Understanding the Connection Between Anxiety, Eating Behaviours, and Body Image

Anxiety in Eating Disorders

Anxiety is a normal human emotion but when it becomes intense, persistent, or linked to food, weight, or body image, it can play a significant role in maintaining an eating disorder. At The London Centre, we help individuals understand and manage the anxiety that sits alongside, contributes to, or results from an eating disorder.

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Anxiety EXPLAINED

Understanding Anxiety Within Eating Disorders

Anxiety is universal. Everyone feels anxious at times, and it is a natural part of living with an eating disorder. But for many people, anxiety symptoms become more intense, more persistent, or more impairing than “normal anxiety”. In these cases, anxiety begins to function as a co-occurring condition that interacts closely with eating disorder thoughts and behaviours.
Many individuals with eating disorders experience features of:

  • Generalised Anxiety Disorder (GAD)
  • Panic symptoms or panic disorder
  • Social anxiety
  • Health anxiety
  • Obsessive worry linked to body checking or food rules

These are not separate conditions we treat in isolation, rather, they are highly relevant clinical features that shape the course of an eating disorder. Understanding this interplay helps clients make sense of their experiences and supports more effective treatment.

Anxiety EXPLAINED

How Anxiety Affects Body Image

Anxiety intensifies self-scrutiny and can distort the way a person sees themselves. This often leads to:

  • Increased body checking
  • Reassurance-seeking
  • Rumination about appearance
  • Heightened sensitivity to perceived flaws
  • Obsessive worry linked to body checking or food rules

For some individuals, this develops into significant body image distress or body dysmorphic disorder (BDD), which is closely linked to anxiety processes.

Addressing anxiety is therefore central to improving body image and reducing appearance-related distress.

Anxiety EXPLAINED

Why Addressing Anxiety is Essential for Eating Disorder Recovery

Treating anxiety alongside eating difficulties can lead to:

  • Reduced reliance on restrictive or compulsive behaviours
  • Greater emotional resilience
  • Improved tolerance of uncertainty and internal sensations
  • More flexible eating
  • Improved social functioning and relationships
  • More stable mood and reduced relapse risk

When anxiety becomes more manageable, the eating disorder loses much of its power.

How Anxiety Contributes to Eating Disorders

For many, anxiety is present long before eating disorder symptoms develop. In these cases, eating disorder behaviours can become a way to:

  • Create a sense of control
  • Soothe or numb anxious feelings
  • Distract from overwhelming thoughts
  • Manage uncertainty
  • Avoid feared sensations or experiences

Restrictive eating, rigid rules, calorie counting, or compulsive behaviours can temporarily reduce anxiety, which unfortunately reinforces and strengthens the eating disorder cycle.

How Eating Disorders Increase Anxiety

Conversely, the eating disorder itself often creates or amplifies anxiety symptoms. This may include:

  • Anxiety around eating or mealtimes
  • Fear of weight change
  • Identify personal emotional triggers
  • Hypervigilance around bodily sensations
  • panic when routines are disrupted
  • increased physiological arousal due to malnutrition
  • heightened anxiety about the impact of food on the body or on physical health
  • social anxiety linked to eating with others or body image beliefs

Physical symptoms of starvation, stress, and disrupted hormones also contribute to higher baseline anxiety, making individuals feel constantly “on edge”. This two-way relationship, anxiety maintaining the eating disorder, and the eating disorder maintaining anxiety, is one of the most important clinical patterns we see.

How We Support you

Recognising Anxiety in the Context of an Eating Disorder

Anxiety commonly shows up in patterns closely tied to eating disorder behaviours. You may notice:
  • Excessive worry about food, weight, or shape
  • Feeling on edge before, during, or after eating
  • Needing certainty, rules, or rituals to reduce anxiety
  • Physical symptoms such as racing heart, dizziness, nausea, or sweating
  • Panic symptoms when faced with feared foods or changes to routine
  • Difficulty sleeping due to worry or rumination
  • Avoidance of social eating
  • Intrusive thoughts or fears related to body image
  • Rigid behaviours aimed at preventing a feared outcome
Personalised Care

How We Treat Anxiety Within Eating Disorder Recovery

At The London Centre, we do not treat anxiety as a standalone condition. Instead, we focus on:

  • Identifying the role anxiety plays within the eating disorder
  • Understanding how anxiety symptoms maintain unhelpful behaviours
  • Working on underlying anxious thinking patterns
  • Supporting individuals to tolerate discomfort without relying on eating disorder strategies

Treatment is integrated, evidence-based, and tailored to each individual’s needs. Some of the main therapeutic approaches used in treating co-morbid anxiety disorders are:

  • CBT-E (Cognitive Behavioural Therapy for Eating Disorders)
  • MANTRA therapy
  • Schema Therapy
  • Compassion-Focused Therapy (CFT)
  • Dialectical Behaviour Therapy (DBT)
  • EMDR, where trauma or panic symptoms are present

Anxiety is addressed not in isolation, but as part of a clear treatment formulation that considers the whole person and the maintaining cycle of the eating disorder.

A Place of Specialist Support

When to Seek Support

If anxiety is influencing your relationship with food, your routines, your body image, or your ability to function day to day, specialist support can be helpful. You do not need a formal diagnosis. What matters is how your symptoms are affecting your quality of life.
Help is available, and recovery is possible with the right support.

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Towards Recovery

Understanding the role anxiety plays in your eating disorder can be a powerful turning point in recovery. Our specialist clinicians can help you make sense of your experiences and begin to feel more in control.

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FAQs

FAQs About Anxiety in Eating Disorders

Yes, anxiety is universal, and it is almost always present within eating disorders. However, in some people, anxiety symptoms become clinically significant and need targeted support.

Absolutely. Eating disorder behaviours often emerge as a way to manage overwhelming anxiety, worry, or uncertainty.

Yes. Physical, emotional, and cognitive changes caused by the eating disorder often heighten anxiety and increase sensitivity to internal cues.

 No. We treat anxiety only as part of a broader eating disorder formulation, rather than as a standalone condition.

Through integrated psychological approaches that target both the eating disorder and the anxiety that maintains it.

Yes. Anxiety can suppress appetite, heighten nausea, or make interoceptive cues difficult to interpret, which can complicate eating disorder recovery.