The Impact of Co-Occurring Disorders on Anorexia Nervosa Treatment

Following a diagnosis of anorexia nervosa, there may be apprehension about what to expect. However, anorexia eating disorder recovery can be a sensitive and very rewarding process. Unfortunately, anorexia nervosa doesn’t appear on its own in many cases, and when someone receives an anorexia nervosa diagnosis along with co-occurring disorders or they receive a dual diagnosis, chances are that they will need access to diverse treatment options, from individual therapy to a stay at an anorexia nervosa treatment center.

While many families are familiar with common eating disorders like anorexia nervosa and bulimia nervosa or binge eating disorder, it’s less commonly known that very often people with eating disorders also have one or more co-occurring mental health disorders. At dedicated eating disorder recovery centers like Oliver-Pyatt, individuals have access to the highest level of care in a comfortable and safe setting.

What Are Co-Occurring Disorders?

In terms of behavioral health treatment and eating disorder recovery, a co-occurring disorder means when a person is diagnosed with at least two psychiatric disorders, such as substance addiction and depression, or bulimia nervosa and PTSD. This means that any time that an eating disorder like anorexia nervosa or binge eating disorder exists at the same time as another mental health disorder, anorexia nervosa disorder treatment can be more complicated and require specialized treatment methodologies. When both conditions are not addressed at the same time, the recovery process can become more complicated and the person going into treatment is more likely to experience a relapse or require longer treatment times for the same outcome.

When loved ones and families of anorexia nervosa patients are helping to seek out an eating disorder recovery solution, they should consider getting all the facts before committing. A consultation with a therapist or psychiatrist can help identify any co-occurring disorders are present. From there, a comprehensive plan can be derived. Unfortunately, it is common to see individuals with a serious mental health condition like depression only treated for their condition as it relates to their eating disorder. Co-occurring counseling for someone with the symptoms of anorexia nervosa often requires additional assessment of the individual before designing a unique treatment program to fit their individual experience. This means that when choosing an eating disorder recovery program, families need to look for a multifaceted and integrated approach to treatment.

The Kinds of Co-Occurring Disorders That Appear With Anorexia Nervosa

Anorexia nervosa symptoms include behavioral aspects, like food restriction and excessive exercise, and those are well known. On the other hand, people often don’t realize that eating disorders are often complicated by other mental disorders like depression as well. Various studies have revealed that as many as 50 percent of people with anorexia nervosa have a co-occurring dual diagnosis, so it’s essential to know what you’re dealing with when going into eating disorder treatment.


Depression is the most common mental health disorder in America and is most likely the most common disorder co-occurring with anorexia nervosa. Characterized by feelings of worthlessness and sadness, as well as decreased motivation and ability to enjoy things, depression can have a dramatic effect on many different facets of life. Depression can result in low energy levels, self-harm, and a sense of insignificance, which can affect body image and lower self-esteem, common contributing factors in the development of eating disorders.

Obsessive-Compulsive Disorder

Another severe psychiatric disorder that in many ways displays similar characteristics to anorexia nervosa and other eating disorders is obsessive-compulsive disorder. This is because the disordered behaviors found in cases of obsessive-compulsive disorder, such as repeated actions and strong anxiety, are very similar to those found in many common eating disorders. Obsessive-compulsive disorder is a type of anxiety disorder that is characterized by repetitive thoughts and actions, with a sense if certain actions are not taken, negative consequences will result.

Many of the people who have obsessive-compulsive disorder experience symptoms that are related to both obsessive thoughts and compulsive behaviors. It is believed that a variety of factors can contribute to the development of obsessive-compulsive disorder including past traumas, genetics, hormonal and chemical imbalances.

Alcoholism, Addiction, and Substance Abuse

It’s estimated that people with anorexia nervosa have an incidence of substance abuse that may reach as much as 5 times higher than that of the general population. Alcoholism and substance abuse are characterized by an uncontrollable and compulsive psychological need to consume alcohol or other drugs, which can also be complicated by physical dependency. Abuse of stimulants like amphetamines and cocaine are common as well, as they are appetite suppressants and metabolism boosters.

Many different factors may contribute to an addiction to alcohol or drugs including genetics, social and biological factors, familial circumstances and more. These are among the same factors that commonly influence developing eating disorders, which can make dual diagnosis treatment for eating disorders even more necessary.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder, normally shortened to PTSD, is another very severe anxiety disorder. With PTSD, past traumatic experiences like being in a car accident or going through a divorce can cause recurring feelings of anxiety, fear, hopelessness or tension, especially when similar events happen later. This means that a PTSD episode can be set in motion by anything that overwhelms an individual’s ability to cope in a stressful situation.


Anxiety is another mental health disorder that is growing in prevalence in recent years and is commonly associated with eating disorders like anorexia nervosa. Some of the most common types of anxiety disorders include social anxiety disorder, panic disorders, phobias, and generalized anxiety disorder. Social anxiety and body-related anxiety are both key causes of eating disorders, with those feelings prompting disordered behaviors like food avoidance or self-induced vomiting that define eating disorders.

Similar to eating disorders like anorexia nervosa and bulimia nervosa, anxiety disorders often develop due to past traumas, a family history of anxiety disorders and relational stresses. Anxiety disorders often occur with eating disorders because they are often developed to help people cope with anxiety.

Why Do Eating Disorders Happen at the Same Time as Other Mental Health Disorders?

Especially with depression and anxiety, many similar factors cause both types of disorder, including genetic factors, family environment, and family history of these diseases. In most cases, eating disorders developed or co-developed as a coping mechanism for feelings of low self-esteem, depression, and anxiety. For example, someone with depression may use food to cope with their feelings of sadness and worthlessness in an effort to make themselves feel better, even momentarily. Or when a PTSD sufferer is having pangs of anxiety, they may retreat to excessive exercise or purging, which come with serotonin releases.

What Type of Treatment Is Available for Co-Occurring Disorders?

Today, there are more options for anorexia nervosa treatment centers than ever before, with an array of inpatient, residential and outpatient options. However, not all eating disorder recovery facilities are created equal and integrated, multifaceted treatment methodologies may not be at each site. At Oliver-Pyatt Centers in South Florida, individuals can receive the benefits of both medical and psychiatric care on-site, meaning the pieces are in place for dedicated dual diagnosis treatment. This is the highest level of care that a patient can receive outside of a hospital setting.

The Importance of Integrated Care

Simply treating an eating disorder while the presence of another disorder like obsessive-compulsive disorder is ignored can often do more harm than good. It’s essential to integrate treatment for both disorders simultaneously with programs that target the symptoms concurrently. With this type of integrated treatment, eating disorder treatment centers can lower the relapse rate among their recovery program graduates and promote long-term recovery outcomes.

Some of the other main reasons why it is so important to treat co-occurring mental health and eating disorders at the same time include:

  • Group therapy provides support from peers who have the same kinds of experience.
  • Integrated recovery programs are designed to help individuals overcome the negative side effects of their co-occurring mental health disorders such as low levels of motivation, the fear of socializing with others and reduced attention spans.
  • Medication therapy is often more effective when addressing both mental health conditions and substance abuse disorders simultaneously, and while it’s not always the best course of action to provide medication, it’s best to coordinate those treatments.

If an anorexia nervosa treatment center can personalize its programs, including specific methodologies for co-occurring disorders, individuals in treatment have a greater chance of achieving long-term success. While mental health and eating disorders in women and men can be very complex, with proper treatment, relapse can be avoided.

What Are Level of Care Options for Dual Diagnosis Treatment

Each of the different levels of care should include provisions for treating co-occurring disorders, and they should keep in mind that there is not a “one size fits all” recovery program. However, different severities and different costs can mean that there is a proper level of care for each case. Parents and other loved ones should consider these factors when choosing the right program for a successful recovery:

  • Residential treatment programs provide structured care in a supervised and safe rehabilitation setting. This includes 24 hours a day supervision and an unparalleled focus on recovery. It’s best suited for severe cases and those which require medical or psychiatric care.
  • Outpatient eating disorder treatment, also known as day treatment, is a great alternative for those who do not require access to 24-hour supervision. This can be ideal doe new parents, students, or those with work obligations who can’t commit to leaving home for 30 days or more.
  • Access to peer support groups, especially in aftercare, or the time after treatment ends, can be extremely important to the recovery process for individuals with a dual diagnosis. This can be through group therapy sessions, meet and greets, or dedicated individual follow-ups with professionals or even with friends made during treatment. These groups reduce isolation and allow for open honest communication about life free from eating disorders.
  • Education and counseling for families may also be a necessary part of a successful recovery program. Having a strong support system in place is vital for anyone who has an eating disorder and another co-occurring mental health condition.

Contact Oliver Pyatt Centers Today

Anorexia nervosa, in both men and women can put individuals at risk for several serious and dangerous health consequences. But with co-occurring disorder or dual diagnosis, treatment can be especially complex. At Oliver-Pyatt Centers anorexia nervosa treatment facilities, we provide the highest quality treatment available outside the hospital setting in a compassionate, comfortable and home-like setting. We offer highly customized treatment that is designed to help individuals through the recovery process with access to both medical and psychiatric care. Call 866-511-4325 or contact our professional admissions team online today to learn more.