Mr. Murphy, my 6th grade health teacher, taught me that eating disorders are a direct result of “the media.” And back then, I believed him.
Now, I’m not so convinced that it’s that simple.
Medical researchers have identified a link between eating disorders and obsessive-compulsive disorder (OCD). At the Royal College of Psychiatrists’ 2009 Annual Meeting in England, researchers estimated that one in five people with OCD also have an eating disorder. In the U.S., approximately 3.3 million people have OCD.
Doug Bunnell, a clinical psychologist who studies the link between obsessive-compulsive disorder and eating disorders, said cultural forces factor into the development of an eating disorder, but that mental illnesses like OCD often play a role.
“It’s the simple explanations that are usually the wrong ones,” Bunnell said.
According to Mental Health America’s website, people with obsessive-compulsive disorder “suffer intensely from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control.” Those with OCD and a poor body image are at risk for developing an eating disorder, because trying to lose weight can easily morph into an obsession.
“If you like order, you like predictability, you like things sort of structured and predictable, you are going to like counting calories, looking at the details of your body,” Bunnell said.
A report from the International OCD Foundation said because eating disorders and OCD are so similar, doctors often mistake one for the other.
“Most people do not think of eating disorders as being part of the OCD spectrum and the relationship between the two disorders has gone relatively unstudied,” the report said. “Even more troubling is the fact that, when patients seek help from mental health professionals in order to alleviate their suffering, clinicians may often mistake one for the other.”
A teenage boy who has both anorexia and OCD, spoke with me via an online forum on the condition of anonymity. He said that when he was around 15 years old, he was trying to lose weight to look good for his girlfriend. At first, he cut out meat from his diet, and then ate nothing but dinner and a small snack at night, along with 6 to 7 cups of green tea to speed up his metabolism.
The young man, who is now 17, said he has never been treated for his OCD. He is obsessed with hair pulling, as well as with his weight. He looks at his stomach in the mirror multiple times a day, drinks green tea religiously, and consistently runs 2 to 4 miles per day.
“If I eat a small amount of food it feels like I have a gut and I drink more water or tea to try and flush it out,” he said. “I check my stomach multiple times a day whenever I’m in the bathroom to see if my cheeks have gotten fatter, if my ribs are visible, and if my hips bones are visible.”
He said he tries to give himself a break from his strict dietary restrictions, but that it never works.
“Yesterday I told myself that I’d go all out and eat whatever I wanted for dinner (I got sesame chicken) but then scratched that promise because a bowl of it made my stomach hurt and I felt bloated and fat,” he said “That made me go to a mirror multiple times and make sure. If I lose control and eat cookies or something, I feel guilty and disappointment and cry.”
Although there is a great deal of literature on the relationship between OCD and eating disorders, the general public is seemingly unaware of this connection. Pediatricians and school health programs need to step it up. It is their oversimplification of eating disorders that is to blame. Unless children are properly educated about the various causes of eating disorders, this epidemic will continue to thrive.