Co-Occurring Mental Health Conditions and Eating Disorders: What You Should Know

Eating disorders rarely exist in isolation. For many individuals, disordered eating behaviors are closely connected to other mental health conditions—sometimes developing alongside them, sometimes as a way to cope with emotional pain. These are known as co-occurring disorders or dual diagnoses, and understanding them is a crucial part of effective, lasting recovery.

At Cielomar Recovery, we recognize that healing requires treating the whole person—not just the eating disorder. Below are some of the most common mental health conditions that co-occur with eating disorders and why integrated care matters.

Anxiety Disorders

Anxiety disorders are among the most common co-occurring conditions in people with eating disorders. This may include:

• Generalized Anxiety Disorder (GAD)

• Social Anxiety Disorder

• Panic Disorder

• Phobias

For some individuals, eating disorder behaviors serve as an attempt to manage overwhelming fear, worry, or a need for control. Food restriction, bingeing, or purging can temporarily reduce anxiety—but often reinforce it over time.

Why integrated treatment matters:Addressing anxiety through therapy, coping skills, and sometimes medication can reduce reliance on disordered eating behaviors as a form of emotional regulation.

Depression

Depression frequently co-occurs with eating disorders, particularly anorexia nervosa, bulimia nervosa, and binge eating disorder. Symptoms may include:

• Persistent sadness or hopelessness

• Loss of interest or pleasure

• Low energy or motivation

• Feelings of worthlessness or guilt

In some cases, the eating disorder develops first; in others, depression precedes disordered eating. Each can intensify the other, creating a cycle that feels difficult to escape.

Why integrated treatment matters:Treating depression alongside the eating disorder can improve emotional resilience, motivation for recovery, and overall quality of life.

Obsessive-Compulsive Disorder (OCD)

There is significant overlap between eating disorders and OCD, especially when rigid rules, rituals, and intrusive thoughts are present. This can look like:

• Compulsive calorie counting or weighing

• Strict food rules that feel impossible to break

• Intense distress when routines are disrupted

While eating disorders and OCD are distinct diagnoses, they can reinforce similar patterns of perfectionism and compulsive behavior.

Why integrated treatment matters:Therapies that address obsessive thinking—such as exposure-based approaches—can help loosen the grip of both OCD symptoms and eating disorder behaviors.

Trauma-Related Disorders (Including PTSD)

Many individuals with eating disorders have a history of trauma, including emotional, physical, or sexual abuse, neglect, or other adverse experiences. Trauma-related symptoms may include:

• Hypervigilance or emotional numbness

• Flashbacks or intrusive memories

• Difficulty trusting others or feeling safe

Disordered eating can become a way to cope with unresolved trauma or regain a sense of control.

Why integrated treatment matters:Trauma-informed care creates a safe environment where individuals can heal at their own pace, without re-traumatization.

Substance Use Disorders

Eating disorders and substance use disorders often co-occur, particularly with bulimia nervosa and binge eating disorder. Substances may be used to:

• Suppress appetite

• Manage emotions

• Cope with shame or distress

Both conditions can significantly impact physical health and increase medical risk.

Why integrated treatment matters:Treating only one condition while ignoring the other can lead to relapse. Coordinated care supports sustainable recovery from both.

Personality Disorders

Certain personality traits—such as emotional intensity, fear of abandonment, or difficulty with self-image—can overlap with eating disorder symptoms. Borderline Personality Disorder (BPD), in particular, is sometimes seen alongside eating disorders.

Why integrated treatment matters:Skills-based therapies can help individuals build healthier relationships, emotional regulation, and self-worth.

The Importance of Treating the Whole Person

When co-occurring mental health conditions are left untreated, eating disorder recovery can feel incomplete or short-lived. At Cielomar Recovery, we take an integrated, individualized approach—addressing both the eating disorder and any underlying mental health concerns with compassion, clinical expertise, and respect.

Recovery is not just about changing behaviors. It’s about understanding why those behaviors developed and learning healthier ways to cope, connect, and heal.

If you or a loved one is struggling with an eating disorder and mental health concerns, help is available—and recovery is possible