What is Orthorexia?
Healthy eating is a good thing, but when it becomes obsessive or takes a toll on your social, physical, and mental health, it becomes unhealthy. Learn all about Orthorexia in today's post.
Healthy eating is an important part of living well and feeling our best. When we supply our body with a variety of nutrient-dense foods, we help meet our vitamin and mineral needs, we support our energy levels and countless other systems in our body, from our digestive to our cardiovascular systems and more.
Healthy eating is good thing.
But in some cases, it becomes an unhealthy obsession and a source of great distress or anxiety if standards aren't being met.
In today's post I want to talk about Orthorexia, or Orthorexia Nervosa, a form of disordered eating.
What is Orthorexia?
Orthorexia is characterized by an unhealthy obsession with healthy eating. It usually involves some form of a restrictive diet, ritualized patterns of eating, and/or rigid avoidance of foods believed to be unhealthy or impure. It's not classified by the DSM-5 as an eating disorder, but it's becoming more recognized by the medical community as a serious form of disordered eating.
Orthorexia differs from other eating disorders, such as anorexia or bulimia, in that it does not focus on quantity of food eaten, but rather quality. Someone with orthorexia has an unhealthy relationship with food whereby there's a fixation on clean, "pure" foods and the benefits of eating healthy.
The American physician Steve Bratman first coined the term “orthorexia” in 1997. It's derived from the Greek word “orthos,” which translates to “right.”
The Signs of Orthorexia
Emphasizing healthy food in the diet is not an indicator of there being a problem. This can make it hard to differentiate between a normal interest in healthy eating and having a disorder.
What we do know is that orthorexia has a negative impact on social, physical, and mental health. Additionally, since healthy eating is generally perceived as a positive behaviour, those with orthorexic tendencies may be encouraged, applauded, or otherwise supported in their decisions around food.
Here are some signs of orthorexia that are not typical in someone with a normal relationship with food:
Restrictive diet or rigid eating patterns
Cutting out a long list of foods that are perceived to be unhealthy or impure, even those that are acceptable to eat
Preoccupation with elimination diets or an increased avoidance of food items without a healthcare practitioners recommendation
Constantly thinking about food and food choices
Obsessive concern with food intake and developing disease or medical condition
Anxiety, depression, or self-loathing if healthy food is unavailable or if "impure" food was eaten
Excessive attention to food item ingredients and/or reading package labels
Weight loss
Malnutrition
How is Orthorexia Diagnosed?
Recently, a diagnostic criteria was proposed by Steven Bratman and Thomas Dunn to help make the distinction between healthy eating and orthorexia more clear.
1. An obsession with healthy eating
The first part is an obsessive fixation on healthy eating. This involves amplified emotional distress related to food choices, including:
Thoughts & Behaviours: Mental preoccupations or obsessive behaviours around foods that are perceived to promote optimal health
Anxiety: Shame/guilt, anxiety, fear of disease/illness, feelings of impurity, or negative physical sensations that arise out of breaking or not adhering to food rules
Severe Restrictions: Food restrictions, such as the elimination of entire food groups, that gradually increase. May also include the addition of cleanses, detoxes, or fasts
2. Behaviours that disrupt daily life
Part two is compulsive behaviour that impedes the normal functioning of day-to-day life, including:
Medical Issues: Nutrient deficiencies/malnutrition, not eating enough, weight loss (especially if it's severe), or other medical complications can be the result of compulsive behaviours found in orthorexia
Lifestyle Disruption: This includes beliefs or behaviours related to healthy eating that cause personal distress or difficult social or academic functioning
Emotional Dependence: Complying with self-imposed food rules can be excessively tied to self-worth, identity, body image, and general life satisfaction
What Causes Orthorexia?
The causes of disordered eating behaviours are multifactorial and more research is needed to determine a definitive conclusion on the causes of orthorexia, but there are a few factors that may make somebody more susceptible:
Having had an eating disorder in the past or currently
Obsessive-Compulsive tendencies
Perfectionism, high anxiety, or the need to control
Those with digestive problems or another health condition, especially those that involve elimination diets or restrictive eating protocols
History of dieting
Studies suggest that healthcare professionals such as nutritionists, Dietitians and others in a health or nutrition field as well as athletes and performers (such as ballet dancers) are at an increased risk of developing orthorexia.
Other factors like diet culture and social media can play a role in how we view food and our body, especially when there is fearmongering or we're being inundated with information on what's healthy or unhealthy, good or bad, toxic or non-toxic.
How Do You Overcome Orthorexia?
Orthorexia can be just as damaging to your mental or physical health as other eating disorders. You might be wondering how you can overcome orthorexia or if it's possible. It is absolutely possible to heal your relationship with food! The steps taken to improve your experience around food and eating takes time and there isn't one specific framework, but here are some general steps that are taken into account
Acknowledge that orthorexia is present. Awareness is an important first step. This can be challenging because those who may be struggling may not easily recognize the signs.
Once you've recognized that you may be struggling with orthorexia or disordered eating, it’s best to seek help from a doctor, psychologist, and/or nutritionist or dietitian that specializes in disordered eating.
Some common treatments that are included in the processes of overcoming orthorexia and healing your relationship with food include:
Food exposure therapy (exposing yourself to food fears) and response prevention
Behaviour modification
Cognitive restructuring
Various relaxation techniques
Education on scientifically sound nutrition information can also be an invaluable tool in helping those with orthorexia better understand and let go of false food beliefs
How to Get Help
It can be hard to be honest with yourself or others about your struggles, especially if there is guilt or shame involved. But if you or someone you know is struggling with orthorexia or another form of disordered eating, know that you are not alone. Here are some steps you can take and resources for you explore.
Get support. Take baby steps by reaching out to a trusted friend or family member
Seek professional help if you need it. Making an appointment with a professional who can guide you is an important part of the recovery process, especially if you feel overwhelmed by next steps. This may include Dietitian’s who specialize in eating disorders or working with a therapist to help you manage anxiety, including health anxiety.
Don't rely on social media apps or influencers for your nutrition information. Unfollow those who are causing anxiety or perpetuating restrictive dieting. For evidence-based nutrition information, seek the help of a qualified nutritionist or Dietitian.
Resources
National Eating Disorder Information Center - Helpline: 1-866-633-4220
Sheena's Place - Toronto
Orthorexia: When Healthy Eating Goes Bad by Renee McGregor
Intuitive Eating by Evelyn Tribole and Elyse Resch