Many people worry about gaining weight—it’s a common concern, after all. While some might address their concerns by following their doctor’s advice, others might go to the extreme to stop themselves from gaining weight, which is when it becomes a more serious issue.
If you’re experiencing persistent, intense fear about gaining weight, it could be a sign of an anxiety disorder known as obesophobia or other mental health conditions, such as an eating disorder, body dysmorphic disorder (BDD), or a subtype of obsessive-compulsive disorder (OCD) known as “just right” or perfectionism OCD.
What is a fear of gaining weight?
If you Google “fear of gaining weight,” the first thing you’ll see in the search results is a specific phobia called obesophobia. Obesophobia, or pocrescophobia, is an anxiety disorder that can cause intense, overwhelming fear of gaining weight.
Symptoms of obesophobia
Obesophobia may cause a range of physical symptoms related to an anxiety or panic attack when thinking about or experiencing weight gain, including:
- Dizziness
- Chills
- Excessive sweating
- Nausea
- Shortness of breath
- Trembling or shaking
- Upset stomach or indigestion
- Heart palpitations
People with obesophobia may also perform safety behaviors to prevent themselves from gaining weight. Some examples of obesophobia-related safety behaviors include:
- Avoiding “unhealthy” foods
- Avoiding social situations that involve food
- Having an addiction to exercise
- Skipping meals
- Overusing laxatives or diuretics
- Obsessing over daily caloric intake
- Spending a lot of time and money to look thinner
What other mental health disorders could be tied to this weight gain fear?
In addition to obesophobia, there are other mental health disorders where people may experience intense fear and anxiety surrounding weight gain. These conditions include the following:
Eating disorders
Eating disorders could also contribute to a weight gain fear. Eating disorders are serious conditions that cause unhealthy eating behaviors, such as eating too little or too much, as well as changes in your thoughts and emotions. These unhealthy eating behaviors may be used as a coping mechanism to manage negative emotions and perceptions about the way you look. Being preoccupied with food, your body weight, and shape could also be signs of an eating disorder.
There are several types of eating disorders, including:
- Anorexia nervosa
- Bulimia nervosa
- Binge-eating disorder
- Avoidant restrictive food intake disorder (ARFID)
- Specified feeding and eating disorder
- Pica
- Rumination disorder
According to Mia Nunez, PhD, LP, a licensed therapist at NOCD, people with eating disorders may perform actions known as compensatory behaviors. “A compensatory behavior is done to reduce anxiety or prevent the feared outcome,” she says.
Some examples of compensatory behaviors include:
- Restrictive eating
- Refusing to eat food
- Eating a lot of food in a short period of time
- Purging (forced vomiting)
- Taking frequent bathroom breaks after eating
- Throwing away or hiding food
- Overexercising
- Taking laxatives
Body dysmorphic disorder (BDD)
Body dysmorphic disorder (BDD) is another mental health condition that aligns with a fear of gaining weight. “Someone with BDD may already not like something about their appearance, so they may think that if they gain weight, it will make it even worse,” says Patrick McGrath, PhD, NOCD’s Chief Clinical Officer.
BDD, or body dysmorphia or dysmorphophobia, causes people to excessively worry about perceived “flaws” in their physical appearance—despite these flaws being unseen by others.
Body dysmorphia may cause the following symptoms:
- Skin or hair-picking
- Camouflaging or hiding your face or body with make-up or clothes
- Avoiding the mirror
- Constantly comparing yourself to others
- Excessive grooming or exercising
Dr. McGrath also mentions that an intense fear of weight gain could be linked to a subtype of BDD known as muscle dysmorphia. Muscle dysmorphia is a condition in which a person is preoccupied with the idea that their muscles are too small or underdeveloped—even if they have a muscular build.
“[A weight gain fear] could also represent a fear of losing muscle tone,” he explains. “You may believe that if you gain weight, you will be unable to see your muscles anymore because they are buried under a layer of fat.”
People with muscle dysmorphia may engage in certain behaviors in order to achieve their desired physique, including:
- Overexercising
- Adopting a rigid diet
- Excessively using dietary supplements and steroids
- Avoiding social activities due to the compulsive need to maintain their exercise and dieting regime
“Just right” or perfectionism OCD
OCD is a mental health disorder characterized by obsessions and compulsions. Obsessions are intrusive thoughts, images, feelings, urges, and/or sensations that cause intense fear and anxiety. Compulsions are physical or mental actions performed to relieve the distress caused by obsessions or to prevent something bad from happening. People with OCD are often stuck in a cycle of obsessions and compulsions that can be difficult to break without proper treatment.
One subtype of OCD that aligns with a fear of gaining weight is “just right” or perfectionism OCD. This OCD subtype involves re-occurring intrusive thoughts revolving around organization, perfection, and making things feel “just right.” To cope with these intrusive thoughts, people will perform certain actions until they feel that something is “perfect” or complete.
If you have perfectionism OCD along with a fear of gaining weight, you may obsess over having the “perfect” physique and may perform compulsions to maintain or achieve a certain weight you deem acceptable.
It’s actually quite common for OCD to co-occur with an eating disorder. “The hospital I worked at had many different specialty programs that would cross over,” says Dr. McGrath. “So, if people needed something from the anxiety program, they would come to us. The highest percentage of people attending our cross-over program was from the eating disorder program.”
Dr. Nunez also adds that the symptoms of OCD and eating disorders are quite similar. “We conceptualize them because they behave similarly,” she explains. “If you think of OCD with obsessions and compulsions, those match almost perfectly with fears and compensatory behaviors with eating disorders.”
When to seek help for a fear of putting on weight
If you’re experiencing intense fear or worry about gaining weight and/or engaging in behaviors that could be a danger to your health, it’s time to seek help from a licensed mental health therapist. You can work with them to identify where this intense weight gain fear comes from and learn healthier ways to cope with your distress.
If you receive a diagnosis for one or more of the above-mentioned mental health disorders, here’s what your treatment may entail:
Treating BDD and eating disorders
Cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) are the most common treatments for addressing BDD and eating disorders. CBT is a talk therapy that teaches you self-help strategies to help you change your way of feeling, thinking, and behaving.
DBT is a form of CBT that aims to help you build coping skills, such as learning to tolerate distress without engaging in compulsive or compensatory behaviors.
In some instances, eating disorders may be treated with another talk therapy known as exposure and response prevention (ERP) therapy, which we’ll cover in the next section.
To learn more about eating disorders and how they are treated, visit the National Eating Disorders Association website.
Treatment for “just right” OCD, phobias, and co-occurring conditions
All subtypes of OCD, phobias, and conditions that commonly co-occur with OCD–such as eating disorders, anxiety, and PTSD—are highly treatable with exposure and response prevention therapy. ERP is a specialized therapy designed to treat symptoms of OCD. This evidence-based treatment is backed by decades of research, with 80% of people with OCD and even 80-90% of people with phobias seeing significant improvements in their symptoms after doing ERP therapy.
You’ll work with a therapist specializing in ERP to identify your triggers, obsessions, and compulsions (or safety or compensatory behaviors) and develop a personalized treatment plan to help you learn to manage or overcome your fear of gaining weight.
Throughout your ERP therapy sessions, your therapist will guide you through exercises known as exposures and response prevention techniques. For fear of weight gain, Dr. Nunez explains that ERP therapy exercises could involve eating a feared food. “Let’s say someone thinks that if they eat cake, there’s a chance they could gain a lot of weight,” she says. “The exposure would be to go ahead and eat the feared food, then resist the urge to overexercise or chew a certain number of times.”
While ERP is very effective, nothing happens overnight. You’ll need to stick to your sessions and do the therapy homework to see a significant change in your symptoms—and start rebuilding your self-confidence.
Bottom line
If your anxiety surrounding weight gain is causing you to take extreme measures to keep weight off—such as overexercising, restricting food intake, or taking laxatives—it could be a sign of obesophobia or another mental health disorder.
If you’re experiencing intense and re-occurring fear surrounding weight gain, please consider working with a therapist. They can work with you to identify your fears and start you on a treatment journey to manage your symptoms.
