Just reading the word “wellness” likely brings a wide array of images to mind: plates of colorful vegetables, shelves of brightly packaged supplements and powders, matching workout sets, or skincare routines that feature five, or ten, or fifteen steps.
The ever-expanding standards of what we popularly consider to be “wellness culture”—many of which are communicated via social media—can often feel simultaneously confusing and hyper-strict. Routines can quickly come to feel like rules. Two pieces of advice might be irreconcilable with one another (for example, “eat only whole foods,” and “try this amazing processed protein powder”) but still be presented as equally important.
For those with obsessive-compulsive disorder (OCD), navigating this often rigid and conflicting advice in a well-intentioned effort to live healthily and feel good can end up activating obsessions and compulsions—especially around subtypes like “just right” or perfectionism OCD, contamination OCD, and health OCD. Wellness is supposed to be relaxing, but OCD can make failing to follow the supposed best possible advice, or breaking a carefully curated routine, feel anxiety-provoking or even dangerous.
Everyone deserves to take care of themselves in a way that’s actually beneficial. The good news is that a specialist in OCD can help you learn tools through exposure and response prevention (ERP) therapy to better navigate the way OCD can magnify the noise of wellness culture, and make lifestyle choices that truly feel good to you.
Exercise to strengthen your body—not your OCD
Regular movement has been demonstrated to positively impact mental health overall, including for those with OCD. Research shows that exercise increases the presence of endorphins, neurotransmitters that are associated with positive feelings. NOCD therapist Heather Brasseur, LMHC, LPC says that, “Regular exercise can help you feel less stressed, improve mood, and overall mental health,” often making OCD treatment more effective.
That being said, if your mindset around your workout routine is too rigid, you could end up exacerbating your OCD. You might find yourself doing an excessive number of reps, or repeating a workout over and over again in an attempt to make it feel “just right.” Or, your OCD might convince you that the only way to stay healthy is to follow a specific workout routine without room for flexibility, even if the routine is more strenuous than you can handle, or doesn’t feel good on a given day. And for some people, magical thinking and hyper-responsibility might make it hard to disentangle a personal commitment to exercise from much larger outcomes that have nothing to do with it—like your value as a productive member of society, or even the health and safety of others. For example, someone may feel convinced that working out at 7:07am on the dot is the only way to ensure that their family stays safe, or their home remains secure.
Certain facets of visiting the gym can also feel especially difficult for people navigating OCD, including feeling like you must achieve a “perfect” number of reps or sets, or experiencing intrusive sexual thoughts in the locker room. If your wellness routine involves exercise—whether at the gym or at home—you might find that the thing making you sweat isn’t the bench press, but instead your intrusive thoughts and compulsive behaviors.
Some people also engage in exercise as a compulsion in order to distract from intrusive thoughts and fears. And while regular exercise can help reduce overall anxiety, turning to exercise as a distraction when intrusive thoughts arrive can quickly become a compulsion that teaches your mind you need exercise in order to distract from certain feelings.
While jogging in the evenings, committing to a 7am movement ritual, or following a regular routine based on your favorite content creator’s recommendations might bring you relief in the immediate because it temporarily quiets your mind, in the long run, it only teaches your brain that your fears are real—deepening an association between those fears and exercise as a compulsion. But OCD doesn’t have to run your workout. You can learn to recognize the difference between a routine that feels good, and a routine that only temporarily staves off the bad feelings of OCD.
Remember “healthy” eating means focusing on mental health, too
For many people, trying to find even basic guidance about healthy dietary choices increasingly means wading through alarmist and often-contradictory perspectives. Your grocery bill balloons as you weigh conflicting nutrition advice and consider frightening assertions about the consequences of eating too many “ultra-processed foods” or too little protein or fiber. Entire days may be taken up by food prep and cooking, leaving less time for other activities that are important to you. You may worry that you’re not making the best possible choices for you and your family.
Adding OCD to the mix only intensifies these experiences. If OCD has latched onto fears about financial scarcity or outside food contamination, a well-intentioned decision to meal-prep on Sundays can start to feel like a life-or-death responsibility that’s necessary to keep you safe from illness or financial ruin. Or, maybe your OCD has convinced you that having food perfectly prepped for your family every week is the only way to assuage intrusive thoughts that tell you that you’re a bad parent.
OCD can also hijack a genuine interest in sourcing healthier or more ethically sourced food, by convincing you that failing to buy exactly the right foods and cook them in exactly the right way means you’re unethical, or will make you directly responsible for any health issues that you or your loved ones might have in the future. Many people with OCD seek reassurance through excessive research, which can become a rabbit hole that makes every grocery decision a minefield.
While committing to a routine that helps you save time and money, or trying to stay informed enough to make healthy choices can be good ideas, being fed is better than staying up past midnight meal-prepping mid-spiral, or spending an hour with your stomach growling while you try to make sure that your snack is perfectly sourced or optimally healthy. It’s important to keep in mind that the healthiest way of eating is by creating habits that are sustainable for you. Eating regular, balanced meals can help keep your mind clear, and your mood boosted, both of which put you in a better position to manage OCD symptoms.
OCD has also been known to frequently co-occur with eating disorders, including avoidant-restrictive food intake disorder (ARFID) and anorexia nervosa. Research shows that over one in ten people with OCD also have an eating disorder. If you have OCD, there are indicators you can look for to help you differentiate between symptoms of OCD versus those of an eating disorder—so you understand the best approaches for managing symptoms. For example, a person with an eating disorder might count the number of bites they take as a means of monitoring caloric intake, whereas someone with OCD might count bites to make sure the number is “just right.” And as Kimberley Quinlan, LMFT points out, it’s important to work with a professional trained in both OCD and eating disorders who can help you accurately identify and manage symptoms.
Building lifestyle routines that avoid rigidity
Maybe you’ve been averaging only a few hours of rest a night as you sleep train your baby, but you still feel like you must wake up early and put yourself through a grueling daily workout. Or maybe you’re hungry in the middle of a day of travel, but the only food option in the rest stop is a prepackaged sandwich that doesn’t meet the meal plan requirements you’ve committed to following, so you forgo a meal altogether even though you haven’t eaten all day.
You might logically see that these actions aren’t helping your health—sleep deprivation and undernourishment are universally understood to be harmful—but if your OCD has seized on wellness culture, it can feel like the alternative options are terrifying or even life-threatening. Having a set of habits that you know truly make your body and mind feel good is one thing, but feeling panicked and getting stuck in a thought-spiral about what will happen if you can’t engage in those habits is the opposite of being “well.”
Meanwhile, learning to be flexible and making lifestyle adjustments specifically recommended for those with OCD can give you the opportunity to thrive—and pursue the elements of wellness that truly speak to your values. An ERP-trained therapist can help you implement these changes in your life by teaching you to identify and resist behaviors that arise from obsessions, so you can figure out what a value-aligned approach to wellness looks like for you. An OCD specialist might suggest that you set a timer for grocery store trips to facilitate decision-making based on your intuition and taste, rather than falling into rumination spirals or compulsive research. If you’re pushing yourself to get in more and more reps at the gym because they don’t feel “right,” an ERP therapist might suggest deliberately stopping on a rep that feels “wrong” to prove to yourself that you can tolerate the discomfort, until it doesn’t feel so urgent anymore, and you can truly work out the way you want to.
Many of the skills you’ll learn in OCD treatment may even overlap with wellness advice—like learning to ground yourself in your true values (and identify what those values are), and supporting your ERP work by properly nourishing yourself and getting enough sleep. But unlike the decrees of a wellness influencer, an ERP therapist will work with you to create an individualized plan—not pressure you into a one-size-fits-all idea of what’s healthy.
A truly balanced lifestyle routine is one that avoids rigidity. This is true for everyone—and crucial for those with OCD. Just like setting a goal to move more or make sure to eat breakfast every day, seeking treatment for OCD can be an important step toward improving your health and wellness.
