It started with ice cream. My son’s preschool class had made the cold, confection a few days prior and my husband, inspired to haul our ice cream maker out of the basement to concoct a similar treat, whipped up a batch of cookies and cream.
I, like most lactose-tolerant beings, love real ice cream — the cold creamy goodness and the inevitable flood of happy childhood memories triggered by consuming that most-beloved of all summertime treats.
This time, though, I took a bite and immediately wanted to spit it out. I could feel the delicious dessert sliding down my throat and into my stomach, where I pictured it making its way to my hips and thighs, increasing my girth to unacceptable proportions. Anxiety gripped me like a vice and my heart began jackhammering a staccato rhythm against my ribs. I wouldn’t touch it again, I told myself, as I discretely scooped the remainder into the sink and washed it away.
I’ve always been thin but healthy — a combination of a quick metabolism and years of exercise fueled by intense anxiety. But at times, I creep closer to underweight.
This new obsession with food has snowballed and within less than a week I’ve removed all desserts from my diet. (I gave all the cookies in the house to my mother-in-law for use in her well-established habit of spoiling my son.)
I wish I could say it stopped there. I’ve been eating smaller and smaller portions at each meal because the feeling of fullness triggers obsessive thoughts that I’m gaining weight.
I’ve been stepping on the scale multiple times per day and experiencing intense anxiety if the number tips upwards by even a tenth of a pound.
And I’ve been reveling in the feeling of hunger, my brain assigning triumph to its presence and my ability to avoid eating in spite of it.
I suffer from obsessive-compulsive disorder, my obsessions usually involving fears that I have or will harm others. I’ve spent the past six months working through an obsession involving knives and am happy to report that that particular obsession has been fully extinguished.
But OCD is tricky. Many times I feel like my brain is a mental illness whack-a-mole — one obsession is finally extinguished and two or three more pop up to take its place. It’s a frustrating, exhausting maze where I try to catch the next obsession before it grows too big to stomp out with relative ease.
To complicate things further, my current obsession with food is a bit different in that its veered off into the territory of disordered eating. I do not have an eating disorder, but I am at risk of developing one. (Some studies have found that those who develop OCD in childhood are at increased risk of developing an eating disorder later in life.)
Eating Disorders & OCD
Numerous studies have now shown that those with eating disorders have statistically higher rates of OCD (11% — 69%), and vice versa (10% — 17%). As recently as 2004, Kaye, et al., reported that 64% of individuals with eating disorders also possess at least one anxiety disorder, and 41% of these individuals have OCD in particular.
Intrusive thoughts and compulsive actions are symptoms of eating disorders and OCD. But in people with eating disorders without a comorbid OCD diagnosis, the obsessions and compulsions are usually limited to actions and thoughts related to food and/or weight.
Things get a bit more complicated when you consider that there are also some general criteria for disordered eating, which is a catchall phrase to describe unhealthy eating behaviors and patterns that are not considered to be full-blown eating disorders.
According to the American Academy of Nutrition and Dietetics, signs and symptoms of disordered eating may include, but are not limited to:
- Frequent dieting, anxiety associated with specific foods or meal skipping
- Chronic weight fluctuations
- Rigid rituals and routines surrounding food and exercise
- Feelings of guilt and shame associated with eating
- Preoccupation with food, weight and body image that negatively impacts quality of life
- A feeling of loss of control around food, including compulsive eating habits
- Using exercise, food restriction, fasting or purging to “make up for bad foods” consumed
I’m not qualified to speak to how the symptoms are teased apart to apply the appropriate diagnosis, where overlap occurs, or which treatments are appropriate. But I can say that I have struggled on and off throughout my life with obsessions about my weight, largely related to my appearance (as opposed to taking a certain number of bites at each meal, for example).
Do my recent behaviors constitute disordered eating? I would say yes. Are they related to OCD? Also yes.
I wish I could say that I’m prepared to work on this obsession immediately, but the truth is, losing weight (and doing it quickly) is seductive, so it’s harder to find the motivation to fight it. Normally when a new obsession begins, it’s sudden, terrifying, and I feel a strong sense of motivation to work through exposure and response prevention exercises to extinguish it as soon as possible. Not so in this case.
Despite my reluctance to do so, I plan to speak with my doctor about all of this as a first step to getting the help I need. It’s another stop on the long and winding journey back to relative mental health.
In the meantime, this is life with chronic mental illness. This is me, warts and all — shrinking away and hoping that sometime soon, I’ll find my footing once more.
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