Does anorexia cause mood swings?

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Anorexia nervosa (AN) is a serious eating disorder that involves caloric restriction and a fixation on body weight and physical appearance. Individuals with anorexia nervosa have an intense fear of gaining weight, even when they are underweight. (1) These symptoms can interfere with physical and emotional wellbeing, and make it difficult to function in daily life. But, does anorexia cause mood swings? Well, one way that AN can affect functioning is by causing or contributing to mood fluctuation.

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The occurrence of anorexia and mood swings

People talk about individuals who have experience with anorexia mood swings, and researchers have explored this topic further to determine if this is a coincidence, or actually a real complication of AN. One recent study in the International Journal of Mental Health Nursing found that patients with anorexia nervosa experience mood swings related to their weight. More specifically, healthcare providers report that a patient’s mood is dictated by their weight on the scale. Furthermore, people with AN may experience mood swings when they make changes to their diet or gain weight. (2)

Individuals with anorexia nervosa may have intense mood swings if the number on the scale is more than they would like, or if they are in a situation in which they are forced to change their eating behaviors. These mood swings can occur because of the extreme fear of weight gain and preoccupation with the calorie content of food. 

In addition, in some cases, the cycle of AN is linked to mood swings. Individuals with AN severely restrict calories, but sometimes, they may have episodes of binging. For example, individuals with the binge/purge subtype of anorexia do restrict calories, but they also have episodes of binging, followed by compensating for the binge with purging behaviors. (3)

Unfortunately, this binge/purge cycle can take its toll on mood. A recent study with patients with eating disorders found that several of them experienced mood swings. During these mood swings, they were likely to feel more anxious, depressed, or stressed, if they engaged in binging behaviors. (4)

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Factors contributing to mood swings

Beyond mood swings associated with food, dieting, and eating disorder symptoms, individuals living with anorexia may be predisposed to experience mood swings. For instance, studies have found that people with anorexia tend to have difficulty regulating their emotions. This means that changes in mood can feel and appear rather intense. For some people, behaviors linked to anorexia, including severe caloric restriction, may be an unhealthy coping mechanism for managing mood swings. (5)

A large amount of research has shown that individuals with eating disorders, including anorexia, have a difficult time managing emotions. Given this fact, mood swings in individuals with AN may occur simply because individuals with mood swings are more prone to develop eating disorders. While distress over eating disorder symptoms and weight can certainly contribute to mood swings, it may simply be that people who are more likely to experience mood swings are also more likely to develop anorexia. (6)

So, does anorexia nervosa lead to mood swings?

Each person is different, but there is evidence to support the existence of mood swings specifically associated with anorexia nervosa. Sometimes, mood swings occur because a person is reacting to distress from body weight, dieting, or the cycle of binging and purging that can occur with anorexia. In other instances, individuals experience anorexia mood swings simply because having an eating disorder makes a person more prone to mood disorders, especially if their body is not being properly nourished. 

If you’re experiencing an eating disorder and struggle with mood swings, getting treatment can benefit you. With the help of a treatment program, you can learn the tools for coping with stress without turning to eating disorder behaviors, while healing your body in the process.

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Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. National Eating Disorders Association. (2022). Anorexia nervosa. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
  2. Wu, W., & Chen, S. (2021). Nurses’ perceptions on and experiences in conflict situations when caring for adolescents with anorexia nervosa: A qualitative study. Journal of Mental Health Nursing, 30, 1386-1394. https://doi.org/10.1111/inm.12886
  3. Substance Abuse and Mental Health Services Administration. (2016, June). DSM-IV to DSM-5 anorexia nervosa comparison. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t15/
  4. Leonidas, C., & dos Santos, M. (2017). Emotional meanings assigned to eating disorders: Narratives of women with anorexia and bulimia nervosa. Universitas Psychologica, 16(4). https://doi.org/10.11144/javeriana.upsy16-4.emae 
  5. Herpertz-Dahlmann, B., Dempfle, A., Konrad, K., Klasen, F., Ravens-Sieberer, U. (2015). Eating disorder symptoms do not just disappear: The implications of adolescent eating-disordered behavior for body weight and mental health in young adulthood European Child & Adolescent Psychiatry, 24, 675-684. https://doi.org/10.1007/s00787-014-0610-3
  6. Puttevils, L., Vanderhasselt, M., Horczak, P., Vervaet, M. (2021). Differences in the use of emotion regulation strategies between anorexia and bulimia nervosa: A systematic review and meta-analysis. Comprehensive Psychiatry, 109. https://doi.org/10.1016/j.comppsych.2021.152262

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