#221: Is It OCD, Anxiety, or Disordered Eating? The Overlap, the Misdiagnosis, and Why It Matters for Recovery with Dana Colthart, LCSW
Abbie sits down with Dana Colthart, LCSW, a therapist specializing in OCD and eating disorders, to explore one of the most under-diagnosed and misunderstood overlaps in mental health.
From intrusive thoughts to diet culture to why you can’t logic your way into recovery, this conversation explores what's truly driving our fears, our coping strategies, and the compulsions holding us back.
The first part of this episode is free for everyone. Paid subscribers can hear the entire conversation. You can upgrade here: https://abbieattwoodwellness.substack.com/subscribe
In this episode:
Why OCD is so much more than hand-washing and organization — and what it actually looks like
The key difference between OCD and generalized anxiety disorder, and why misdiagnosis is so common
How the OCD cycle works: the obsession, the compulsion, the temporary relief, and why that relief is the trap
What reassurance-seeking 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
What ego-dystonic versus ego-syntonic 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 to call a therapist yet
About Dana:
Dana Colthart, LCSW, is the clinical director of Clear Light Therapy, a boutique practice based in Englewood, New Jersey. She provides evidence based treatment for OCD, anxiety disorders, and eating disorders, blending Exposure and Response Prevention, Acceptance and Commitment Therapy, and integrative mind body approaches. Dana is also a Certified Eating Disorder Specialist.
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Podcast Cover Photography by Anya McInroy
Podcast Administrative Support by Alexis Glaubach
Podcast Editing by Brian Walters