How Exposure Response Prevention Can Help Overcome Anxiety in Eating Disorder Recovery

For the many individuals who suffer from an eating disorder, including anorexia, bulimia, or binge eating disorder, anxiety is often an underlying issue. Anxiety, in its many different forms, can co-occur with eating disorder behaviors, often exacerbating the problematic symptoms that result from these mental illnesses. Because anxiety and eating disorders are so closely intertwined, treatment must address the anxiety component for optimal healing and long-term recovery.

Understanding the Connection between Anxiety and Eating Disorders

In many cases, anxiety can be a contributing factor to the development of an eating disorder. For example, a woman who may be suffering from an anxiety disorder, such as social anxiety, may use the manipulation or control of food as a coping mechanism. This can look like restricting overall intake, over-exercising, or binging and purging. In other cases, an eating disorder and its associated behaviors can contribute to anxiety, such as a person who is fearful of eating certain foods or gaining weight.

Ultimately, it is important to recognize how anxiety and eating disorders often go hand-in-hand. One study found that 94% of individuals who were hospitalized for an eating disorder also met the criteria for a co-occurring mood disorder, including anxiety disorders [1]. Anxiety disorders are among the most common and pervasive mental disorders in the United States, affecting over 40 million adults across the country [2]. Some of the anxiety disorders that may present alongside eating disorders can include:

  • Generalized Anxiety Disorder
  • Panic Disorder
  • Phobia-related disorders
  • Social Anxiety Disorder
  • Separation Anxiety Disorder

Because eating disorders are complex psychiatric illnesses influenced by a multitude of factors, it is important to be assessed for other mental health conditions that may be present, including anxiety disorders. Identifying a co-occurring mental health issue, like an anxiety disorder, is necessary for comprehensive treatment.

Anxiety can be a contributing factor to the development of an eating disorder.

Using Exposure Response Prevention for Anxiety Treatment

Eating disorder treatment should include a holistic approach to recovery to help address the many areas in which a person has been affected. At The Meadows Ranch, we recognize the impact of anxiety on eating disorder recovery and the necessity for treatment approaches that help a woman heal, not only from the eating disorder but from the underlying anxiety that may also be contributing to her mental health.

As a treatment program, The Meadows Ranch prioritizes evidenced-based practices for healing and recovery from an eating disorder and co-occurring anxiety. One of the innovative treatment approaches utilized in The Meadows Ranch Model of Care includes Exposure Response Prevention therapy or ERP. This form of therapy is designed to systematically desensitize a person to their fears through repeated exposure in a safe and nurturing environment. For a woman recovering from anorexia who fears eating, this might include gradual exposure to food in different forms that help lessen that anxiety and build more confidence around eating.

According to Mike Gurr, Executive Director of The Meadows Ranch, ERP can be a powerful therapy tool for helping patients who have a fear of and/or a poor relationship with food. In describing this further, Mr. Gurr notes, “One way to help with that is to introduce them and give them experiences with food a little at a time. Exposure response actually starts to rewire the brain and make new connections that create a new belief and meaning for the patients and food as they have created one that invokes fear and withdrawal from food.”

Executive Director of The Meadows Ranch, Mike Gurr, joins host David Condos to discuss the life-and-death situations facing women with eating disorders and how his team helps patients and their families build a sustainable, healthy relationship with food.

In the context of eating disorder treatment, ERP can be effective for renegotiating a woman’s experience with food in a neutral setting. Some of the benefits of ERP for anxiety in eating disorder treatment include:

  • Opportunities to experience something new with the support of staff and peers
  • The reiteration that once was previously scary with food and body no longer has to be so
  • Practices with food challenges in a safe setting that build tolerance and confidence with eating in recovery
  • A foundation for creating a different and positive belief system and relationship with food

Because anxiety can make basic tasks like eating or grocery shopping feel nearly impossible, ERP can be an essential tool for learning how to navigate these experiences. According to Mr. Gurr, “Because it creates a different relationship and a different belief system the patient has with food. If we can help change that, it changes a habit; if we change a habit, we change a life.”

Finding Help and Treatment for Co-Occurring Anxiety and Eating Disorders

At The Meadows Ranch, the goal of our program is to disempower the eating disorder by uncovering the complex psychological factors contributing to the patient’s unhealthy relationship with food. For many women, this means giving them the tools, guidance, and support needed to heal from underlying anxiety.

ERP is one form of structured experiential therapy activities utilized at The Meadows Ranch, where women are provided opportunities to experience successes and overcome challenges while recovering from an eating disorder. This may involve exposure to food in a multitude of appropriate ways, gradually within safe settings, such as:

  • Meal preparations in the kitchen
  • Grocery shopping and handling food
  • Cooking and cleaning after meal prep
  • Restaurant outings
  • Clothes shopping and more

At The Meadows Ranch, this is integrated at all different levels of care, including residential treatment (RTC) and partial hospitalization (PHP). As noted by Mr. Gurr, “We want our patients exposed to it as they will be in the real world.”

If you have been struggling with an eating disorder and anxiety, know that you can rewrite a different ending to your story. Connect with our caring and compassionate team today so we can guide you toward lasting recovery and healing. For additional information about The Meadows Ranch approach to the treatment of eating disorders, please call to speak to an Intake Coordinator at 866-329-7713.


[1]: National Eating Disorder Association, “Anxiety, Depression, and Obsessive Compulsive Disorder” Accessed 16 November 2018

[2]: Anxiety and Depression Association of America, “Facts and Statistics”