Make Room for Growth

Confidence doesn’t always arrive with a bold entrance. Sometimes, it builds quietly, step by step, as we show up for ourselves day after day. It grows when we choose to try, even when we’re unsure of the outcome. Every time you take action despite self-doubt, you reinforce the belief that you’re capable. Confidence isn’t about having all the answers — it’s about trusting that you can figure it out along the way.

The key to making things happen isn’t waiting for the perfect moment; it’s starting with what you have, where you are. Big goals can feel overwhelming when viewed all at once, but momentum builds through small, consistent action. Whether you’re working toward a personal milestone or a professional dream, progress comes from showing up — not perfectly, but persistently. Action creates clarity, and over time, those steps forward add up to something real.

You don’t need to be fearless to reach your goals, you just need to be willing. Willing to try, willing to learn, and willing to believe that you’re capable of more than you know. The road may not always be smooth, but growth rarely is. What matters most is that you keep going, keep learning, and keep believing in the version of yourself you’re becoming.

Eating Disorders and OCD: When Treatment Needs to Address Both

Eating disorders and obsessive-compulsive disorder (OCD) can sometimes look remarkably similar.

Both can involve rigid rules, repetitive behaviors, intrusive thoughts, avoidance, checking, reassurance seeking, and a powerful feeling that something is wrong unless a particular behavior is completed.

For someone experiencing both an eating disorder and OCD, it can become difficult to tell where one ends and the other begins.

And sometimes, treatment needs to address both.

Why Do Eating Disorders and OCD Seem So Similar?

Imagine someone who needs to check a food label repeatedly before eating. They may feel intense anxiety if they cannot check it or may avoid the food entirely when they aren't certain what's in it.

From the outside, this looks like one behavior.

But what's driving it?

Someone with an eating disorder might be checking because they're afraid of calories, weight gain, or losing control over what they eat.

Someone with OCD might be checking because they're afraid the food is contaminated or contains an ingredient they believe could cause harm.

And for some people, both processes may be happening at the same time.

Understanding the reason behind a behavior can be just as important as identifying the behavior itself.

When Food Rules Become Rituals

Eating disorders often create rules.

You may need to eat at particular times, use specific utensils, prepare food in exactly the same way, eat foods in a certain order, repeatedly check labels, or follow increasingly complicated rules about ingredients and portions.

Some of these rules may be directly related to weight, shape, or eating disorder fears.

Others may feel more like compulsions, a behavior you feel driven to perform to reduce anxiety or achieve a feeling that something is finally “right.”

You might even recognize that the rule doesn't make logical sense and still feel unable to break it.

That's one of the reasons treating co-occurring OCD and eating disorders can become complicated.

Not Every Food Fear Is About Weight

Once someone has an eating disorder diagnosis, there can be a tendency to assume that every food-related behavior is part of the eating disorder.

But people avoid food for many reasons.

Someone may fear contamination or food poisoning. Another person may have an intense fear of vomiting. Someone else may experience intrusive thoughts about accidentally harming themselves or another person through food.

Sensory experiences can also affect eating, as can conditions such as ARFID.

At the same time, not every rigid food behavior is OCD. Eating disorders themselves can produce significant rigidity, anxiety, and ritualized behavior.

This is why good assessment involves more than asking what someone does.

We also need to understand what they believe will happen if they don't do it.

What About Intrusive Thoughts?

OCD is characterized in part by obsessions, recurrent, unwanted thoughts, images, or urges that can cause significant distress.

Compulsions are behaviors or mental acts someone feels driven to perform, often in an attempt to reduce that distress or prevent something feared from happening.

Eating disorders can also involve persistent, distressing thoughts.

Thoughts about food, weight, shape, exercise, calories, health, or eating may occupy enormous amounts of someone's day.

This can make it difficult for people to determine whether they're experiencing an eating disorder thought, an OCD obsession, or both.

The label matters less than understanding the pattern well enough to determine what kind of intervention is likely to help.

Reassurance Can Become Part of the Cycle

Reassurance seeking is another area where eating disorders and OCD can overlap.

You might repeatedly ask:

Was that too much food?

Are you sure this is safe to eat?

Did I exercise enough?

Do I look different?

Are you sure I didn't eat something that will make me sick?

Receiving reassurance may temporarily reduce anxiety.

But the relief often doesn't last.

Soon, the uncertainty returns and another reassurance is needed.

Over time, treatment may involve learning how to tolerate some of that uncertainty rather than continually trying to eliminate it.

Why Treating Only One Condition May Not Be Enough

Treatment becomes more challenging when interventions that make sense for one condition accidentally reinforce another problem.

Eating disorder treatment often involves creating enough structure and consistency around nutrition to support recovery.

OCD treatment, meanwhile, frequently focuses on reducing compulsive behaviors and increasing someone's ability to tolerate uncertainty.

For someone experiencing both, treatment may need to distinguish between helpful structure and rigidity that has become part of a compulsive cycle.

For example, following an appropriate nutrition plan may support eating disorder recovery.

Checking that plan repeatedly, needing absolute certainty that it has been followed perfectly, or becoming unable to tolerate a small deviation may be maintaining anxiety rather than reducing it.

The goal isn't to eliminate all structure.

It's to help someone develop greater flexibility within their life.

Both Conditions Can Make Your World Smaller

One of the most painful similarities between eating disorders and OCD is how gradually they can restrict someone's life.

At first, there may be a few rules.

Then certain foods become impossible.

Restaurants become stressful.

Travel becomes complicated.

Spontaneous plans feel overwhelming.

Social events require extensive preparation—or are avoided entirely.

Relationships can begin revolving around reassurance, food, exercise, rituals, or attempts to prevent anxiety.

Eventually, someone may realize that a tremendous amount of their life is organized around trying not to feel uncertain or afraid.

Treatment isn't simply about getting rid of a particular thought.

It's about helping someone reclaim parts of life that anxiety, rituals, and eating disorder behaviors have gradually taken over.

What Does Treatment Look Like When You Have Both?

There isn't one treatment plan that works for every person with an eating disorder and OCD.

Treatment may involve collaboration among an eating disorder therapist, registered dietitian, medical provider, psychiatrist, or other specialists depending on the individual's needs.

It may also incorporate evidence-based approaches used for OCD alongside specialized eating disorder treatment.

Most importantly, treatment should account for the whole clinical picture rather than forcing every symptom into a single diagnosis.

Sometimes the most useful question isn't:

“Is this my OCD or my eating disorder?”

Instead, we can ask:

“What is this behavior doing for me, what keeps it going, and how much of my life is it controlling?”

Those questions can provide a much more useful place to begin.

Specialized Eating Disorder Treatment in Westport, Connecticut

Dr. Joy Zelikovsky provides individualized outpatient eating disorder treatment at Shoreline Eating Disorder Center in Westport, Connecticut, including treatment for individuals experiencing eating disorders alongside OCD, anxiety, trauma, and other co-occurring concerns.

Treatment is designed around the individual rather than assuming every eating disorder—or every person's relationship with recovery—looks the same.

In-person treatment is available in Westport, with telehealth available for appropriate clients throughout Connecticut.

A complimentary 15-minute consultation is available to discuss your needs and whether working together may be a good fit.

This article is for educational purposes and is not intended to diagnose OCD or an eating disorder or replace individualized medical or mental health care.

I've Been in Eating Disorder Treatment Before. Why Am I Still Struggling?

Finishing eating disorder treatment, or spending months or years in therapy, doesn't always mean that the eating disorder disappears.

You may be eating more consistently but still thinking about food constantly. You may understand your eating disorder intellectually but find yourself returning to familiar behaviors when life becomes overwhelming. Perhaps you've completed residential, PHP, or IOP treatment and made significant progress, only to find that maintaining those changes outside of treatment is much harder than expected.

Sometimes people reach a particularly frustrating point: “I know what I'm supposed to do. So why am I still struggling?”

That experience doesn't necessarily mean that treatment failed. It may mean that the next phase of treatment needs to look different.

Eating Disorder Recovery Isn't Always Linear

Eating disorders are complicated conditions. Although nutrition and behavioral stabilization are essential components of treatment, an eating disorder rarely exists completely independently from the rest of someone's life.

Anxiety, obsessive-compulsive symptoms, trauma, perfectionism, ADHD, depression, relationships, identity, sensory experiences, and major life transitions can all interact with eating disorder symptoms.

As treatment progresses, the question sometimes shifts from:

“How do we interrupt the eating disorder?”

to:

“What continues to make the eating disorder necessary, useful, or difficult to give up?”

Those can require different therapeutic conversations.

You May Have Outgrown the Treatment You Previously Needed

Different phases of recovery may require different kinds of support.

Earlier treatment may appropriately focus heavily on medical stabilization, nutritional rehabilitation, reducing dangerous behaviors, establishing regular eating, or preventing hospitalization.

Later, someone may need more individualized work around the factors that continue to maintain their eating disorder.

For example, a person may no longer meet criteria for a higher level of care but still experience significant distress around food, exercise, weight, body image, relationships, or uncertainty.

The absence of an acute crisis doesn't necessarily mean someone is fully recovered.

Knowing What to Do Isn't the Same as Being Able to Do It

People with longstanding eating disorders often know an extraordinary amount about eating disorder treatment.

You may already know what a meal plan looks like. You may recognize your eating disorder thoughts. You may understand your triggers. You may even be able to identify exactly what your therapist or dietitian would tell you to do.

And still struggle to do it.

That isn't necessarily a knowledge problem.

Therapy may need to explore what happens between knowing and doing.

What does the eating disorder protect you from? What feels frightening about changing? What happens when you experience uncertainty or loss of control? What other coping strategies are available—and do they actually work for you?

These questions often require more than repeating information you already understand.

Ambivalence Is Part of the Conversation

Not everyone entering eating disorder treatment feels completely ready to recover.

Sometimes people desperately want their life to change while simultaneously feeling terrified of giving up the eating disorder.

Both can be true.

Rather than pretending that ambivalence doesn't exist, effective therapy can make room to understand it.

For some individuals, particularly those with longstanding or complex eating disorders, treatment may involve collaborative conversations about motivation, autonomy, risk, quality of life, and harm reduction while continuing to monitor safety.

You May Need More Specialized Care

If you've been in therapy but continue to struggle significantly with eating disorder symptoms, it may be worth considering whether your current treatment matches the complexity of what you're experiencing.

Eating disorders can overlap with OCD, anxiety, trauma, ADHD, mood disorders, neurodivergence, medical conditions, and other concerns. Treatment may need to account for those interactions rather than treating each issue as though it exists separately.

It can also be important to reassess whether outpatient therapy remains the appropriate level of care. Sometimes continued difficulty is a sign that additional structure or medical and nutritional support is needed.

Struggling Again Doesn't Erase Your Progress

Returning symptoms don't mean you're back at the beginning.

Recovery often involves learning what happens when treatment meets real life: relationships, work, school, travel, stress, grief, changing bodies, illness, independence, and uncertainty.

Sometimes the next stage isn't about starting over.

It's about understanding what still isn't working and developing a treatment approach that fits where you are now.

Specialized Eating Disorder Treatment in Westport, Connecticut

Dr. Joy Zelikovsky provides specialized outpatient eating disorder treatment at Shoreline Eating Disorder Center in Westport, Connecticut, as well as telehealth for appropriate clients.

Treatment is individualized and may be particularly helpful for individuals with complex or longstanding eating disorders, co-occurring concerns, previous treatment experiences, or ambivalence about recovery.

A complimentary 15-minute consultation is available to discuss whether treatment may be a good fit.

This article is for educational purposes and is not a substitute for individualized medical, nutritional, or mental health care.

Eating Disorders in Larger Bodies: Why Serious Symptoms Are Often Missed

One of the most persistent myths about eating disorders is that you can tell whether someone has one simply by looking at their body.

You can't.

Eating disorders occur across the weight spectrum. People in larger bodies can experience significant restriction, binge eating, purging, compulsive exercise, nutritional deficiencies, and serious medical complications. Yet their symptoms are often recognized later—or overlooked entirely.

In some cases, the very behaviors that would cause concern in a thinner person are praised when they occur in someone living in a larger body.

An Eating Disorder Doesn't Have a “Look”

Popular images of eating disorders have historically focused on extremely thin individuals, particularly young white women with anorexia nervosa.

That stereotype leaves many people wondering whether their own experience is serious enough to count.

A person may be restricting significantly, losing weight rapidly, experiencing intense fear surrounding food or weight, or becoming increasingly rigid about eating and exercise without ever appearing stereotypically underweight.

One example is atypical anorexia nervosa. Individuals with atypical anorexia can experience the restrictive behaviors, fear of weight gain, and significant psychological distress associated with anorexia while not meeting the low-weight criterion for anorexia nervosa.

The word atypical can unfortunately make the disorder sound unusual or less severe.

Neither assumption is necessarily true.

Weight Loss Can Hide an Eating Disorder in Plain Sight

Imagine two people begin skipping meals, dramatically restricting what they eat, exercising despite exhaustion, and becoming increasingly preoccupied with food.

One loses weight from an already smaller body.

The other loses weight from a larger body.

The first person may quickly receive expressions of concern.

The second may receive compliments.

Friends may ask what they're doing. Healthcare professionals may congratulate them. They may be told to “keep it up.”

Nobody asks what it is costing them.

That difference matters because social reinforcement can make it much harder for someone to recognize that their relationship with food has become dangerous or distressing.

Medical Risk Isn't Determined by Appearance

Eating disorders affect much more than someone's weight.

Restriction, purging, dehydration, binge eating, and other eating disorder behaviors can affect cardiovascular functioning, electrolytes, gastrointestinal functioning, hormones, cognition, energy, bone health, and other body systems.

Someone's appearance cannot tell us whether they are medically stable.

That is why appropriate eating disorder care often involves collaboration among therapists, physicians, registered dietitians, psychiatrists, and other professionals.

Weight Bias Can Follow People Into Healthcare

People in larger bodies sometimes encounter a particularly confusing situation in treatment.

One provider recognizes an eating disorder and encourages adequate nourishment and reduced eating disorder behaviors.

Another focuses primarily on weight loss.

The patient is left trying to reconcile two seemingly incompatible messages.

For someone already struggling with food, weight, and body image, this can reinforce eating disorder thoughts and make trusting treatment more difficult.

A weight-inclusive approach does not mean ignoring health.

It means evaluating health comprehensively rather than assuming body size alone tells us what someone should eat, how healthy they are, or whether an eating disorder is serious.

“I'm Not Sick Enough”

Many people with eating disorders struggle with the belief that they aren't sick enough to deserve help.

For people living in larger bodies, that belief can be especially powerful.

You may compare yourself to people you met in treatment, images you've seen online, or cultural stereotypes of eating disorders and conclude that your symptoms aren't severe enough.

You may even have had eating disorder behaviors praised as “healthy.”

But eating disorders are not competitions.

You do not have to reach a particular weight, appearance, or level of medical crisis before your relationship with food deserves attention.

Treatment Should See the Whole Person

Effective eating disorder treatment considers much more than a number on a scale.

It looks at eating behaviors, thoughts, emotions, medical functioning, nutritional status, relationships, culture, identity, quality of life, and the function an eating disorder may serve.

For many people in larger bodies, treatment may also involve addressing years of weight stigma—including experiences within healthcare—that have influenced how they understand their bodies and whether they believe they deserve care.

Your body does not have to look a certain way for an eating disorder to be real.

And you do not have to wait until someone else decides you look sick enough to ask for help.

Weight-Inclusive Eating Disorder Treatment in Westport, Connecticut

Dr. Joy Zelikovsky provides specialized, weight-inclusive eating disorder treatment at Shoreline Eating Disorder Center in Westport, Connecticut.

Treatment is available for adolescents and adults with eating disorders and disordered eating, including individuals whose symptoms have previously been overlooked or minimized because of their body size.

In-person and telehealth treatment are available for appropriate clients. A complimentary 15-minute consultation is available to discuss your needs and whether treatment may be a good fit.

This article is for educational purposes and does not provide medical advice or determine medical stability. Eating disorders can cause serious medical complications, and individuals experiencing concerning symptoms should seek appropriate medical evaluation.