Managing Anxiety In Eating Disorder Recovery: Tools for Resilience

Contributed by Guest Blogger : Brittany Bacarella, LMHC

The Link Between Anxiety Disorders and Eating Disorders

Anxiety and eating disorders often go hand-in-hand. Many people struggling with eating disorders often experience racing thoughts/constant worry, physical tension, difficulty sleeping, changes in appetite, perfectionism/fear of making mistakes, avoidance behaviors, panic symptoms, and constant self-criticism. All of these symptoms can lead to both physical and mental exhaustion. 

How Anxious Thoughts Can Trigger Eating Disorder Behaviors

When anxiety shows up, it can feel like your mind is in overdrive mode, which leads to the desire for a way to feel in control. This can show up as avoidance (avoiding meals), perfectionism (rigid rules around food), or racing thoughts about food (thinking about food constantly or what you ate/didn’t eat that day). No matter what the behavior is, anxiety can often be a driving force. Unfortunately, these behaviors can reinforce the anxiety even more. This can create an exhausting cycle of anxious thoughts and eating disorder behaviors that feed off one another, making recovery more challenging. Being able to identify and understand this connection is essential to breaking this cycle and developing healthier coping strategies.

Coping Tools for Managing Anxiety

While it can be really challenging to manage anxiety and refrain from engaging in eating disorder behaviors, there are some tools that can help in getting started.

• Distress Tolerance: The ability to manage difficult emotions without engaging in maladaptive behaviors. This is a way to “sit with” the discomfort and assists in managing anxiety and overwhelming emotions in healthier ways. Some ways to practice distress tolerance could include grounding, mindfulness, and deep breathing mentioned below, or even positive affirmations, distraction, and self-soothing/self-care techniques (something that might feel calming for you in the moment).

• Grounding Examples: 

• 5-4-3-2-1 Technique 

• Identify and Name:

• 5 Things You See

• 4 Things You Can Touch

• 3 Things You Can Hear

• 2 Things You Can Smell

• 1 Thing You Can Taste

• Physical Grounding

• Pressing feet into floor

• Touching/holding a calming/soothing object or even just an object in the room with you

• Splash cold water on face or holding ice

• Describe Your Environment

• Verbally describe what’s around you, focusing on colors, shapes, objects, sounds to remind you of where you are

• Mindfulness:

• Mindful Observation: Select an object to observe and notice/describe its traits (colors, shapes, textures, etc.)

• Meditations: Find a calming/soothing meditation or even repeat a list of self-soothing/kind affirmations.

• Noting Thoughts and Emotions: Identify your thoughts and emotions by labeling it without judgment and then allow yourself to return to the present moment. 

• Deep Breathing:

• Box Breathing (Square Breathing)

• Inhale slowly through your nose for 4 seconds

• Hold for 4 seconds

• Exhale slowly through mouth for 4 seconds

• Hold for 4 seconds

• Repeat as Needed

• Paced Breathing

• Breathe in and out at a slow, steady pace (maybe 5-6 breath per minute)

• Thought Challenging/Cognitive Restructuring: Ways to identify, evaluate, challenge, and replace unhelpful thoughts. For example, “I messed up my meal plan today. I might as well binge” could be reframed by identifying evidence for and evidence against this thought. Evidence for could be “I didn’t follow my plan exactly” while evidence against could be “While I didn’t quite follow my meal plan, binging leads me to feel guilt and shame and doesn’t change that I steered away from my meal plan.” After identifying evidence for and against can then assist in identifying an alternative thought. It’s important to make sure it’s not just the opposite of your thought, but something you truly believe. It can be helpful to find the “loophole” in your thought that doesn’t make it so “black-and-white.” For example, “My body told me I was hungry in that moment, so I honored my hunger cues and trusted my body, and binging won’t help me in the long run.”

• Thought-Feeling-Behavior Awareness: Being aware of how your feeling, thinking, and behaving is one of the most important steps in coping with anxiety and eating disorder behaviors. Keeping a written log of emotions, thoughts, physical sensations, and behaviors when experiencing heightened anxiety or having the urge to engage in the eating disorder can increase your awareness and allow you to identify ways to intervene before these feelings become too overwhelming to manage. 

Final Thoughts

While experiencing anxiety and eating disorder behaviors can be mentally and physically exhausting, it is completely normal for them to be so closely connected. Anxiety often feels overwhelming and eating disorder behaviors can seem like a way to get some relief from this feeling. There are ways to manage both anxiety and eating disorder behaviors, and therapy can be a great place to start.

Interested in learning more about how to manage your anxiety? Get Started Here.

Listen to founder Francesca Emma, LMHC speak more about this on the Renfrew Center Podcast Here!