The Hidden Link Between Anxiety, Perfectionism, Control, and Eating Disorders
Anxiety, Perfectionism, and Control – The Hidden Link Between Anxiety, Perfectionism, Control, and Eating Disorders.
Eating disorders are complex mental health conditions. While they often involve food, weight, or eating behaviors on the surface, the real struggles lie deeper.
Beneath patterns like restricting, binging, purging, or avoiding food altogether are emotional forces that can feel overwhelming: anxiety, perfectionism, and the need for control.
Many people with eating disorders aren’t trying to “look” a certain way (although it can appear that way to them on the surface) — they’re trying to feel a certain way: safe, in control, less anxious, or good enough. Whether someone is avoiding food out of fear, binging for comfort, or striving for rigid food rules, these behaviors often serve a deeper purpose.
Let’s explore how anxiety, perfectionism, and control show up across various eating disorder diagnoses—and why true healing depends on addressing what’s happening beneath the surface.
Anxiety, Perfectionism, and Control: Root Issues in Eating Disorders
Anxiety is often the emotional engine behind disordered eating. It might show up as fear of the unknown, fear of being overwhelmed, fear of failure, or even fear of physical sensations like fullness, nausea or even hunger.
Perfectionism creates constant pressure—telling you that you should be doing better, eating “perfectly,” performing flawlessly, or meeting unrealistic standards in every area of life. This internal pressure can contribute to feelings of shame and self-criticism.
Control becomes a coping strategy. When life feels unpredictable or unmanageable, controlling food, eating habits, or routines can create a sense of stability. Over time, this need for control can become rigid and emotionally exhausting.
How These Traits Show Up Across Different Eating Disorders
Anorexia Nervosa
In Anorexia, anxiety and perfectionism are often deeply ingrained. Many individuals describe feeling safest when everything is tightly controlled—from food intake to daily routines. The drive isn’t always about being thin—it can be about managing overwhelming emotions or proving self-worth through self-discipline and restraint. Learn more about the warning signs of Anorexia here.
Bulimia Nervosa
With Bulimia, there’s often a tension between high expectations and emotional overwhelm. People may feel pressure to appear in control externally while secretly struggling with intense emotions or inner chaos. The binge-purge cycle may serve as a release valve for stress, shame, or unmet perfectionistic standards. Learn more about the warning signs of Bulimia here.
Binge Eating Disorder
With Binge Eating Disorder, perfectionism and anxiety can be just as present here—often in the form of chronic self-criticism, internalized shame, or the belief that one is "failing" at managing emotions or food. Binge eating can become a way to cope with emotional pain, numb discomfort, or feel temporarily soothed in a world that feels demanding and overwhelming. Learn more about the warning signs of Binge Eating Disorder here.
ARFID (Avoidant/Restrictive Food Intake Disorder)
ARFID is less about body image and more about anxiety and control. People with ARFID may avoid food due to sensory sensitivity, fear of choking or vomiting, or past traumatic experiences with food. Control shows up as extreme caution, food rituals, or avoidance behaviors that create a sense of safety, even if it limits life and health. Learn more about ARFID here.
Why Addressing Root Issues Is Key to Recovery
Eating disorder behaviors may help people feel safer in the moment—but they reinforce the belief that you can’t trust yourself or cope in other ways. Sustainable recovery requires going deeper:
Building tools to tolerate uncertainty and manage anxiety
Challenging rigid thinking and perfectionistic expectations
Learning to trust your body, your emotions, and your ability to navigate discomfort
It’s not about giving up control—it’s about finding new ways to feel empowered, supported, and capable.
Final Thoughts
Eating disorders aren’t just about food. They’re about how we relate to ourselves, our emotions, and the world around us. Whether you’re dealing with restriction, binging, purging, or food avoidance, know that you are not alone—and you don’t have to keep managing this on your own.
Healing means understanding the deeper emotional patterns driving the behavior—and slowly building something safer in their place.
Looking for Support?
If you're struggling with anxiety, perfectionism or the need for control, I offer virtual therapy throughout Long Island, New York and Florida.
I work with individuals working through eating disorders (including Anorexia, Bulimia, Binge Eating Disorder, ARFID & Orthorexia), body image concerns, and trauma—as well as for family members or partners who want to better understand and support someone they care about.
If you’re ready to begin the healing process, I invite you to schedule a free consultation call. Let’s take that first step together.
Coming Soon: Feelings of Identity Loss in Recovery
Recovery isn’t just about changing behaviors—it’s about rewriting your story. In our next post, we’ll explore how eating disorders can become intertwined with identity, making the thought of recovery feel like losing a part of yourself. We’ll talk about why this happens, what it means, and how to rebuild a sense of self beyond the eating disorder. Stay tuned.
*Disclaimer* - I am not a medical doctor and this post does not constitute as medical advice. This post is derived from my experience working with clients, research and collaborating with medical professionals.