Eating should be easy, but for people with food OCD, it can feel anything but. Intrusive thoughts can take over and turn every bite into a battle with fear, doubt, and rituals that don’t make sense but feel impossible to ignore. Instead of nourishment, food becomes a source of stress.
Here’s a complete breakdown of food OCD, what it involves, and how it’s treated.
OCD can create significant challenges when it comes to maintaining a healthy and balanced relationship with food. Those with food OCD experience immense anxiety that’s tied to food preparation and consumption. This anxiety is driven by obsessive thoughts that lead to compulsive behaviors, making mealtimes stressful rather than enjoyable.
One of the ways OCD interferes with eating is by introducing strict, ritualized behaviors around food. Individuals may feel stressed if they’re unable to follow specific rules or routines and can feel compelled to repeat actions until they feel “just right.”
For some, these behaviors become so restrictive that they limit dietary intake, which can sometimes result in noticeable weight loss. Research suggests that in certain cases, the compulsions around food can result in patterns that resemble restrictive eating disorders, such as anorexia nervosa.
Because eating is necessary for survival, food-related OCD can affect not only physical health but also emotional health and social interactions. Avoiding certain foods or engaging in time-consuming preparation rituals can make it difficult to dine out, eat with family, or try new meals.
While picky eating, avoidant/restrictive food intake disorder (ARFID), and food OCD can all influence eating behaviors, they do so in different ways. Here’s a breakdown:
Feature | Picky Eating | ARFID | Food OCD |
Main Cause | Personal preference | Fear-based avoidance | Intrusive thoughts and compulsions |
Day-to-Day Impact | Minimal, usually outgrown | Can lead to severe restriction and malnutrition | Causes distress, time-consuming rituals, and strict eating patterns |
Fear of Choking/Vomiting | No | Yes | Yes |
Compulsive Food Rituals | No | No | Yes |
Food Safety Concerns | No | Sometimes | Frequently |
Body Image Concerns | No | No | No |
Commonly Co-Occurs With | None | ADHD, OCD, Autism, Anxiety Disorders | Anxiety Disorders, OCD |
As you can see, food OCD and ARFID share many of the same characteristics, like a fear of choking, but those with OCD engage in compulsive behaviors in an attempt to ease their anxiety. That being said, a significant portion of people with ARFID have co-occurring mental health conditions, including OCD, ADHD, and anxiety disorders.
Food OCD is separated into two categories: obsessions (intrusive thoughts) and compulsions (repetitive behaviors). Common obsessions include:
Compulsions then develop as a way to cope with these fears, but they reinforce the OCD cycle. Examples include:
Food OCD can be a challenging condition to deal with everyday; however, there are some treatments that can help. Treatment can involve one or a combination of therapy, medication, and nutritional support.
Exposure and response prevention (ERP) is typically the go-to therapy for treating OCD, including eating behaviors. When food is involved in an OCD diagnosis, the patient will be gradually exposed to fear-inducing foods or eating situations.
For example, a person may be asked to eat a meal without following their usual rituals, such as using a specific plate. Over time, this process reduces anxiety and helps break the cycle of obsessive thoughts and compulsive actions.
Other ERP techniques might include:
For people with purging behaviors, ERP may also involve carefully monitored prevention strategies to ensure they don’t use harmful coping skills, such as vomiting or using laxatives.
If your food OCD symptoms are interfering with your everyday life, a doctor may suggest trying a prescription drug. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed and work by increasing serotonin levels in the brain, which helps regulate mood and anxiety. Some of the most common medications used for OCD include:
One case study proves the effectiveness of medication in treating food OCD. A woman developed extreme food avoidance and anxiety after hearing a news story about food contamination. Her symptoms led to severe dietary restrictions and weight loss. However, after starting an SSRI, her anxiety decreased, and she was able to eat without fear.
Many people with food OCD develop restrictive eating patterns, which can cause nutritional deficiencies, unbalanced diets, and even weight loss. Nutritional counseling focuses on:
Unlike traditional dieting methods, nutritional counseling for OCD does not focus on weight loss, but rather on normalizing eating habits and reducing food-related anxiety.
Transcranial magnetic stimulation (TMS) is an emerging treatment for OCD that targets specific areas of the brain that contribute to OCD symptoms. A recent study showed that applying TMS to the bilateral pre-supplementary motor area, dorsolateral prefrontal cortex, orbitofrontal cortex, and medial prefrontal cortex/anterior cingulate cortex is more effective than the placebo in reducing OCD symptoms.
As research on TMS for OCD continues to grow, it could become essential for those struggling with severe, treatment-resistant food OCD.
Living with food OCD can be exhausting as it can turn every meal into a source of stress and anxiety. At Cura Behavioral Health, we specialize in evidence-based treatments like therapy, medication management, and TMS to help people take back control from OCD.
Take the first step today. Contact Cura Behavioral Health to learn more about how we can help you overcome OCD and build a healthier relationship with food.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
