Eating Disorders and Obsessive-Compulsive Disorder: An ...

approval and acceptance (Rieger, Touyz, Swain, & Beumont, 2001; Rothernberg,
1986).
Based on the obsessions and compulsions that are regularly exhibited by
individuals with an eating disorder, Rothenberg (1986) has argued that eating disorders
are a contemporary expression of OCD and can be considered a “modern obsessive-
compulsive syndrome” (p. 45), drawing on similarities in the obsessional focus on
particular stimuli (e.g., food, shape, and weight), a need for control (e.g., over dietary
intake, exercise), and associated fears that are irrational and overestimate the
likelihood of a feared consequence. If eating disorders were to represent a form of
OCD, a fundamental question lies in the nature of the obsessions and compulsions
evident in these conditions. Simply put, it has been argued that preoccupations with
shape and weight are a form of obsession whilst binge eating and purging behaviours
demonstrate compulsions (von Ranson et al., 1999). Such a conceptualisation of the
function of eating disorders is parsimonious, yet may oversimplify the nature of
symptoms associated with these disorders.
Theorists contend that rumination about food; thinking about one’s body shape
and weight; and mental images about food constitute obsessive thoughts, whilst the
overwhelming fear of weight gain is consistent with the obsessive fear of harm to self
maintained by a proportion of patients with OCD (Du Bois, 1949; Nilsson, Gillberg,
Gillberg, & Rastam, 1999; O’Brien & Vincent, 2002; Rothernberg, 1986). Individuals
with an eating disorder often have the belief that eating even a small portion of food will
have a disproportional impact on body shape. The resultant development of rigid and
uncompromising rules surrounding food and eating may function as a neutralising or
anxiety-reducing behaviour and in this context, may be operationalised as
compulsions. Such behaviours include calorie counting, excessive monitoring of dietary
intake, eating at certain times of the day or with particular utensils, and engaging in
exorbitant amounts of exercise.
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