Eating Disorders & Anxiety in 2015

Contributor: Jacquelyn Ekern, MS, LPC.

puppy-324617_640Anxiety, that miserable, tense feeling that something is imminently wrong and something bad is about to happen. It is painful and distracting to endure this feeling for all of us. But, for those who endure an unending assault of this worrisome state – life can be extremely difficult.

Eating Disorders and anxiety, can and often do, occur together. They can and should be treated simultaneously. However, it is important to note that they are two separate, yet, interwoven issues and one of the two may improve while the other lessens, remains the same or worsens. So, it is essential to recognize both issues individually and collectively.

Cognitive Behavioral Therapy

The most effective and empirically supported treatment for anxiety is Cognitive Behavior Therapy (CBT). I have a deep personal appreciation for CBT because of the profound change it brought about in my own life as I struggled to recover from an eating disorder.

I have been further impressed when witnessing its effectiveness in quelling anxiety and worry in clients of my private practice.

Finding Rational Ways to Perceive a Situation

In a nutshell, Cognitive Behavior Therapy provides tools to examine erroneous thoughts and conclusions about life events and offers new, more rational ways to perceive a situation. For example: one former client, an accomplished ballerina named Sarah, worried incessantly about how she appeared in the ballet practice room mirror, in comparison to her colleagues.

She reported that she had frequent thoughts, such as: “If I eat pizza with friends tonight, I will gain weight and look bloated tomorrow at practice”. She endured a relentlessly anxious inner diatribe berating her to not eat, be critical of her body and obsess about how others saw her.

Examples of Erroneous Thinking Errors

people-164542_640Examples of the erroneous thinking errors that CBT pointed out to Sarah were:

She is overgeneralizing and / or thinking in black and white terms when she concluded that the pizza would make her gain weight and look bloated. We all know that a couple of pieces of pizza cannot cause someone to gain weight overnight.

Just like all foods, our body will process the pizza and derive nutrients from it. The pizza converts to energy in the body, just like all foods. Even if the pizza has more fat or calories than her normal food choices, a few pieces of pizza are not going to equate to weight gain over night.

She is an active athlete, she needs a variety of nutritious foods and she can eat all foods in moderation.

Choosing More Rational Thoughts

So, as our friend Sarah recognized, her initial irrational self-talk about eating the pizza needed to be questioned. She was not telling herself the truth and was, in fact, somewhat traumatizing herself by her faulty conclusions.

When she identified her thinking errors: overgeneralization, black and white thinking and jumping to conclusions; she was then able to choose more rational thoughts that included her reasonable and wise thoughts about nutrition, how the body processes food, and what really constitutes weight gain.

Helping Anxiety Sufferers

shoes-166866_640In addition to cognitive behavior therapy, ongoing brain research is being conducted to help anxiety suffers. Particularly promising is the neuroimaging studies that allow researchers to closely examine the brain of eating disorder sufferers.

This technology is assisting researchers in isolating where and how anxiety originates in the brain – promising more effective treatment modalities in the future. The tools used are highly sophisticated and frankly, fascinating!

Neuroimaging Tools

A few of these interesting neuroimaging tools are outlined here:

fMRI – Functional Magnetic Resonance Imaging

  • Noninvasive / Safe
  • High Resolution Images
  • Clearly defines separate tissues of the brain

PET – Positron Emission Tomography

  • Noninvasive / Safe
  • Measures brain activity through oxygen and blood flow

SPECT – Single Photon Emission Computed Tomography

  • Radiation exposure / minor – less than a routine x-ray
  • Injection required of gamma emitting radioisotope
  • Provides 3D view of brain
  • Demonstrates blood flow through arteries and veins of brain

Perhaps the most encouraging suggestion of the research I reviewed is that we may soon be able to predict the potential effectiveness of therapy and / or medication for each individual, thus increasing the likely success of the chosen treatment path.

Hopeful for New Treatments

shadow-269889_640While remaining hopeful of new and effective treatments coming from these neuroimaging studies, I am also cautiously optimistic. Some of the research, reports conflicting findings and more troublesome, even though the neuroimaging research regarding anxiety has been going strong for the last decade, the rate of anxiety has continued to increase dramatically.

So, we have to question is the research translating to effective new treatments for anxiety? Are we failing to utilize the study results to our best advantage? Or do we just need more time, more research and further study to reverse the increasing trend of anxiety in society?

Community Discussion – Share your thoughts here!

Jacquelyn brings up some good questions regarding research and our utilization of research in regards to new treatments. What are your thoughts? Are we failing to utilize these studies to our best advantage or do we need more time to make impactful changes?


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  3. What is fMRI? (n.d.). Retrieved January 27, 2015, from
  4. Stewart, C. (Ed.). (2013, February 1). SPECT (single photon emission computed tomography) scan. Retrieved January 26, 2015, from
  5. Cognitive and Behavioral Therapies for Generalized Anxiety Disorder. (n.d.). Retrieved January 27, 2015, from
  6. Ball, T. M., Stein, M. B. and Paulus, M. P. (2014), TOWARD THE APPLICATION OF FUNCTIONAL NEUROIMAGING TO INDIVIDUALIZED TREATMENT FOR ANXIETY AND DEPRESSION. Depress. Anxiety, 31: 920–933. doi: 10.1002/da.22299
  7. Burns, D. (1980). Feeling good: The new mood therapy. New York: Morrow.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on January 31st, 2015
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