Overcoming Anxiety in Eating Disorder Treatment

young woman with illusion of Control in the Development of Eating Disorders

Two-thirds of people with an eating disorder diagnosis will suffer from anxiety in their lifetime [1]. That means two-thirds of people will have to fight for recovery from their anxiety and eating disorders.

Talk about overwhelming odds.

This comorbidity can alter how the individual develops, experiences, is treated for and recovers from their eating disorder.

Comorbidity of Anxiety and Eating Disorders

We can’t discuss the co-occurrence of anxiety and eating disorders without having the “chicken-or-the-egg” conversation – which causes which? As with the “chicken-or-the-egg” conversation, there is no clear answer.

However, research indicates that the onset of an anxiety disorder often precedes that of an eating disorder, so make of that what you will [2].

Researchers are often one of the 3 camps related to why these disorders commonly co-occur – 1) anxiety is a risk factor for eating disorder development, 2) anxiety is secondary to eating pathology, and 3) both disorders share common vulnerability factors [2].

Regardless of which of these you believe, there is no denying that the two seem to be related, with individuals with bulimia nervosa showing a lifetime prevalence rate of anxiety disorders of 25-75% and individuals with anorexia nervosa showing a lifetime prevalence rate of anxiety disorders of 23-75% [2].

Co-occurring Treatment

Man Experiencing anxiety and eating disordersThe existence of an anxiety disorder in eating disorder treatment can mean changes in how the eating disorder psychopathology and behaviors are treated.

As such, it is important to make your treatment team aware of any previous anxiety disorder diagnoses as well as be honest and open about the symptoms you experience.

Research shows that recovery outcomes are improved if both disorders are treated simultaneously as opposed to attempting to treat one then the other.

In treatment, there is a likelihood that the topic of taking anti-anxiety medications to mitigate some of these symptoms will come up. The process of taking medication is purely based on your willingness, however, so don’t hesitate to voice your thoughts and opinions in this process.

The presence of a co-occurring anxiety disorder is a challenge in eating disorder treatment. However, it is not unsurmountable. In fact, processing and treating both at once may provide valuable insights into how the two disorders are interrelated for you, which can be valuable information to have for recovery.

Above all, know that it is absolutely possible to live a life free of the shackles of an anxiety disorder and an eating disorder.


[1] Unknown (2018). Eating disorders. Anxiety and Depression Association of America retrieved from https://adaa.org/understanding-anxiety/related-illnesses/eating-disorders.

[2] Swinbourne, J. et al. (2012). The comorbidity of eating disorders and anxiety disorders: prevalence in an eating disorder sample and anxiety disorder sample. Australian and New Zealand Journal of Psychiatry, 46:2.

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published November 19, 2019, on EatingDisorderHope.com
Reviewed & Approved on November 19, 2019, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.