Comorbid Anxiety and Eating Disorders: Addressing the Complexity

Posted on 2016-07-01 16:34:00

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Rogers Behavioral Health’s Tampa, FloridaNashville, Tennessee; and Skokie, Illinois; locations offer a variety of partial hospital and intensive outpatient programs for children, teens and adults with anorexia nervosa, binge eating disorder and bulimia nervosa. The Rogers’ teams, however, often find their patients also dealing with comorbid conditions related to anxiety.

Anxiety disorders are quite common among youth and adults and these disorders frequently co-occur with disordered eating behaviors,” says Eric Storch, PhD, clinical director of Rogers Behavioral Health–Tampa Bay and a Morsani College of Medicine professor. “Although exact prevalence rates are difficult to specify for many reasons, we receive many calls from individuals seeking treatment for comorbid eating and anxiety symptoms.”

Matthew Brown, DO, child and adolescent psychiatrist of Rogers Behavioral Health–Chicago, explains that disordered eating habits can develop from a person’s fears. “Many eating issues stem from some sort of anxiety, such as feeling too fat to be loved, nervous that he or she will never be loved or desiring to be the ‘perfect’ weight,” he says. “Many eating disorders are about control and control tends to be driven by anxiety.”

But do anxiety disorders always revolve around food? “Youth and adults presenting for intensive treatment of anxiety disorders at our regional locations display a wide variety of difficulties. These difficulties range from social difficulties; to fears of specific places, people or things; to nearly anything imaginable,” says Joshua Nadeau, PhD, clinical supervisor of eating disorder and obsessive-compulsive disorder and anxiety disorder services at Rogers–Tampa. “Eating disorders—that is, anxiety manifesting as disordered associations with weight, body shape, or eating habits—are one example of impairment related to anxiety.”

Dr. Storch explains that there currently is not enough research in the field to explain the cause of comorbid anxiety and eating disorders. “To some extent, we focus very little upon the ‘why’ of the disorder and very much upon the ‘what now’ in terms of setting goals and helping our patients to reach them,” he says. “Our treatment program focuses upon providing skills training, reducing ‘maintaining factors’ (those things in your environment that reinforce disordered eating behaviors) and providing ample opportunities for practicing the adaptive skills in multiple settings.”

According to Dr. Storch, it’s important that comorbid conditions like eating disorders and anxiety are treated at the same time. “It is not enough to simply change the specific eating disorder behaviors, as the incorrect thought patterns associated with anxiety will more than likely manifest in other areas, and decrease the patients’ motivation for change in the future,” he says. “Our treatment of eating disorders and comorbid anxiety addresses the full range of complexity that people with these problems experience with the goal of healthy lifestyle, happiness and improved quality of life.”

“The Rogers regional programs represent a shift towards more evidence-based methods of addressing patients with anxiety disorders that manifest in disordered eating behaviors,” adds Dr. Nadeau. “Specifically, our programs utilize an adaptation of extended cognitive behavioral therapy (CBT) to provide education, teach and build skill competencies in problem areas, ‘defusing’ maintaining factors and building generalization across settings through significant amounts of skills practice.”

Rogers offers one of a few eating disorder programs that practice not only evidenced-based treatment for eating disorders, but we also have experts in evidenced-based treatment for anxiety as well. “Here we are able to treat the whole patient with the goal of placing them in control of their own lives and teaching them that they can be healthy and they can be successful if they are willing to invest in themselves,” says Dr. Brown.

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