This is a topic I’ve wanted to explore in more depth here for a long time.
It’s both clinically important and personally meaningful. I spent most of my life being told I had generalized anxiety disorder, when what I actually had was OCD. And I think the gap between those two things (the years of wrong treatment, of trying to think my way out of something that doesn’t respond to thinking) is a big part of why I eventually developed an eating disorder. The OCD needed somewhere to go, and it found one.
I know I’m not alone in that story. And I know that a lot of people listening to this podcast are carrying something similar — a sense that their relationship with food, with their body, with exercise, and with control is more complicated than it looks from the outside. That maybe it has roots they haven’t fully found yet.
In today’s episode, I’m joined by Dana Colthart, a Licensed Clinical Social Worker based in New Jersey who specializes in OCD, anxiety, and eating disorders. What makes her perspective so valuable is that she holds all of these worlds at once. She understands how they mirror each other, how they can run simultaneously, how healing from one can sometimes cause the other to surface. And she understands the culture we’re all trying to heal inside of—the one that is, in so many ways, still working against us.
This conversation goes deep, because we get into what’s truly driving our fears, our coping strategies, and our struggle to get out of frustrating thought loops. I hope it gives you language for something you’ve been trying to name.
The first part of the episode is free for everyone. To hear the full conversation, upgrade to paid right here.
In this episode:
What OCD actually looks and feels like: because it isn’t hand-washing and organization
The key difference between OCD and generalized anxiety disorder: why misdiagnosis is so common
How the OCD cycle works: the obsession, the compulsion, the temporary relief, and why that relief is the trap
Reassurance-seeking: what it is, why it counts as a compulsion, and how it shows up in relationships with food and body image
Pure-O OCD: when the compulsions are entirely mental, and why this goes undiagnosed so often
Taboo and shameful intrusive thoughts: why the people most disturbed by a thought are almost never the ones who’d act on it
Ego-dystonic versus ego-syntonic: what it means and why that distinction matters in disentangling OCD from eating disorders
How diet culture functions like a mass OCD delivery system: rules, rituals, fear, and relief that never quite arrives
Why clinicians treating eating disorders are often the only voice in a client’s life saying “you don’t have to do this” — and how hard that is
The particular cruelty of food and body-related intrusive thoughts in a world that confirms them everywhere
How OCD and eating disorders mimic each other, overlap, and take turns — and what that seesaw can look like in recovery
What ERP (Exposure and Response Prevention) actually is and why the discomfort is the point
Why your brain watches your actions, not your words (and what that means for recovery)
The systemic piece: how disordered behaviors get praised in some bodies and diagnosed in others
What to do if you’re recognizing yourself in this episode but aren’t ready or able to get support yet
I’d love to hear from you about OCD, anxiety, or other co-occurring conditions alongside disordered eating — in whatever way feels safe for you to share.
I’m a huge believer that sharing our stories reduces stigma, and I’m here to hold space for your experiences. Comments are just for paid subscribers on this one to keep everyone comfortable ❤️
