Reader’s Question

I’m wondering how I can stop obsessing about food all the time.

I’m a 20-year-old female, and I’ve had OCD since I was little. It got really bad when I started living in Egypt about 6 years ago. Two years ago I lost about 20 pounds with diet and exercise but have had obsessions about food ever since. Before going on a normal diet I had anorexia. I can’t put anything in my mouth without thinking about the calories and feel very guilty after. I’ve been having health problems because my weight is getting too low, so I have to gain weight again. I know I have to do this for health reasons, but I can’t bring myself to do it. Can you give me some tips on how to stop obsessing about the food and thinking about it all the time?

Our Clinical Psychologist’s Reply

It is not uncommon for individuals who struggle with some type of eating disorder to have obsessive-compulsive symptoms as well. In fact, a fair number of individuals qualify for multiple diagnoses, including that of an eating disorder such as Anorexia Nervosa or Bulimia Nervosa as well as Obsessive-Compulsive Disorder. The main feature of an eating disorder is intense anxiety associated with gaining weight that prompts a disturbance of the normal eating pattern that persists even when it poses a risk to health. The main feature of Obsessive-Compulsive Disorder is the presence of recurring intrusive thoughts and urges that are significantly time consuming, cause distress, and impair normal functioning. It’s quite common for persons afflicted with an eating disorder to have obsessions related to food as well as non-food issues. Depressive and other anxiety features can also be present.

Treatment for eating disorders is most often a multi-faceted endeavor. Medication is often helpful to reduce obsessive thinking, improve impulse control, and stabilize mood. Cognitive-Behavioral Therapy is also a recommended treatment. Such therapy focuses on re-framing disturbing thoughts and substituting alternative behaviors for the behaviors that perpetuate anxiety and reinforce dysfunctional patterns.

Although seeking formal help and therapy is recommended, you can begin to alleviate symptoms by taking notice of the thoughts you have that foster unhealthy concerns about your weight and changing those thoughts. It’s also important to put other, desirable behaviors in place of the “compulsive” behaviors that are linked to your fears and obsessions. For example, when you find yourself saying to yourself something like “I just can’t trust myself to eat this meal because I’ll get as fat as a blimp,” you can modify the self statement to something like: “Eating one healthy meal won’t cause me to be overweight.” Similarly, when you find yourself wanting to avoid certain situations, places and people that place you “at risk” for symptomatic behavior, you can incrementally and systematically deliberately choose to put yourself in such a situation and then “reward” yourself, either internally with words of self-praise, or externally. This not only helps reinforce a healthier behavior but also provides a much needed sense of “control” over things. Maintaining a sense of control is a key aspect involved in both eating disorders as well as overcoming eating disorders.

Necessarily, the above examples are very simplified and not meant to be a substitute for effective professional intervention. But you can take hope that your symptoms are treatable and that you can lead a more obsession-free life once you invest yourself in a program of comprehensive care.