Binge eating disorder (BED) and obsessive-compulsive disorder (OCD) are two different mental health conditions that frequently co-occur. Both can involve upsetting thoughts, compulsive behaviors, and emotional dysregulation.
Researchers aren’t yet sure why BED and OCD overlap so frequently. But it’s likely due to a combination of shared risk factors, including brain differences, genetics, and environmental concerns.
Both BED and OCD can be managed with medical support (if needed), therapy, medication, and self-care.
Eating disorders (EDs) and obsessive-compulsive disorder (OCD) frequently go hand in hand. Research shows that up to 18% of people [1] with an ED also have OCD. The most common co-occurring ED with OCD is anorexia. But about 7% of people diagnosed with OCD [2] also meet the criteria for binge eating disorder (BED).
Experts don’t yet fully understand all the reasons for the overlap between OCD and BED. But if you’re concerned that you or someone you care about may have BED, OCD, or both, know that you’re not alone and help is available.
Learning more about how these conditions overlap can help you recognize them in yourself and others and know when to seek treatment.
Ways binge eating disorder and OCD are related
BED and OCD are two different mental health conditions that often show up together.
With BED, a person consumes large amounts of food in a short period of time (called binging). They often feel out of control while eating and ashamed after a binge. OCD also causes thoughts and behaviors that are difficult to control. It can lead to a cycle of upsetting, intrusive thoughts followed by ritualistic behaviors called compulsions.
Having OCD doesn’t automatically mean you’ll develop BED, or vice versa. However, it appears the conditions share some risk factors and similarities.
Here’s what the research says about how these conditions are related [3]:
Emotional regulation: In both OCD and BED, compulsive behavior is often an attempt to numb uncomfortable emotions or reduce stress. While these behaviors might provide some temporary relief, they may encourage this unhealthy pattern to continue.
Unwanted thoughts: OCD and BED can both lead to unwanted thoughts or black-and-white thinking that can be difficult to control without support. In OCD, these thoughts tend to revolve around a person’s obsessions. With BED, a person may find themselves constantly thinking about food.
Shared risk factors: People with OCD or BED may have differences in the areas of their brains that control [4] emotional reactivity and how they experience pleasure [5] or rewards. Both conditions may also have a genetic component [6] and may be more likely to occur in people who have [7] a trauma history [8].
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Signs of binge eating in OCD
When someone has more than one mental health condition, the symptoms can sometimes interact and make each other harder to manage.
Here are some examples of what co-occurring OCD and BED might look like:
After performing her nightly cleaning ritual, Amelia feels temporarily relaxed. But later, she lies in bed worrying that she didn’t sanitize her countertops well enough. After tossing and turning for an hour, she’s riddled with anxiety again. So she gets up and heads to the pantry, where she binges in an attempt to find relief. Afterward, when she realizes how much food she’s consumed, she feels so ashamed.
Sal considers himself a perfectionist. Making a mistake, even a small one, tends to send him into a downward spiral. Anytime he doesn’t complete his preferred rituals in just the “right” way, he feels like a total failure. In the case of his eating habits, if he veers away from his strict diet even slightly, he feels like everything is ruined. So he binges until he’s physically uncomfortable to cope with these feelings.
Without a consistent routine, Dani feels incredibly anxious — especially around mealtimes. All day long, they have intrusive thoughts about food and meal routines. They must eat the same food, in the same portion, at the same time. If something affects this eating ritual or upends their routine, they experience intense emotional distress and may binge on a large quantity of “forbidden” foods to cope.
When binge eating disorder and OCD go untreated
Left untreated, BED and OCD [9] can seriously affect your physical well-being, mental health, and quality of life.
Without support, these conditions can interact with one another and make your symptoms worse. They can also make it harder to care for yourself, keep a job, go to school, or sustain healthy relationships.
Fortunately, healing is possible with comprehensive care that addresses both BED and OCD at the same time.
Managing and treating binge eating and OCD together
Treating OCD and BED together can improve outcomes. However, if a person is experiencing health challenges or other severe concerns, those symptoms may need to be addressed before they access other levels of care.
For example, if a person has severe BED, they may require medical intervention or nutritional support to achieve stability before they can access other forms of treatment.
From there, they can explore other supports, like:
Therapy: Individual, group, and family therapy (if appropriate) can help people manage symptoms of BED and OCD. Cognitive behavioral therapy [10] (CBT) is considered one of the most effective treatments for BED. One type of CBT, called exposure response prevention (ERP), can be especially helpful for OCD.
Medication: Medications for BED and OCD may be used alongside therapy and other supports. If you’re interested in this option, talk to your provider about if this is the right option for you. They can walk you through how these medications work, how long it takes for them to kick in, and any potential side effects.
Self-care: While not a replacement for professional help, self-care can be an important part of recovery from BED and OCD. Creating consistent meal time routines, making time for movement you enjoy, reflecting on your triggers, and learning healthy coping skills can help you feel more in control of your thoughts, feelings, and behaviors.
A helpful shift is learning to see the ‘mistake’ as a moment, not a total failure. I often encourage clients to challenge the idea that one disruption ruins everything. When they begin to replace all-or-nothing thinking with flexibility, the urge to binge often loses some of its power.
Brandy Chalmers, LPC
Clinical reviewer
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BED and OCD are two separate mental health conditions that frequently show up together. BED is characterized by consuming large amounts of food in one sitting and feeling ashamed afterward. OCD involves a combination of obsessive thoughts and repetitive behaviors called compulsions.
When someone experiences both of these conditions, they might experience a combination of unwanted thoughts, feelings, and behaviors around food that are difficult to control. Left untreated, co-occurring BED and OCD can negatively affect your quality of life.
Fortunately, both conditions can be managed with the right support. This typically includes therapy, medication, and self-care along with medical and nutritional oversight, if needed.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Rates of comorbid obsessive-compulsive disorder in eating disorders: A meta-analysis of the literature https://www.sciencedirect.com/science/article/abs/pii/S0165032720326975?via%3Dihub
- Eating disorders in patients with obsessive-compulsive disorder: Prevalence and clinical correlates https://research.monash.edu/en/publications/eating-disorders-in-patients-with-obsessive-compulsive-disorder-p/?utm_source=chatgpt.com
- Eating Disorders and Obsessive Compulsive Disorder (OCD) https://www.nationaleatingdisorders.org/eating-disorders-and-obsessive-compulsive-disorder/
- Emotion Regulation in Obsessive-Compulsive Disorder: An Ecological Momentary Assessment Study https://www.sciencedirect.com/science/article/pii/S0005789424000224
- The Neurobiology of Binge-Eating Disorder Differs from Obesity: Implications for Differential Therapeutics https://pmc.ncbi.nlm.nih.gov/articles/PMC7902428/#:~:text=In%20neuroimaging%20studies%2C%20individuals%20with,compared%20to%20controls134%2C%20135.
- Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-or-repetitive-behaviors-take-over
- Trauma-related obsessive–compulsive disorder: a review https://pmc.ncbi.nlm.nih.gov/articles/PMC4346088/
- Binge eating disorder https://pmc.ncbi.nlm.nih.gov/articles/PMC9793802/#:~:text=Issues%20with%20weight%20and%20weight,BED%2Drelated%20functional%20impairment46.
- Mental health aspects of binge eating disorder: A cross-sectional mixed-methods study of binge eating disorder experts' perspectives https://pmc.ncbi.nlm.nih.gov/articles/PMC9520774/#abstract1
- Psychological Treatments for Binge Eating Disorder https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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