The Importance of Treating Co-Occurring Disorders and Eating Disorders

Sunflower in the Woods

Contributor: Staff at Sierra Tucson

Eating disorders and other mental health disorders, such as depression, anxiety and substance use disorders, commonly occur together. When another mental health disorder exists at the same time as an eating disorder, they’re referred to as co-occurring disorders.

Co-occurring disorders can worsen the symptoms of eating disorders and vice versa, making treatment more complex. An effective eating disorder treatment plan should include care for all co-occurring conditions to help ensure lasting recovery.

Most Common Co-Occurring Disorders

According to the Anxiety and Depression Association of America, two-thirds of people who have an eating disorder also suffer from an anxiety disorder at some point in their lives [1]. They also found that the most common anxiety disorder among eating disorder patients was obsessive-compulsive disorder (OCD) [1].

Other common co-occurring mental health concerns include a history of trauma or post-traumatic stress disorder (PTSD), self-harm and suicidal thoughts.

Individuals who have eating disorders may also be at an increased risk for developing a substance use disorder. According to one study by the National Center on Addiction and Substance Abuse, approximately 50% of people who have eating disorders misuse drugs or alcohol, compared with only 9% of the general population [2].

While eating disorders and mental health disorders often occur together, it’s unclear if one causes the other. One potential cause of the conditions co-occurring is an overlap in risk factors. This includes environmental factors such as abuse or bullying or a history of trauma. Researchers believe that there may also be a biological link between eating disorders and substance use disorders [2].

Eating disorders and mental health disorders also share symptoms, which can make it difficult to differentiate between the conditions. Shared symptoms include withdrawal from family and friends, mood swings, perfectionism, low self-esteem and feeling depressed.

Because eating disorders and mental health conditions often share the same risk factors and symptoms, it’s important to receive a diagnosis for each condition that may be present so that a mental health professional can treat both.

How Co-Occurring Disorders Impact Eating Disorders 

Co-occurring mental health disorders or substance use disorders can worsen eating disorder symptoms and increase the risk for negative outcomes. The existence of more than one disorder can also make treatment more complex and recovery more difficult to maintain.

For example, if someone who struggles with a mental health condition like depression or anxiety receives treatment only for an eating disorder, they may return home and still struggle with mental health concerns that were untreated.

For many who have eating disorders, food may be a source of control, and eating disorder behaviors can occur more often during times of stress, anxiety and fear. Someone who does not receive a treatment plan that addresses these negative feelings may still struggle with them even after eating disorder treatment. These ongoing concerns can be potential triggers for future eating disorder behaviors, making recovery more difficult.

Treating the Source of Eating Disorders

While not always the case, mental health disorders can be underlying causes of eating disorders [1]. That’s why treating the co-occurring condition is so important when it comes to eating disorder care.

Mental health disorders such as anxiety, depression and OCD may increase the risk for developing an eating disorder. Therefore, if someone is showing symptoms of these mental health concerns, a professional should include treatment for those in their eating disorder care plan.

A history of trauma is another common risk factor for eating disorder symptoms [1]. Individuals who have an eating disorder along with a history of trauma or PTSD should follow a trauma-informed care plan. Addressing past trauma can increase the success of eating disorder treatment.

Like mental health disorders, substance use disorders can increase a person’s chances of developing an eating disorder. Along with drugs and alcohol, those who have a substance use disorder may also be more likely to misuse dieting pills, laxatives and other weight loss medications [2]. Individuals who have a substance use disorder may have a more difficult time beginning eating disorder treatment unless they receive the proper addiction care first.

Treating co-occurring mental health conditions can make treating an eating disorder more successful. If you are struggling with an eating disorder and co-occurring mental health concerns, help is available.

Butterfly and Pink Flowers


[1] Anxiety & Depression Association of America. Eating Disorders. ADAA.

[2] Muhlheim, L. (2019, March 18). Eating disorders and substance abuse. Verywell Mind.

About Our Sponsor:

Located in Tucson, Arizona, Sierra Tucson is the nation’s leading residential and outpatient treatment center for co-occurring concerns.

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 August 2, 2021, on
Reviewed & Approved on August 2, 2021, by Jacquelyn Ekern MS, LPC