Generalized Anxiety Disorder & Eating Disorders

When It's More Than Just Normal Worrying


Everyone experiences anxiety from time to time, and people who have eating disorders are no exception. Eating disorder sufferers experience anxiety about gaining weight, eating (or not eating) meals, how to hide eating disorder behaviors, and how their body looks. However, some people experience anxiety on an even broader level. Those people may be suffering from generalized anxiety disorder - a problem that can affect people with eating disorders, other psychiatric conditions as well as those without any co-morbid conditions at all.

What is Generalized Anxiety Disorder?

In order to be diagnosed with generalized anxiety disorder (GAD), a person must meet all of the following criteria:

  • The person experiences anxiety and worry a majority of days over the course of at least six months and it is about a number of different events or activities (i.e. not limited to one particular stressor).
  • It is difficult to stop worrying or calm the anxiety.
  • The person experiences at least 3 of the following symptoms as part of the anxiety/worry: Restlessness or being 'on edge,' Fatigue, Problems with concentrating, Irritability, Muscle Tension, or Sleep problems (can be problems with falling asleep, staying asleep, or simply having restless sleep).
  • The things that the anxiety is focused on are not limited to another disorder. This means that for a person with an eating disorder, the anxiety is not limited to worries about food or weight and must include other areas of their life (work, school, money, relationships etc.)
  • The anxiety or worry causes problems in the person's life to the point that it interferes with functioning.
  • The anxiety is not caused by a medical condition or substance use.

Many people who have GAD report that they have experienced anxiety, worry and/or fear since childhood and sometimes have difficulty remembering a time when they weren't anxious.

Sometimes it can seem difficult to differentiate an anxiety disorder from the anxiety we all face in our daily lives. However, the key criteria when thinking about whether or not you have an anxiety disorder is whether or not it is interfering in your daily life. If you aren't able to engage in activities or relationships because anxiety has taken over, it is important for you to seek help.

How does GAD relate to eating disorders?

People with eating disorders already experience a great deal of anxiety in relation to topics such as food and weight. They are also often experience anxiety in other areas of their lives as well. Research has shown that around two-thirds of people with either anorexia or bulimia suffer from some type of anxiety disorder in their lifetime. This includes obsessive-compulsive disorder, phobias and generalized anxiety disorder.

Most individuals who have both GAD and an eating disorder, experienced the onset of anxiety symptoms prior to the onset of their eating disorder.

The eating disorder often exacerbates these symptoms as well. Even those eating disorder sufferers who do not have an anxiety disorder tend to experience perfectionism and anxiety.

How does it affect treatment?

Anytime that a person is suffering from multiple problems, it can complicate the treatment process. However, the good news is that there are effective treatments for both GAD and eating disorders. Most therapists who treat eating disorders are also familiar with the treatment of anxiety disorders as well.

Treatment for GAD often includes medication. It also typically includes some type of psychotherapy. Cognitive-behavioral therapy has been shown to be effective at treating GAD and can be done on an individual and/or group basis. Mindfulness-based therapies and relaxation training may also be helpful.


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC: Author.

Borkovec, T.D., Costello, E. (1993). Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61(4), 611- 619.

Dugas, M., Ladouceur, R., Leger, E., Freeston, M.H., Langlois, F., Provencher, M.D., & Boisvert, J. (2003). Group cognitive-behavioral therapy for generalized anxiety disorder: Treatment outcome and long-term follow up. Journal of Consulting and Clinical Psychology, 71(4), 821-825.

Kaye, W.H., Bulik, C.M., Thornton, L., Barbarich, N., Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia. American Journal of Psychiatry, 161(12), 2215-2221.

Maslowsky, J., Mogg, K., Bradley, B., McClure-Tone, E., Ernst, M., Pine, D.S., & Monk, C.S. (2010). A preliminary investigation of neural correlates of treatment in adolescents with generalized anxiety disorder. Journal of Child and Adolescent Psychopharmacology, 20(2), 105-11.

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