorder

Also known as OCD, obsessive-compulsive disorder is a severe form of anxiety disorder that bears some similarities to eating disorders with repetitive behaviors, such as bulimia nervosa. People with this condition typically experience fears and anxieties about their actions and environment that can result in a compulsion to behave a certain way. For example, someone with OCD might have to turn their oven on and off 7 times before leaving the house, otherwise, they will spend all day worrying that their house will burn down.  In a similar fashion, a person with anorexia nervosa might refuse to eat of two different foods touch on the same plate.


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