The Ongoing Journey of Recovery: Anxiety, BDD, and OCD

A while back, I wrote a blog describing my experience with my eating disorder and anxiety. My anxiety preceded my eating disorder, led to its development, and maintained the disorder. Even after recovering from severe depression, alcoholism, and an eating disorder, I am still left with troubling anxiety. It just goes to show that there is no endpoint with recovery. No finish line to cross, making you magically done with the recovery work. You are ever-evolving, and there is always more work to do.

After I weight restored and recovered from my eating disorder, body image issues persisted. I continued to feel extremely uncomfortable in my body, was still distorted with what I saw in the mirror, and while I accepted that my body had to be at this new weight to recover and would never alter behaviors to change that weight, the nagging desire to lose weight persisted. I wasn’t engaging in eating disorder behaviors anymore, but I wasn’t free either.

Recognizing Body Dysmorphic Disorder (BDD)

About a year ago, I started seeing a therapist for body dysmorphic disorder (BDD). BDD is often not diagnosed or is written off as general body image issues tied to an eating disorder. A good rule of thumb is to weight restore and make progress in eating disorder recovery—and see if the body image issues persist.

For me, that’s exactly what happened. My BDD shows up as extreme discomfort in my body, a preoccupation with my stomach, and a variety of worries and compulsions focused on my body. While I no longer engaged in eating disorder behaviors, my brain was still caught in an obsessive cycle about my body. Ultimately, at its core, BDD is an anxiety disorder. And like many anxiety disorders, it responds best to exposure and response prevention (ERP) work.

Early in our work together, my therapist and I did a variety of exposures to challenge my core beliefs about myself. I went out in public without wearing makeup. I wore shorts and clothing that exposed more skin. We combined these exercises with social anxiety exposures, focusing on my body in social situations. For example, I asked a salesperson at Target if she thought a particular pair of pants would fit me and what size she thought I would need. She actually guessed my exact size, an exposure in itself.

I am pleased to say that this work was successful. I can do all those things now without overthinking them. That said, the discomfort in my body persists. So does the desire for weight loss. My therapist fully believes I can get to a place where I not only accept my body but even like it. I anxiously await that day.

The Unseen OCD: Unraveling Decades of Compulsions

As we dug deeper into my anxiety and compulsive thought patterns, my therapist started to notice something else. Some of my thoughts weren’t just anxious—they were obsessive. I often get stuck in repetitive worries, replaying them in my mind over and over.

For example, if I make a mistake at work or receive negative feedback, my brain catastrophizes immediately. I spiral into a scenario where I lose my job, have to move home with my parents, and ultimately relapse. Even though I logically know this is irrational, the fear still grips me, and this fear has persisted for years.

Health anxiety is another frequent worry. I stress over lab results, fearing my health will deteriorate. I worry what my future holds if my health does not improve. Luckily with adequate nutrition and maintaining a healthy weight, it has. Even knowing that, every time I get labs done I worry things will worsen again.

Then there are the compulsions—the small, seemingly harmless actions that reveal deeper patterns of obsessive thinking. I’ve often had to turn around and drive home just to check if my hair straightener was unplugged. I worry fires will start in my apartment. I go over conversations in my head for hours, analyzing every word for something I may have said wrong.

It all started to make sense. My eating disorder and BDD therapists now believe I’ve had undiagnosed and untreated OCD for over twenty years. And looking back, it’s painfully obvious.

I mean, no one practices for eight hours a day or plays the same measure over and over for an hour at a time without some compulsive drive at play. My perfectionism wasn’t just high standards—it was obsessive. The need to repeat, fix, and control was always there, just hidden under the guise of "working hard" or "being responsible."

Learning to Live with It

Coming to terms with my OCD diagnosis has been both validating and overwhelming. On one hand, it explains so much. On the other, it means yet another layer of work to do. I have come so far and yet I have another piece of myself to unravel and heal.

But if recovery has taught me anything, it’s that healing is never linear. It’s not about erasing the past or “fixing” myself—because I was never broken to begin with (a belief I once felt after the music loss and have had to challenge it repeated to finally believe it). It’s about learning to live with my brain, learning to manage the thoughts and urges without letting them control me.

So, here I am, still in the thick of it. Still doing the work. Still showing up for myself every day. And maybe that’s what recovery really is—not a finish line to cross, but a daily commitment to keep going.

And that, I can do.

Coping Strategies for Anxiety, BDD, and OCD in Recovery

While recovery is an ongoing process, there are specific tools and techniques that can make navigating anxiety, BDD, and OCD more manageable. These strategies have helped me and many others—perhaps they can help you, too.

1. Exposure and Response Prevention (ERP)

Gradually expose yourself to feared situations while resisting compulsions.

• For body image, wear clothing that makes you uncomfortable and sit with the feeling instead of changing.

• For OCD, practice resisting checking behaviors. If you typically check if your straightener is unplugged, leave home without double-checking and remind yourself, “I trust myself to have turned it off.”

2. Practicing Mindfulness and Acceptance

• Thought Defusion: Instead of trying to fight intrusive thoughts, acknowledge them without engaging. Tell yourself, “This is just a thought, not a fact.” For example, say,  “I am having that body image thought again.”

• Body Neutrality: If body positivity feels unreachable, try body neutrality—remind yourself that your body is a vessel that carries you through life, regardless of how it looks. Appreciate it for what it can do for you.

• Grounding Techniques: Engage in the 5-4-3-2-1 technique (naming five things you see, four you feel, three you hear, two you smell, and one you taste) when spiraling. Boxed breathing is also helpful for grounding.

3. Reframing Perfectionism

• Challenge all-or-nothing thinking. Instead of “I have to do this perfectly or I’ve failed,” reframe it as “Done is better than perfect.”

• Remind yourself that growth happens in imperfection—true learning and progress come from showing up consistently, not perfectly.

4. Self-Compassion Over Self-Criticism

• Anxiety, BDD, and OCD thrive on self-judgment. Speak to yourself like you would a close friend.

• Instead of “I shouldn’t be feeling this way,” try “It’s okay that I’m struggling—I’m working through it.”

Implementing these techniques can be challenging, especially when navigating deep-rooted patterns of anxiety, OCD, or body image distress. Working with a licensed professional or trained coach can provide the structure, accountability, and support needed to make real progress. A therapist or coach can tailor these strategies to your specific situation, ensuring that you use them effectively and compassionately.

If You’re Struggling, Help is Available

If any of this resonates with you, you’re not alone. Eating disorders, anxiety, OCD, and body image struggles are incredibly isolating—but recovery is possible, and you don’t have to do it alone.

As a certified eating disorder recovery coach, I work with individuals navigating these exact challenges. Whether you’re struggling with food, body image, compulsive thoughts, or anxiety, support is available.

I offer free consultation calls to see if coaching is the right fit for you. If you’re ready to take the next step in your recovery journey, reach out to me or visit my website https://www.wedorecoveredcoaching.com/ to book a call. You deserve support, and you don’t have to do this alone.