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  • Isara Moriya

Mindfull X Shield - Co-occurring Disorders

Introduction to Co-occurring Disorders

Co-occurring disorders refer to the combination of two co-existing disorders. It is most commonly used for mental illness and substance use disorder. Just counting individuals with both a mental illness and a substance use disorder, 7.7 million Americans are affected. However, other disorder combinations exist for different individuals. This is no different for eating disorders. A different mental illness quite often accompanies eating disorders, either the eating disorder being the cause or effect of that prior disorder. 

Co-occurring Disorders in Eating Disorders

Eating disorders are complex and individualized. Therefore, different individuals face different problems and are triggered by different things. Such complexity means that their eating disorders don’t just stand on their own. Here are some of the most common co-occurring disorders that people with eating disorders are found to have. 


Anxiety is the most common health concern in the US, with approximately 40 million individuals affected, which translates to about one in eight children suffering. Anxiety is defined as the overwhelming feeling of worry that persists and hinders daily living. Often, the anxiety disorder will come first, then the eating disorder. Individuals may rely on food to control their disquieting life which constantly feels out of control.


Depression is a mood disorder that causes a constant feeling of sadness. This sadness gets reflected in other aspects of emotional and physical life, changing daily living for the worse. Research suggests that depression can be an indication of an eating disorder, and an eating disorder can predict depression. To reduce the symptoms of depression and negative mood, people may comply with eating disorder behavior. However, these efforts may backfire when feelings of guilt, being out of control, and failure take over.

Substance use/Alcohol

The co-occurrence of an eating disorder and substance use can be detrimental, leading to severe addiction and dependence which may result in dangerous behavior. Death may occur if things get out of control. While there are solutions, such as therapy and medication, to get one out of the perpetual cycle of substance use, it is never an easy process. 


In the DSM-5, self-injury is formally known as “nonsuicidal self-injury disorder (NSSID)” because there is no intention of suicide. Some examples of self-injury include cutting oneself, hitting the walls, carving one’s skin, or burning oneself. Sadly, about 30% of individuals who engage in self-injury behavior also engage in binging and purging. Therefore, statistically, self-injury and eating disorders often co-exist. This is especially true with adolescents and teens. 

Borderline Personality Disorder (BPD)

An individual with BPD will have unstable and intense moods, as well as interpersonal relationships resulting in impaired impulse control and unhealthy behaviors such as cutting, binging, and purging. People with BPD often feel empty and unstable and in constant fear of abandonment. BPD and other personality disorders are extremely difficult to treat because they encompass childhood memories and experiences ingrained in individuals’ brains. 

Obsessive-Compulsory Disorder (OCD)

OCD, often misrepresented in mainstream media, is the repetitive, unwanted thoughts (aka. obsessions) together with excessive urges to do a specific action (aka. compulsion). OCD is one of the most co-occurring disorders with eating disorders, often understood because of its sheer similarities with eating disorder behavior. Some of these similarities are meticulousness, challenges in daily living, obsessive beliefs, and extreme patterns. Both are heavily associated with self-control. 


As seen above, co-occurring disorders occur with a multitude of different illnesses. Eating disorders are complex, and people with eating disorders often have complicated thought processes and actions. Therefore, it is not surprising that other disorders could develop alongside or cause an eating disorder. No mental illness has an easy fix. Therefore, it is crucial to understand the connecting and overlapping behaviors of different disorders for medical practitioners to provide adequate care and support. There is a long way to go, but with more research, effort, and advocacy, more and more people are bound to hear, understand, and help people with individuals. 

If you or someone you know has an eating disorder or co-occurring mental disorders, it is recommended you reach out to a healthcare professional and educate yourself on mental disabilities. 

Writer: Isara Moriya




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