Eating disorders and rigid, perfectionistic personality traits often occur together. Treating only the eating disorder can leave the deeper pattern untouched. A recent case study followed a 17-year-old girl with anorexia nervosa alongside obsessive-compulsive personality disorder marked by strong perfectionistic traits, describing how an extended course of therapy addressed both.
She received an enhanced form of cognitive behavioural therapy for eating disorders, adapted for her age with extra attention to motivation, the therapeutic relationship, and her parents' involvement. Six additional sessions targeted her perfectionism directly, working on her tendency to judge her own worth almost entirely by achievement, rather than by weight and shape alone.
Her eating disorder symptoms and perfectionism eased gradually over a year of treatment. She reached a healthy weight and began eating a wider range of foods. She became more socially engaged, and learned to set boundaries and ask for rest from family, friends and her sports team, something her rigid perfectionism had made difficult before. By the end, she no longer met the criteria for anorexia or for OCPD with perfectionistic traits, though some perfectionism still surfaced around achievement, and treatment addressed this directly.
One young person's experience is not proof that this approach suits everyone. It does suggest perfectionism deserves direct attention in treatment, not just the eating disorder built around it. If perfectionism or disordered eating is affecting you or your family, professional support can help untangle both.