Can Depression Lead to Eating Disorders?

The link between depression and eating disorders is well-documented, though the exact cause depends on factors such as:

• genetics
• environment
• personality traits

Emotional factors can play a role, too, according to the National Alliance on Mental Illness (NAMI).

Alexa Shank, a psychotherapist and certified eating disorder specialist in Houston, explains that when you live with depression, you may:

• feel stuck without coping skills
• have a desire to exert control over something tangible
• seek to improve yourself

These feelings may cause changes in your eating habits. For some, this behavior could pave the way for eating disorders.

A 2018 review shows that anorexia nervosa and depression symptoms frequently occur together.

Depression can often reduce appetite, which may cause you to lose weight. If those around you compliment your body, it could boost your mood and make you want to restrict your food intentionally, says Shank.

“Our diet-obsessed society praises any form of weight loss, so you usually receive positive feedback from others,” she adds. “This may encourage you to want to lose more weight and continue receiving positive feedback.”

For those already living with anorexia, depression symptoms can reinforce your desire to restrict your food intake, says Hannah Guy, a licensed clinical social worker in Philadelphia.

Common symptoms of depression — like a lack of motivation, hopelessness, or apathy — may make recovery feel out of reach, which can exacerbate your anorexia symptoms.

“If your depression shows up in these ways, it may make it extremely difficult to find a reason to recover from your eating disorder. For some, it can really feel like a lose-lose when you are stuck in the middle of depression and an eating disorder,” says Guy.

“However, this doesn’t mean all is hopeless. There is room for healing and growth with the right support,” she adds.

Like other eating disorders, binge-eating disorder (BED) is often a coping mechanism for difficult feelings, including those that may accompany depression.

“There is some pleasure in eating, which can act as a temporary distraction from the emotional pain,” says Timothy Yen, a psychologist in Dublin, California.

For some, binge eating may help to compensate for where your quality of life is lower or you’re feeling deprived, he explains.

“The needs that are unmet for those living with depression can be a wide range of possibilities, from feeling lonely, hopeless, purposeless, and worthless,” he says.

All of these feelings, and others, can understandably lead to a desire to binge eat.

“Binge eating makes sense if you have the feeling of an endless void,” he says. “Eating can be a symbolic way of feeling full and filling that void.”

There may also be a neurological tie-in to BED.

A 2019 study suggests that depression symptoms can reduce executive functioning skills, such as self-control and decision making ability, which can understandably make symptoms of binge-eating disorder more difficult to regulate.

Still, recovery with the right support and treatment plan is possible.

Eating to cope isn’t inherently bad, and everyone does it from time to time, says Shank.

“Just think of how you might crave your favorite mac and cheese when you’re especially tired, or you only want your mom’s chicken noodle soup when you’re sick,” she says.

The challenge is that food, while pleasurable and comforting, serves only as a temporary coping mechanism, she says. “People tend to eat past fullness, never feeling completely satisfied or emotionally taken care of.”

Then, once the temporary comfort wears off, you may be left with feelings of guilt about what you’ve eaten, triggering depression symptoms in a cycle: feeling low, eating, feeling low again.

“Data has shown that those who live with bulimia may have characteristics that could make them inherently more susceptible to struggling with regulating distressing emotions,” she says. “This may then increase your chances of developing depression, thus perpetuating a cycle of depression and bulimia.”

Still, it’s possible to learn healthy coping patterns and break out of this cycle for good.

If your eating habits are negatively impacting your life, you could be living with other specific feeding and eating disorders (OSFED).

This may include:

• atypical anorexia, where you meet the diagnostic criteria for anorexia but your body weight falls in the “normal” range
• bulimia nervosa of low frequency or limited duration
• binge eating disorder of low frequency or limited duration
• purging disorder, where you purge but do not binge eat
• night eating syndrome

“Ultimately, regardless of the specific diagnosis, eating disorders can serve the same functions for coping with depression in OSFED as they do in the more mainstream eating disorders,” says Shank.

When eating disorder symptoms don’t meet the criteria for a specific diagnosis but still cause significant distress, it may be considered an unspecified feeding or eating disorder (UFED).

Symptoms of UFED can commonly be fueled by depression. It can be beneficial for your doctor to note these symptoms early enough to recommend treatment before a diagnosable eating disorder develops.

No matter how you’re feeling right now, no case is too dire. With the right support, you can get through this.

Psychotherapy

You don’t have to go through this alone. You may find it useful to work with a therapist who specializes in depression and eating disorders.

“A professional can help you figure out the source of your symptoms,” says Yen. “Is depression driving the need for more control, which leads to eating disorder behaviors? Or is the eating disorder behavior causing physical manifestations that contribute to feeling depressed? Or both? Figuring out the source will help you figure out the best course of action.”

Medications

Your doctor can help determine whether medication may be right for you.

Antidepressants or anti-anxiety medications might be prescribed to help you manage your depression and eating disorder symptoms in tandem.

A 2017 review shows that fluoxetine (Prozac) may be effective for bulimia. Also, the stimulant lisdexamfetamine (Vyvanse) may help those who live with binge eating disorder. Both are approved by the Food and Drug Administration for treating depression and eating disorders.

Hospitalization

Living with an eating disorder can be taxing on your:

• mental faculties
• emotional well-being
• physical body

If left untreated, eating disorders can be fatal.

If any of these functions are declining, or you’re having thoughts of self-harm, a temporary hospitalization program may be the best fit for you.

Whether you’re doing inpatient treatment (staying at the hospital) or outpatient treatment (visiting the hospital at regular intervals), a trained team can work with you to provide safety, support, and an appropriate treatment plan.

Lean into your support system

Living with an eating disorder and symptoms of depression may feel like an isolating experience, but there are others who can relate, provide support, or both.

“Much of the time, people feel like they are the only one struggling with these things, which is just not true,” explains Guy.

“Unfortunately, this can lead people to isolate themselves from loved ones. One of the most important things in recovering from an eating disorder and depression is to have a strong support system,” she adds.

You may find it helpful to join eating disorder support groups or depression support groups in your area through the National Alliance on Mental Illness (NAMI).

Managing depression and eating disorder symptoms can feel like a journey, but you are not alone and treatment for both conditions is possible.

It’s common for depression and eating disorders to co-occur. Many doctors, therapists, and dietitians are trained in handling these conditions together.

If you are experiencing symptoms of depression and eating disorders, talking with your doctor or therapist could be your gateway to treatment.

Try to be easy with yourself. Healing is possible and available.