Is there a link between Eating Disorders and OCD

In recent years, the link between Eating Disorders and OCD, Obsessive Compulsive Disorder has been a focal point of research for psychologists, as well as an area that has seen some promising progress in the field.

However, in many of the peer-reviewed journals you read on this subject, a prominent theme is; Obsessive Compulsive Disorder (OCD) and Eating Disorders (ED) have high comorbidity, yet more research is required on the subject matter. For reference, “comorbidity” would be when an individual is suffering from two or more separate mental health diagnoses at the same time.

So if the comorbidity which is seen between the two disorders has been researched thoroughly and still is being at this juncture in time, why are peer review journals stating more research is needed?

Within this article, I will talk a little bit about the comorbidity we’ve seen and where we can focus specific research in the future.

I believe, the link between OCD and ED is well displayed in research by Micali et.al 11. This research discovers that, within the female sample, individuals who are admitted for treatment for OCD, are shown to have a 1% prevalence of ED.

However, after treatment, at a 5-year check-up, ED is shown to have a prevalence of 13% within the same female population. This is a stark percentage increase and thus, very much highlights the need for future research to establish what could be the cause for the elevation observed.

It was also put forward by Micali and his team that clinicians should consider adding an assessment or screening process, at admission and discharge, to assess the risks of developing an ED for those treated for OCD.

However, in recent years, even with the research into the comorbidity within these disorders, there are some criticisms that have been brought forward. One of these criticisms is that currently, research appears reluctant to examine the phenomenon past a diagnostic level, focusing mainly on the existence of comorbidity, its self.

It has been suggested that focusing on other areas within this field might allow for greater insight into the phenomenon. One of these other areas has been shown to be the salience of the symptoms themselves. In fact, it has been through this research, that we have now highlighted the impact that Thought Action Fusion (TAF), can have on the development of these disorders.

Thought Action Fusion is the tendency to incorrectly associate one’s own thoughts with their external reality and that their thoughts are in fact tantamount to reality. This is a symptom that features heavily in both disorders.

TAF can lead to people believing that their thoughts about killing someone are just as bad as actually killing someone. As you can imagine, this is a problem that is often seen in both OCD and ED as well as many other psychiatric disorders.

Research by Lee, Barney & Twohig Et.al. in 2020 has highlighted that the improvement to TAF symptoms post-treatment is positively correlated to the reduction of ED and OCD symptoms in individuals who have been in residential ED care.

This research promotes the need for further insight into the implication that TAF can have on ED and OCD treatment in the future.

Another area of research that could be further promoted is focusing on the temporal sequencing of the comorbidity. The minimal research which has been performed in this area, most notably by Kinkel-Ram, Shruti Shankar et.al 20, suggested that there is a correlative link between the symptoms observed within the comorbidity and how they interact with each other over time.

The observation of specific symptoms within OCD and ED, displayed a relationship that when ED symptoms worsen, so will OCD symptoms and vice versa. This displays a bi-directional relationship between ED and OCD definitely highlights a need for more research on this matter also.

So with the research into salience as well as temporal sequencing, the phenomenon of comorbidity between OCD and ED is really in a prime location for some further groundbreaking research. This relationship appears to be a promising avenue that could provide greater insight into how we could be treating both OCD and ED.

Whilst this article only mentions salience and temporal sequencing they are by no means the only course of intrigue within this research area.

The purpose of this article was to bring to light a few areas of interest surrounding the relationship between Obsessive Compulsive Disorder and Eating Disorders and provide a little insight into how we are progressing with the research at this juncture.