This blog post represents the author’s views and should not be interpreted as professional/medical advice or endorsed by NEDA.
Does Anorexia or OCD Come First?
For those of us considering or currently committed to various treatments for co-occurring anorexia and obsessive compulsive disorder (OCD), an ancient philosophical question boggles the mind: Did the chicken or the egg come first? (Well, we substitute chicken and egg for anorexia and OCD, but the question remains the same nevertheless).
As I’ve embraced recovery for my anorexia and exposure therapy for my OCD, I’ve found comfort in the fact that we’re not alone in asking these questions, as therapists and nutritionists face the same dilemma when identifying the true cause of our physical, mental, and emotional disorders.
Steps to Navigating Anorexia and OCD
In the early days of my treatment, my two disorders reached a rather concerning standstill: I needed to eat more to raise my dangerously-low weight, but my OCD rituals took up all of my time.
However, through taking the following steps, my team found a key approach to navigating the two disorders. That said, everyone’s recovery journey is unique, and what worked for me may not work for everyone. To ensure the best approach, it’s important to consult a treatment team specializing in both eating disorders and OCD. They can create a personalized plan that meets your specific needs.
1. You have to start somewhere
When you’re first introduced to your therapist and nutritionist, you’re in over your head with the ritual that is your life. So, the best thing you can do is start, whether that be by tackling a food rule or a compulsion that causes the least amount of anxiety for you (no matter how small). At this point in your recovery, you just have to get the ball rolling.
2. Work with what you’ve got
After your first couple of exposures, you become increasingly comfortable with the fact that you’ve committed to recovery. So, it’s time to keep up the momentum and build your strength.
Respecting that your OCD can take up most of your time, focus on increasing the snacks/meals that you already eat, whether that be increasing portion sizes or adding new foods.
3. Time adds up
As you and your team gain confidence in your ability to eat larger portions, consider how to make time in your day for more opportunities to show off this growth. Focus on reducing your compulsions, as opposed to eliminating them completely, and you’ll gain – not only practice for future exposures – but a shocking amount of time for more nourishment.
4. Center exposures
Once you’re able to add snacks into your daily routine, acknowledge how reducing your compulsions has given you more time to focus on recovery and challenge yourself to eliminate behaviors that have to do with food and/or meal time. Ultimately, doing this will make even more time for your nourishment and create positive associations as you build strength.
5. Embrace the flip
At this point, you’ll begin to notice your newfound clarity. You may even begin to question the compulsions you have yet to tackle, wondering why you even indulged in them in the first place. Refrain from questioning the reality of your OCD and instead keep in mind that your brain is simply regaining the small percentage of functioning that it had lost. And, in turn, embrace – what feels like – the flip of a light switch in your brain, riding out the recovery process to the end. Take it slow, be patient with yourself, and trust that your brain is – in fact – stronger than it has been in a while.
Knowing Which Comes First
When you feed your body, you nourish your brain. When you nourish your brain, you regain your spark. When you regain your spark, you value your life more than any compulsion that crosses your newly satisfied brain. When you choose your life over your OCD, you have time to feed your body. And, so, the cycle continues.
In short, based on my experience, I believe that there is a rather simple answer to this chicken-egg dilemma: anorexia comes first.
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Amaya Warner is a newly recovered teen who has journeyed through both anorexia and OCD in order to regain her “spark.”
