Anorexia: A Form of OCD?

This week we’ll explore the relationship between anorexia nervosa and obsession. While anorexia clearly involves an obsession with food, body image, and weight, the scientific community has long been questioning the connection between anorexia and OCD. Most researchers agree that the two disorders are somehow connected, but the question of the nature of that connection still remains unclear. Psychologists and psychiatrists continue to explore whether the two disorders are co-morbid illnesses or if instead anorexia is actually a particular manifestation of OCD.

Those who suggest anorexia is a form of OCD argue that the obsession in cases of anorexia is with food and control, and the compulsions are related to methods of eating and maintaining order. On the other hand, proponents of a co-morbid relationship maintain that the obsessions and compulsions in anorexia do not meet the same requirements mentioned in Osborn’s book. Furthermore, the compulsions, unlike in OCD, are not meant to achieve relief.

You will all be familiar with Dana's story, the 8-year-old with anorexia. Another documentary, Thin, follows a group of American women who are in-patients at an eating disorder clinic. The following is the first part of the film (the rest is available on youtube as well, and I suggest you view the first few parts, at least).

Considering these materials, what is your first impression of the relationship between the disorders? Are anorexia and OCD two conditions that often strike the same individual or is anorexia instead a form of OCD? Do these women seem to fit the criteria that Osborn outlines?

OCD Treatment: Exposure Therapy.

We spoke in class about the creation of a progress narrative when it comes to "recovery" from Obsessive Compulsive Disorder and the discovery of a "cure." Likewise, we also began talking about the current treatment methods used in many cases of OCD--most commonly the combination of medication and exposure therapy. The following clip from A&E's Obsessed depicts one session of exposure therapy.





It's important to remember that this therapy does not work for everyone--Osborn cites figures that put the success rate at 60-70%--and as you'll hear in the clips for Tuesday, it is not a one time fix.

This clip is interesting for a second reason as well: the woman's obsession depicts the way that OCD can take a healthy (or helpful) behavior to such an extreme that it becomes dangerous. Her compulsions drove her to exercise for much of the day every day, and she was unable to interact with her husband or children as a consequence. Clearly this is a very different type of obsession than the sort we discussed on the first day of class.

Hopefully this clip, in combination with the two for Tuesday, help distinguish both pop-culture and clinical definitions of obsession as well as obsessions and compulsions in OCD.

Hobby, Preoccupation, Passion... or Obsession?

While we'll be focusing on the clinical diagnosis most obviously related to obsession--Obsessive Compulsive Disorder--for the first couple of weeks, I want to take this moment to highlight an issue we began to discuss this past Thursday.

It's become popular to speak in terms of obsession. People sometimes claim to be obsessed with television shows, their hobbies or collections, their favorite colors. And then, as we discovered last class, there's food. For example, take this clip from Anthony Bourdain's No Reservations:

This promotional video uses the pop-culture preoccupation with obsession to sensationalize its topic... and it works! But are cooks, bloggers, butchers, cheese-makers, and your garden variety restaurant patrons all really obsessed? More than likely the answer lies in the word's definition. Luckily, the clip cites a dictionary.

obsession: the compulsive preoccupation with a fixed idea or an unwanted feeling or emotion , often accompanied by symptoms of anxiety.

According to this then, an obsession is a particular kind of preoccupation--one that the obsessive doesn't want and can't seem to control. We'll also speak more about fixed ideas in a few weeks but suffice it to say these thoughts aren't going away. Finally anxiety, that nervous feeling you get when you think something horrible is about to happen, is often a key part of obsession.

So then in other words: an obsession is an unwanted idea you can't distract yourself from. It isn't connected to your surroundings, and it's often accompanied by a feeling of dread.

Is this how you imagine cooks and food bloggers? And really, going back to another idea from last class, can something like this every really be "balanced" or is it by its very definition excessive?

Something to think about.