Perfectionism and rigidity — the hallmark traits of Obsessive-Compulsive Personality Disorder (OCPD) — show up far more often in eating disorders than most people realise. A 2025 study of 208 hospitalised patients with anorexia nervosa measured OCPD-related traits and compared them with healthy controls.
The results were clear: patients with anorexia nervosa scored significantly higher across the board on OCPD traits, including rigidity, emotional overcontrol, maladaptive perfectionism, reluctance to delegate, and difficulty tolerating change. Higher OCPD-trait scores were also linked to greater eating disorder severity. Interestingly, though, the researchers found these elevated traits didn't necessarily predict how well someone responded to short-term treatment, and average scores were still lower than in people with a full OCPD diagnosis — suggesting overlap, but not a simple one-to-one relationship between the two conditions.
Why does this matter? Because if rigid rules and rituals around food and eating are part of a much broader pattern of needing things ‘exactly right’ in many areas of life, treatment that only addresses eating behaviour may not be enough. Recognising the OCPD-like traits underneath can help shape more effective, longer-term treatment planning.
If perfectionism, rigid control, and disordered eating are showing up together for you or someone you care about, a psychologist who understands both can help address the full picture.