Exploring OCD and Eating Disorders
Attempting to better understand the relationship between obsessive-compulsive disorder (OCD) and pathological eating disorders (and subsequently the dispositional characteristics common among individuals suffering from either diagnosis), researchers Vartanian & Grisham designed and carried out a study in Australia (2012). Their objective was to examine the relationship between OCD, perfectionism, and compulsive body checking. The researchers note that co-morbidity is often observed between OCD and eating disorders (ED), citing a study by Kaye, Bulik, Thornton, Barbarich, Masters, and Price Foundation Collaborative Group (2004) that demonstrated a 41% prevalence of life-time OCD in a sample of patients with eating disorders (Vartanian & Grisham, 2012).
There is an intuitive relationship between body checking in patients with eating disorders and OCD symptoms. Checking behaviors are often common in patients with a diagnosis of OCD because the checking serves to reduce anxiety temporarily, thus negatively reinforcing and perpetuating the behavior. However, body checking has actually been shown to increase body dissatisfaction (Reas, Whisenhunt, Netemeyer, & Williamson, 2002). Patients, therefore, can become intertwined in a paradoxical endeavor whereby attempts to reduce anxiety contribute to greater and more pathological body dissatisfaction—and, consequently, more severe eating disorders.
Assessing the Dispositions
Vartanian & Grisham (2012) wanted to identify precursors to clinical eating disorders first. The proposed study was to examine dispositional characteristics (specifically perfectionism and negative affect) that are common to both OCD symptoms and body checking. The researchers primarily hypothesized that perfectionism and OCD symptoms would be positively related to body checking, and subsequently that body checking would be associated with greater body dissatisfaction. Participants were recruited from a psychology course at a university in Australia, as well as community volunteers. The subjects were asked to complete several questionnaires, including Obsessive-Compulsive Inventory Revised (OCI-R) (Foa, Huppert, Leiberg, Langner, Kichic, & Hajcak, 2002); Body Checking Questionnaire (BCQ) (Reas, et al., 2002); Multidimensional Perfectionism Inventory (MPI) (Frost, Marten, Lagart, & Rosenblate, 1990); Depression, Anxiety, and Stress Scales (DASS) (Lovibond & Lovibond, 1995); Body Dissatisfaction Subscale of the Eating Disorder Inventory (EDI-BD) (Garner, Olmstead, & Polivy, 1983).
Paths to Greater Body Dissatisfaction
Consistent with the researchers’ hypothesis, both obsessive-compulsive symptoms and perfectionism showed a positive relationship with body checking. Additionally, body-checking behavior was also positively correlated with greater body dissatisfaction, indicating that checking simultaneously reduces (short term) and creates (long term) further anxiety about one’s body image. These findings have important implications for clinicians when identifying patients at risk for clinical eating disorders and in evaluation of patients presenting with symptoms of OCD and body checking.
Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N., Masters, K., & Price Foundation Collaborative Group (2004). Comorbidity of anxiety disorders with anorexia nervosa and bulimia nervosa. American Journal of Psychiatry, 161, 2215–2221.
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., et al. (2002). The Obsessive-Compulsive Inventory: Development and evaluation of a short version. Psychological Assessment, 14, 485-496.
Frost, R. O., Marten, P., Lagart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14: 449–468.
Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34.
Lovibond, S. H. & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. Sydney: Psychology Foundation.
Reas, D. L., Whisenhunt, B. L., Netemeyer, R., & Williamson, D. A. (2002). Development of the Body Checking Questionnaire: A self-report measure of body checking behaviors. International Journal of Eating Disorders, 31, 324–333.
Vartanian, L. & Grisham, J. (2012). Obsessive-compulsive symptoms and body checking in women and men. Cognitive Therapy Resources, 36, 367-374.