Obsessive-compulsive disease, often referred to as OCD, is a type of anxiety disorder. People with OCD have recurring, unwanted obsessive thoughts; uncontrollable compulsive behaviors or, 90 percent of the time, have both obsessive thoughts and compulsive behavior. These obsessions and compulsions are unwanted and disruptive to daily life. OCD can be associated with eating disorders, anxiety disorders or depression, reports the National Institute of Mental Health. OCD has complex ties to eating behavior and weight loss, and may be associated with weight gain, difficulties losing weight or unhealthy weight loss.
Obsessions and Compulsions
Obsessive thoughts, such as fear of germs, are often coupled with compulsive behaviors, such as excessive hand washing or cleaning. Ritualistic behavior is sometimes more randomly linked to obsessive thoughts. For example, a person might compulsively turn a light off and on 10 times before leaving a room because they fear something bad will happen if they don’t complete the ritual. People with OCD have an irrational belief that their compulsive rituals can help them avoid what are often imagined aversive outcomes. They experience intense anxiety if they fail to carry out the obsessive ritual. People with OCD may develop strong fears or aversions toward food or may become obsessed with maintaining a low weight.
Incidence and Cause
OCD affects over 2 million American adults, according to the National Institute of Mental Health. It is more common than bipolar disorder, panic disorder and schizophrenia but often is overlooked by mental health providers and advocacy groups, perhaps because it co-occurs with other more apparent disorders. OCD likely results from a chemical imbalance in the brain involving the neurotransmitter serotonin. It may involve metabolic problems in particular areas of the brain including the basal ganglia and the frontal lobes, which contributes to rigid thinking, repetitive movements and lack of spontaneity, according to the National Alliance on Mental Illness.
An estimated 11 to 13 percent of those with OCD also have an eating disorder, such as bulimia or anorexia, according to Dr. Steven Tsao, PhD, a licensed clinical psychologist who specializes in the treatment of both obsessive- compulsive disorder and eating disorders. An affected person fears becoming fat or being perceived as fat, and severely restricts calorie intake. Typically, people with anorexia have distortions or delusions about their bodies. Despite being abnormally thin, they perceive themselves as overweight.
Those with bulimia also have an impaired body-image. They obsess over their weight and are highly critical of their appearance. They often restrict eating, but then during periods of stress or when their hunger overcomes them, they binge, consuming excessive amounts of food in a short period of time. After overeating, they become anxious and distressed, worried about the weight they will gain from their binge. They then purge the food by inducing vomiting, taking laxatives or engaging in unhealthy amounts of exercise.
Difficulties Losing Weight
On the other hand, many who take medications to treat OCD struggle with weight gain and have difficulty losing weight. Serotonin reuptake inhibitors, such as clomipramine, one of the medications commonly used to treat OCD, have side effects that can include increased appetite, fatigue and weight gain. A 2004 study reported in the “Journal of Clinical Psychiatry” found that clomipramine caused greater weight gain than sertraline and fluoxetine. Differences in side effects between medications may influence compliance with medication use, especially for those who are interested in losing weight.