He Ate What?

Dan Gorske of Wisconsin ate 23,000 Big Macs over 36 years. The Big Mac fanatic admits he has OCD and is obsessed with numbers. That may explain his fascination with the fatty burger and why he's kept every Big Mac receipt in a box. Gorske can remember the exact days (there aren't many of them) during the 36-year binge when he's missed out on eating his favorite sandwich. Now he keeps some in his freezer -- for emergencies.

OCD Causes and Diagnosis

OCD usually appears in early adulthood, although children can have it too. In such cases, the disorder usually appears around age 10 [source: Mayo Clinic]. The actual causes of the disease remain unknown, though it likely has a hereditary component [source: NIH]. Stress also seems to boost one's chances of developing OCD, while many OCD-related thoughts and rituals can themselves inflict enormous stress. Recent research indicates a relationship between the areas of the brain associated with decision-making, movement, and checking or stopping thoughts; overactivity in this mental circuit could contribute to the disorder [source: Men's Health].

OCD can only be definitively diagnosed through a clinical interview with a doctor. A doctor will ask a patient a variety of questions about his or her behavior and medical history in forming a diagnosis. But new research may offer doctors new tools in identifying the disorder, even in identifying a person's susceptibility to developing it. The new technique depends on fMRI scans, which allow doctors to look at areas of the brain known to be associated with OCD. (These areas of the brain are also associated with Parkinson's disease.) In the brain of someone with OCD, the area linked with making basic decisions becomes highly active as the patient struggles to make choices [source: CNN].

We've discussed some of the main symptoms of OCD, which include obsessive thoughts and compulsive rituals designed to control or suppress those thoughts. These obsessive thoughts can generally be broken down into four main types. First, there's the obsession over germs, commonly associated with OCD. Then there's the need for things to be in the right place, often in a manner producing acceptable symmetry. The third type is doubt, such as feeling like you might have hit a pedestrian or constantly needing to confirm that an appliance hasn't been left on. Finally, there are disturbing, pressing thoughts that don't go away -- uncomfortable sexual urges or the desire to commit a violent act.

Not every compulsion is evidence of OCD. For example, many people bite their nails as a regular habit. There can be a relaxing element in doing this (as in, biting nails lessens the compulsion to do so), but on its own, nail biting isn't evidence of a disorder. Remember: OCD provokes anxiety and produces unwanted images, thoughts, compulsions and a pathological level of doubting.

OCD symptoms can ebb with time or proper treatment, but in general, the condition is chronic, and many people must contend with it for their entire lives. Besides the hours consumed in rituals, the overwhelming pressure to perform these rituals and the public embarrassment that they can produce often cause people to shelter themselves inside, afraid to engage the world and encounter friends or family. This condition is often known as agoraphobia, a fear of crowded places. Besides agoraphobia, many OCD sufferers have additional anxiety disorders, depression or eating disorders. OCD is also associated with an increased rate of substance abuse.

On the next page, we'll take a look at the treatment options for OCD.