Food is, of course, a necessity for life.

For some people, food offers more than an essential source of fuel. If you enjoy sitting down to eat with loved ones or exploring new cuisines while traveling, for example, you might also consider food a source of pleasure. Some people even bake or cook as a way to ease tension and relax.

But if you live with an eating disorder, or a pattern of disordered eating habits, you might find that food prompts feelings of anxiety instead.

The signs and symptoms of eating disorders can depend on the type of eating disorder. Not to mention, they can vary from person to person. That said, they generally involve an extreme focus on food and eating habits, along with some kind of emotional distress related to food or eating.

Yet many people with eating disorders also live with anxiety that goes beyond these feelings of food-related distress. As a matter of fact, as many as two-thirds of people with eating disorders also have an anxiety disorder at some point in life.

Below, we’ll explore the link between anxiety and eating disorders and offer some guidance on finding support.

Eating disorders and anxiety have something of a complex relationship.

While it’s true they commonly occur together and involve some overlapping symptoms, neither directly causes the other. Eating disorders also don’t begin solely as an attempt to maintain control over challenging, painful, or unknown circumstances — though a need for control can absolutely play a part.

Many people living with both conditions notice symptoms of anxiety first, before symptoms of the eating disorder begin. Yet that doesn’t mean anxiety causes eating disorders — after all, not everyone who lives with anxiety will feel distress around food, or develop disordered eating habits.

Research from 2021 does suggest, however, that a co-occurring anxiety disorder or obsessive-compulsive disorder (OCD) may:

  • help maintain symptoms and behaviors associated with eating disorders
  • lead to more severe symptoms over time

In short, having anxiety doesn’t mean you’ll develop an eating disorder. But if you have both conditions, they may play off each other and lead to worse symptoms.

Keep in mind, too, that while eating disorders can certainly involve extreme fear and worry around food and eating, food-related anxiety doesn’t automatically translate to an anxiety condition.

What’s more, some people with eating disorders might have feelings of guilt and shame, dysphoria or a distorted body image, and diminished self-confidence — but not anxiety.

Still, the fact remains: Anxiety and eating disorders involve plenty of overlap.

One potential explanation lies in their shared risk factors.

  • Genetics. Evidence from family and twin studies suggests genetic makeup plays a part in the development of eating disorders. You’re also more likely to have an anxiety disorder if a close family member has anxiety. But emerging research also suggests eating disorders and anxiety disorders may involve similar genes.
  • Brain chemistry. Serotonin, a brain chemical that helps regulate mood, sleep, appetite, and other important bodily processes, appears to factor into both anxiety and eating disorders, though future research may offer more insight into its exact role.
  • Brain processes. With both anxiety disorders and eating disorders, you’re likely to pay more attention to things that seem threatening than things that don’t seem to pose a threat. Cognitive inflexibility, or difficulty coping with changes in your environment or routine, also tends to characterize both conditions.
  • Personality traits. Temperament and personality traits linked to both anxiety and eating disorders include neuroticism, perfectionism, harm avoidance, and difficulty tolerating uncertainty.
  • Childhood experiences. Experiencing abuse in childhood, particularly sexual abuse, is a risk factor for developing an eating disorder. When it comes to anxiety, any repeated negative or traumatic childhood experiences, including sexual abuse, is a risk factor.

Different anxiety disorders involve related but distinct symptoms.

Generalized anxiety disorder (GAD)

This condition involves extreme, persistent, and overwhelming feelings of worry about everyday things and activities that don’t pose an actual threat to your safety.

Anxiety can eventually lead you to avoid any circumstances that trigger these feelings in order to help ease your distress.

Other key signs of GAD include:

  • feelings of restlessness, irritability, and a sense of being on edge
  • sleep issues, including fatigue and insomnia
  • “brain fog,” or difficulty concentrating or remembering things
  • physical symptoms, including stomach distress, muscle tension, and headaches

Obsessive-compulsive disorder (OCD)

OCD involves at least one of two main components, but usually both:

  • Obsessions, or frequent, persistent, and unwanted urges, thoughts, or mental images
  • Compulsions, or repeated mental or physical actions performed to help suppress obsessions, keep them from coming true, and reduce the distress they cause

With OCD, these obsessions and compulsions:

  • cause anxiety and other emotional distress
  • take up a lot of time each day (more than an hour or two)
  • affect your regular routine, daily life, and relationships

Learn more about the difference between obsessions and compulsions.

According to the most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), OCD no longer falls into the category of anxiety disorders. The manual lists it separately.

That said, many experts still consider OCD and anxiety closely related. Research exploring the link between anxiety and eating disorders also tends to include both OCD and post-traumatic stress disorder (PTSD), since previous editions of the DSM did include these as anxiety conditions.

Phobias

A specific phobia involves feelings of extreme fear and anxiety around a specific situation, animal, or object.

You might experience physical and emotional symptoms of anxiety when you:

  • encounter what you’re afraid of
  • think about it
  • hear it or see a picture of it

Eventually, these feelings of anxiety might lead you to avoid any situation where you might come across the object of your phobia. A phobia that involves something very common — cars, dogs, clocks, or trees — can often make it difficult to navigate everyday life.

The DSM-5 recognizes 5 types of phobias:

  • animal phobias
  • natural environment phobias
  • injury, blood, or medical procedure phobias
  • situational phobias
  • other phobias

Learn more about specific phobias.

Two phobias are diagnosed as separate mental health conditions:

  • Social phobia (social anxiety) refers to a fear of social situations that might trigger negative judgment or criticism.
  • Agoraphobia involves a fear of situations and places that leave you feeling trapped and helpless.

Panic disorder

This condition involves:

  • repeated panic attacks
  • extreme worry and fear about having another panic attack

A panic attack, in a nutshell, involves a rush of extreme fear and physical discomfort. These feelings, which might last anywhere from 5 minutes to half an hour or so, might include:

  • overwhelming fear
  • a sense of oncoming death or doom
  • sweating and chills
  • nausea and stomach pain
  • dizziness, trembling, and lightheadedness
  • trouble catching your breath or swallowing
  • pain in your chest
  • numbness and tingling in various body parts
  • a pounding heart

While it’s possible to have a panic attack after encountering something you fear, they can also happen with no recognizable trigger.

Again, eating disorders can show up differently from person to person. That means you could have an eating disorder even if your symptoms don’t exactly align with these criteria.

Keep in mind, too, that people of any gender and body size or shape can experience any eating disorder.

Many people with eating disorders don’t appear physically unhealthy — but their symptoms can still cause plenty of distress as well as serious health concerns.

ARFID

Avoidant/restrictive food intake disorder (ARFID) is a newer eating disorder classification.

Unlike other types of eating disorders, ARFID has nothing to do with a person’s perspective of their body or appearance.

Instead, people with ARFID might find it physically difficult to eat most foods because of anxiety, sometimes related to the sensory characteristics of food.

If you have this condition, you might avoid eating due to overwhelming feelings of anxiety and fear about:

  • food itself
  • certain textures, smells, or sensations
  • concerns about consequences that might occur after eating

This condition isn’t the same as picky eating. In fact, you might feel hungry and want to eat, but sitting down to a plate of food prompts an extreme physical reaction.

You might, for example:

  • feel as if your throat is closing up
  • gag involuntarily
  • feel nauseous or worry that you’ll become nauseous or throw up

Anorexia nervosa

Anorexia nervosa is an eating disorder defined by very restricted eating patterns.

This condition primarily involves intense anxiety and fear around eating. You might:

  • worry about gaining weight
  • experience additional anxiety about eating in public places or with others
  • have a strong desire to control your environment and food

This eating disorder has two subtypes:

  • restricting, or eating very little food
  • binge eating and purging, or eating large amounts of food and then purging by vomiting, exercising, or using laxatives

While this condition more commonly affects women, it can develop in people of any gender.

Bulimia nervosa

This condition involves binges and purges.

Bingeing refers to the consumption of large amounts of food in a short period of time. Purging refers to any attempts to expel consumed food to get rid of the calories and relieve discomfort.

Methods of purging might include:

Anxiety can play a role in both bingeing and purging. When feeling powerless in certain situations, eating might feel like a way to regain control. Purging, which can also offer a sense of control, might happen in response to anxiety around weight gain or an altered physical appearance.

Bulimia nervosa is also more common in women, and it most often develops during adolescence and early adulthood.

Binge eating disorder (BED)

This condition also involves episodes of binge eating, often to the point of discomfort. These episodes generally take place in one sitting or a short span of time. But unlike bulimia nervosa, BED doesn’t involve purges.

Instead, excessive eating generally causes significant emotional distress, including feelings of:

  • anxiety
  • guilt
  • shame
  • disgust

These emotions may prompt a desire to eat more.

Like bulimia nervosa, BED often begins in adolescence and early adulthood, but it can begin at any stage in life.

Both anxiety and eating disorders can improve with treatment and support.

Treatment typically involves some combination of:

  • Cognitive behavioral therapy (CBT). This approach helps you learn to recognize and address unwanted and unhelpful emotions and behaviors related to food and eating, along with other fears and worries. Experts recognize exposure therapy, a subtype of CBT, as an effective approach for both anxiety and eating disorders.
  • Family-based therapy. Therapists generally recommend involving family members in treatment. For parents of children with ARFID, a family-centered program may help parents and children work through the complications of the eating disorder.
  • Medications. Medications, including fluoxetine (Prozac), can be helpful for eating disorders. Medications for co-occurring anxiety conditions might include:
  • Support groups. The compassionate support and encouragement you receive from others also navigating eating disorder recovery can make support groups a valuable addition to your treatment toolbox. Of course, anxiety support groups can also have benefit.
  • Inpatient treatment. Eating disorder treatment facilities offer specialized care, round-the-clock medical attention, and mental health support.
  • Nutritional counseling. Registered dietitians with training in eating disorder recovery can offer guidance with creating an eating plan that helps you feel good and keeps you healthy.

If you think you or your child could have an eating disorder, it’s important to seek treatment sooner rather than later.

Keep in mind that it’s always worth getting support, even if the disordered eating patterns you’ve noticed don’t fully meet the diagnostic criteria for a specific eating disorder.

Without treatment, eating disorders often get worse over time, and they can have serious health consequences. Even if they don’t affect your physical health right away, they can still cause ongoing emotional distress that affects your everyday life and relationships.

Treatment is often successful, but overcoming an eating disorder generally does require professional help.

Therapy can offer a good place to start addressing negative or unwanted emotions around food and eating and learn helpful strategies to cope with anxiety and distress. That said, it often requires a team of trained, supportive experts to work toward eating disorder recovery.

You can get support by contacting:

  • National Eating Disorders Association (NEDA). NEDA’s helpline, at 800-931-2237, offers a screening tool that can direct you to professional help for eating disorders, including free and low-cost support.
  • Anxiety and Depression Association of America. ADAA can help connect you to a therapist or behavioral health treatment center in your area. They also provide valuable guidance on applying for assistance, including Social Security Disability.
  • Your hospital’s education office. A local hospital can also be a good resource for finding support groups, in-network providers, or treatment centers that provide free, low-cost, or income-based support.
  • A therapist who specializes in eating disorder treatment. You can use therapist directories, try a Google search, or ask a healthcare professional for a referral. A therapist can also offer more guidance on finding the right treatment program for your needs.

Not sure how to find the right therapist? Our guide can help.

If you have anxiety about food, you’re not alone. Know, though, that both anxiety and eating disorders can improve with the right treatment.

There’s no denying that recovery is a process. It can take time and effort. But by reaching out to ask for help, you’re taking an important first step — not just toward healing, but also toward regaining control of difficult or painful emotions.

Crystal Raypole writes for Healthline and Psych Central. Her fields of interest include Japanese translation, cooking, natural sciences, sex positivity, and mental health, along with books, books, and more books. In particular, she’s committed to helping decrease stigma around mental health issues. She lives in Washington with her son and a lovably recalcitrant cat.