The Relationship Between Eating Disorders, Anxiety and Perfectionism

What is an Eating Disorder?

An eating disorder is a mental illness that is characterized by a maladaptive and obsessive preoccupation with body image, shape or weight in conjunction with extreme eating habits and exercise. It is estimated that approximately one in 20 Australians have an eating disorder with eating disorders experienced by 15% of Australian women at some point in their lifetime. Although more commonly seen in women, men are also affected. Eating disorders impact individuals not only mentally but also physically as the complications that arise can affect all major organs with physical complications of eating disorders associated with a mortality rate that is the highest of any mental illness and 12 times higher than the normal population.

 There are a number of different disorders specified under the umbrella of eating disorders which are as follows:

Anorexia Nervosa: Characterised by a persistent restriction of energy intake, an intense fear of gaining weight and a disturbance in the way one’s body image is experienced.

Bulimia Nervosa: Characterised by recurrent episodes of binge eating, recurrent compensatory behaviour in order to prevent weight gain, such as self-induced vomiting, on a regular basis.

Binge Eating Disorder: Characterised by recurrent episodes of binge eating accompanied by marked distress and feelings such as that of being uncomfortable full, eating more rapidly than normal or eating large amounts of food when not physically hungry on a regular basis.

Pica: Characterised by persistent eating of non-nutritive substances such as dirt or clay.

Rumination Disorder: Characterised by repeated regurgitation of food that may be re-chewed, re-swallowed or spit out.

Avoidant/Restrictive Food Intake Disorder: Characterised by an eating or feeding disturbance manifested by a persistent failure to meet appropriate nutritional requirements in conjunction with significant weight loss, significant nutritional deficiency, dependent on suppliments and/or marked interference with psychosocial functioning.

Other Specified Feeding or Eating Disorder: Diagnosed when an individual presents with feeding or eating behaviours that cause clinically significant distress or impairment without meeting the full criteria of any other feeding or eating disorder.

Unspecified Feeding or Eating Disorder: Diagnosed when an individual presents with feeding or eating behaviours that cause clinically significant distress or impairment but do not meet the full criteria of any other feeding or eating disorder, however, the clinician chooses not to specify why the criteria are not met.


While these are the behaviours typically associated with an eating disorder, many individuals with an eating disorder may not recognise that their behaviour is problematic or may go to extreme lengths to hide their behaviour such that the signs can be difficult to recognise.


There are many factors that may increase an individual’s predisposition towards developing an eating disorder. Two of these that are  very prominent amongst individuals with eating disorders are anxiety and perfectionism.


What is the Relationship Between Eating Disorders and Anxiety?

It is worth noting that research has found that there is a relationship between eating and anxiety disorders with studies finding that approximately two-thirds of individuals with an eating disorder also have had one or more diagnosed anxiety disorder, commonly social anxiety disorder, in their lifetime with most reporting an onset of their anxiety before they developed an eating disorder. However, while there is a link between clinical anxiety and eating disorders, a number of other, non-clinical anxieties are found amongst those with eating disorders. One of the most prominent anxieties found in research to be associated with eating disorders is anxiety regarding body image and the thin ideal portrayed in the media, particularly in magazines. Typically this effect of the media is seen more in women than in men and, specifically, amongst young adult women more so than children or adolescence suggesting that it is long-term exposure to the media’s thin ideal during childhood and adolescence that lays the foundation for anxiety regarding body image in young adulthood. Although the impact on men has not found to be as strong, the media portrayal of the ideal man as trim and muscular may also lead to anxiety surrounding body image and body dissatisfaction amongst men.  It is suggested that this anxiety about body image may trigger an eating disorder as individuals conclude that restrictive eating and over exercising will reduce their anxiety about their body image by bringing their body more in line with the body image ideals portrayed in the media. Such thinking can then lead to disordered eating patterns and an obsession with weight and appearance that develops into an eating disorder. The relationship between anxieties surrounding body image and a desire to meet expectations and the development of an eating disorder may also be strengthened by a perfectionistic personality and it is worth looking into this personality trait that is commonly related to the development of eating disorders.


What is the Relationship Between Eating Disorders and Perfectionism?

Research has found that individuals with eating disorders commonly have a perfectionistic personality and report that this personality trait long precedes their eating disorder. Those with a perfectionistic personality typically set unrealistically high standards for themselves an experience extreme distress if they fail. Individuals with these traits are typically critical of their own performance, have difficulty dealing with making mistakes and are driven by a fear of failure rather than a desire to achieve a goal. This trait is commonly seen in individuals with eating disorders as they take their desire to control their weight and meet the ideal they have set, that is likely heavily influenced by the media, to extreme levels in order to avoid failure. By looking at the impact of body dissatisfaction and perfectionism on the development of eating disorders, it can be seen that, at their core, eating disorders are about far more than just food and weight, rather issues with food and body weight are symptoms that represent are much more deep rooted issue with success, and a perceived pressure to reach perfection.



What Treatment is Available?

As eating disorders involve complex issues with both the mind and body, a holistic, team approach to treatment involving a number of different professionals is recommended. This is such that treatment involves getting back to a healthy weight, maintaining healthy eating and changing the way in which the individual thinks about food and themselves. This is such that a treatment plan for an individual recovering from an eating disorder may involve seeking psychological support, medical care and monitoring, nutritional counselling and potentially medication. Ultimately, the goal of treatment is to improve overall wellbeing and ensure that an individual regains their physical and mental health and establishes new routines and beliefs surrounding food and themselves to experience a greater sense of balance and wellbeing.



Who do we recommend at Anxiety House?



        Amber Rattray

Clinic Psychologist



  • Extensive experience treating anxiety within a CBT framework
  • Worked in inpatient and outpatient settings in the Public sector
  • Four years in a speciality Eating Disorders Service working with CBT
  • Worked in a Youth Speciality Service and in adult services
  • Developed treatment pathways and a CBT group treatments
  • Numerous workshops and additional training in (Metacognitive Therapy Workshop, Mindfulness Training)




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