Obsessive-compulsive symptoms in individuals with a history of eating disorders

Avantika Kapadia; Laura M Thornton; Melissa A Munn-Chernoff; Amitai Abramovitch; Dean McKay; Jonathan S Abramowitz; Zeynep Yilmaz; James J Crowley; Cynthia M Bulik; Hunna J Watson

doi:10.1016/j.jad.2025.01.068

Obsessive-compulsive symptoms in individuals with a history of eating disorders

Avantika Kapadia, Laura M Thornton, Melissa A Munn-Chernoff, Amitai Abramovitch, Dean McKay, Jonathan S Abramowitz, Zeynep Yilmaz, James J Crowley, Cynthia M Bulik, Hunna J Watson

Department of Public Health - National Centre for Register-based Research

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

BACKGROUND: OCD symptoms are well documented in anorexia nervosa (AN) and to a lesser extent in bulimia nervosa (BN), yet remain virtually unstudied in binge-eating disorder (BED).

METHODS: In this cross-sectional observational study, 5927 participants with lifetime eating disorders (EDs) (i.e., past or current) were categorized into five groups based on their diagnostic histories: AN only (n = 2330), BN only (n = 740), BED only (n = 665), AN and another ED diagnosis (AN Mixed) (n = 1293), and BN and BED (BN-BED) (n = 899). Obsessive-Compulsive Inventory-12 scores were compared across these groups and with OCD (n = 1040), anxiety-related disorders (ANX) (n = 423), and non-clinical community (NCC) (n = 1194) cohorts.

RESULTS: OCD symptoms were common among individuals with lifetime AN, BN, BED, and multiple EDs, with obsessing being the most prevalent dimension, followed by ordering, checking, and washing. The obsessing scale, which captures general intrusive thoughts rather than traditional OCD obsessions, was notably high. ED groups generally scored higher on the OCI-12 subscales than the ANX and NCC cohorts but lower than the OCD cohort, although ordering severity was higher in some ED groups. Positive correlations were found between ED symptoms and OCI-12 subscales, and gender-diverse individuals and men had greater OCD symptoms than women.

CONCLUSIONS: Clinicians should be vigilant for OCD symptoms in individuals with AN, BN, and BED. These findings call for research on the mechanisms linking EDs and OCD symptoms and support integrated treatment approaches for both conditions.

Original language	English
Journal	Journal of Affective Disorders
Volume	375
Pages (from-to)	496-507
Number of pages	12
ISSN	0165-0327
DOIs	https://doi.org/10.1016/j.jad.2025.01.068
Publication status	Published - 15 Apr 2025

Keywords

Anorexia nervosa
Binge-eating disorder
Bulimia nervosa
Comorbidity
Eating disorders
Gender
Obsessive-compulsive disorder symptoms

Access to Document

10.1016/j.jad.2025.01.068

Cite this

@article{f9044695c6304ae29fb3037c7bbfe412,

title = "Obsessive-compulsive symptoms in individuals with a history of eating disorders",

abstract = "BACKGROUND: OCD symptoms are well documented in anorexia nervosa (AN) and to a lesser extent in bulimia nervosa (BN), yet remain virtually unstudied in binge-eating disorder (BED).METHODS: In this cross-sectional observational study, 5927 participants with lifetime eating disorders (EDs) (i.e., past or current) were categorized into five groups based on their diagnostic histories: AN only (n = 2330), BN only (n = 740), BED only (n = 665), AN and another ED diagnosis (AN Mixed) (n = 1293), and BN and BED (BN-BED) (n = 899). Obsessive-Compulsive Inventory-12 scores were compared across these groups and with OCD (n = 1040), anxiety-related disorders (ANX) (n = 423), and non-clinical community (NCC) (n = 1194) cohorts.RESULTS: OCD symptoms were common among individuals with lifetime AN, BN, BED, and multiple EDs, with obsessing being the most prevalent dimension, followed by ordering, checking, and washing. The obsessing scale, which captures general intrusive thoughts rather than traditional OCD obsessions, was notably high. ED groups generally scored higher on the OCI-12 subscales than the ANX and NCC cohorts but lower than the OCD cohort, although ordering severity was higher in some ED groups. Positive correlations were found between ED symptoms and OCI-12 subscales, and gender-diverse individuals and men had greater OCD symptoms than women.CONCLUSIONS: Clinicians should be vigilant for OCD symptoms in individuals with AN, BN, and BED. These findings call for research on the mechanisms linking EDs and OCD symptoms and support integrated treatment approaches for both conditions.",

keywords = "Anorexia nervosa, Binge-eating disorder, Bulimia nervosa, Comorbidity, Eating disorders, Gender, Obsessive-compulsive disorder symptoms",

author = "Avantika Kapadia and Thornton, {Laura M} and Munn-Chernoff, {Melissa A} and Amitai Abramovitch and Dean McKay and Abramowitz, {Jonathan S} and Zeynep Yilmaz and Crowley, {James J} and Bulik, {Cynthia M} and Watson, {Hunna J}",

note = "Copyright {\textcopyright} 2025. Published by Elsevier B.V.",

year = "2025",

month = apr,

day = "15",

doi = "10.1016/j.jad.2025.01.068",

language = "English",

volume = "375",

pages = "496--507",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

}

Obsessive-compulsive symptoms in individuals with a history of eating disorders. / Kapadia, Avantika; Thornton, Laura M; Munn-Chernoff, Melissa A et al.
In: Journal of Affective Disorders, Vol. 375, 15.04.2025, p. 496-507.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Obsessive-compulsive symptoms in individuals with a history of eating disorders

AU - Kapadia, Avantika

AU - Thornton, Laura M

AU - Munn-Chernoff, Melissa A

AU - Abramovitch, Amitai

AU - McKay, Dean

AU - Abramowitz, Jonathan S

AU - Yilmaz, Zeynep

AU - Crowley, James J

AU - Bulik, Cynthia M

AU - Watson, Hunna J

PY - 2025/4/15

Y1 - 2025/4/15

N2 - BACKGROUND: OCD symptoms are well documented in anorexia nervosa (AN) and to a lesser extent in bulimia nervosa (BN), yet remain virtually unstudied in binge-eating disorder (BED).METHODS: In this cross-sectional observational study, 5927 participants with lifetime eating disorders (EDs) (i.e., past or current) were categorized into five groups based on their diagnostic histories: AN only (n = 2330), BN only (n = 740), BED only (n = 665), AN and another ED diagnosis (AN Mixed) (n = 1293), and BN and BED (BN-BED) (n = 899). Obsessive-Compulsive Inventory-12 scores were compared across these groups and with OCD (n = 1040), anxiety-related disorders (ANX) (n = 423), and non-clinical community (NCC) (n = 1194) cohorts.RESULTS: OCD symptoms were common among individuals with lifetime AN, BN, BED, and multiple EDs, with obsessing being the most prevalent dimension, followed by ordering, checking, and washing. The obsessing scale, which captures general intrusive thoughts rather than traditional OCD obsessions, was notably high. ED groups generally scored higher on the OCI-12 subscales than the ANX and NCC cohorts but lower than the OCD cohort, although ordering severity was higher in some ED groups. Positive correlations were found between ED symptoms and OCI-12 subscales, and gender-diverse individuals and men had greater OCD symptoms than women.CONCLUSIONS: Clinicians should be vigilant for OCD symptoms in individuals with AN, BN, and BED. These findings call for research on the mechanisms linking EDs and OCD symptoms and support integrated treatment approaches for both conditions.

AB - BACKGROUND: OCD symptoms are well documented in anorexia nervosa (AN) and to a lesser extent in bulimia nervosa (BN), yet remain virtually unstudied in binge-eating disorder (BED).METHODS: In this cross-sectional observational study, 5927 participants with lifetime eating disorders (EDs) (i.e., past or current) were categorized into five groups based on their diagnostic histories: AN only (n = 2330), BN only (n = 740), BED only (n = 665), AN and another ED diagnosis (AN Mixed) (n = 1293), and BN and BED (BN-BED) (n = 899). Obsessive-Compulsive Inventory-12 scores were compared across these groups and with OCD (n = 1040), anxiety-related disorders (ANX) (n = 423), and non-clinical community (NCC) (n = 1194) cohorts.RESULTS: OCD symptoms were common among individuals with lifetime AN, BN, BED, and multiple EDs, with obsessing being the most prevalent dimension, followed by ordering, checking, and washing. The obsessing scale, which captures general intrusive thoughts rather than traditional OCD obsessions, was notably high. ED groups generally scored higher on the OCI-12 subscales than the ANX and NCC cohorts but lower than the OCD cohort, although ordering severity was higher in some ED groups. Positive correlations were found between ED symptoms and OCI-12 subscales, and gender-diverse individuals and men had greater OCD symptoms than women.CONCLUSIONS: Clinicians should be vigilant for OCD symptoms in individuals with AN, BN, and BED. These findings call for research on the mechanisms linking EDs and OCD symptoms and support integrated treatment approaches for both conditions.

KW - Anorexia nervosa

KW - Binge-eating disorder

KW - Bulimia nervosa

KW - Comorbidity

KW - Eating disorders

KW - Gender

KW - Obsessive-compulsive disorder symptoms

UR - http://www.scopus.com/inward/record.url?scp=85216886214&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2025.01.068

DO - 10.1016/j.jad.2025.01.068

M3 - Journal article

C2 - 39864784

SN - 0165-0327

VL - 375

SP - 496

EP - 507

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Obsessive-compulsive symptoms in individuals with a history of eating disorders

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this