Orthorexia: How to recognize when an obsession with healthy eating becomes unhealthy

Do you find yourself compulsively checking ingredient lists and nutritional labels?

Are you eliminating an increasing number of food groups from your diet? (all sugar, all carbs, etc.)

Are you unable to eat anything but a narrow group of foods deemed “healthy?”

Do you become extremely distressed when “healthy” foods aren’t available?

Do you obsessively follow food or healthy lifestyle blogs on social media?

These are some of the warning signs of orthorexia nervosa, an eating disorder that is often difficult to recognize, but which can severely impact your mental health and well-being.

Awareness about eating disorders has risen in the last decade and most people are familiar with the symptoms and warning signs of anorexia nervosa and bulimia nervosa. However, many people are much less familiar with orthorexia nervosa. As an eating disorder counsellor, I’m often asked questions about different types of disordered eating. When I explain to others the basic definition of orthorexia: an unhealthy obsession with healthy eating, many people are left wondering at what point does the desire to eat healthy turn into a disorder? Here are some red flags to help you recognize some of the characteristics of orthorexia:

  • an obsession with food choice, planning, purchase, and preparation of food

  • dietary restrictions escalate over time and may come to include elimination of entire food groups

  • the persistent belief that dietary practices are health-promoting despite physical signs of malnutrition (ex: thinning hair, loss of period, brittle nails, feeling dizzy or lightheaded, feeling cold all of the time etc.)

  • the avoidance or the elimination of certain types of food that aren’t seen as “pure” such as artificial colors, flavors, and preservatives and/or an obsession with food being clean, raw, fresh, organic, GMO-free, etc., to the extent that it interferes with your quality of life and ability to engage in social events.

  • defining health only by what you’re eating or how you’re exercising while ignoring other factors which contribute to health such as stress management, self care, getting adequate sleep, social connections, mental and emotional health etc.

  • an obsession with food and exercise accounts on social media (ex: constantly looking to instagram to decide what and how much to eat)

  • difficulty engaging socially due to anxiety around eating at restaurants or because social outings get in the way of exercising or eating a certain way

  • food is regarded primarily as medicine (only as a source of health rather than also a source of pleasure)

  • distress when in proximity to prohibited foods (sugar, processed foods etc.),  

  • strong beliefs that elimination of particular kinds of food can prevent or cure disease or greatly affect daily well-being.  Often certain foods are idealized as semi-magical healing agents while others are demonized as evil

  • moral judgment of others based on dietary choices and a feeling of superiority (the belief that you are eating and exercising in the best way possible and nobody else is doing as good a job as you)

As anorexia often begins with a restrictive diet (which then progresses to more extreme behaviors), orthorexia often begins with a strong interest in healthy food, which becomes obsessive and extreme over time. In our culture, thinness and health have become conflated such that it becomes challenging to pursue the goal of health without also pursuing weight loss. For many, the obsession over healthy eating is often fueled by an underlying desire to change one’s body and/or lose weight. However this agenda is often hidden and the focus is kept on the desire to “be healthy.” For others, obsessive beliefs may begin with the desire to protect oneself from diseases or address health issues (digestion or hormonal issues) but the ensuing weight loss which occurs is often met with compliments from others, and losing more weight or maintaining the lost weight becomes a secondary goal. As with all eating disorders there are other contributing factors (family of origin, trauma, personality factors, life experiences etc.) which play a role in the development of orthorexia.

Over time the elimination of more and more foods and rigidity around eating may lead to a decrease in food variety and caloric intake, which can in turn lead to nutrition deficiencies and malnourished body systems and organs. For example, vegetables are often consumed excessively and often used to replace carbs, resulting in energy depletion (carbs are the body and brain’s main source of energy). Exercise may become more and more obsessive, resulting in extreme exercise which is very harmful for the body due to the effects of energy depletion. Our cultural obsession with healthy eating and our tendency to congratulate others on their eating choices, exercise, and weight loss often normalizes orthorexic tendencies and makes these behaviors very difficult to recognize as problematic. Just as with other eating disorders, when someone is struggling with orthorexia they often are consumed by thoughts about food and their body, and food (or restriction of food) becomes their primary source of self-worth, happiness, and meaning in their lives.

With orthorexia, the initial goal of being healthy goes so far that one’s mental and emotional health become compromised. Those who struggle with orthorexia may experience an initial a boost in self esteem because eating a certain way is tied to an inner sense of morality or the initial compliments about weight loss lead to a feeling of exhilaration. However, this is often a temporary feeling, rather than a long lasting change. Over time, the rigidity of the disorder makes it difficult to feel fully present and engaged in life. There is often a sense that there is something more that one could be doing, something else to cut out, some other type of more vigorous exercise, or some other way of being more healthy or more perfect. The obsession with food and the body may leave little mental or physical energy for one to pursue other life passions.

If you notice some orthorexic tendencies in yourself, try to have some self-compassion for yourself. Orthorexia is a serious mental disorder and the struggles that you are experiencing are very real and painful. Additionally, Orthorexia is perpetuated by the wellness industry and by the diet culture surrounding us. And although the problem seems to be an individual one, it is actually a a part of a larger social problem. You are not alone in struggling to have a healthy relationship with food. Many people struggle with various aspects of orthorexia even if they don’t meet all of the criteria. If you are experiencing symptoms of orthorexia, I urge you to reach out for counselling or other support to help you along the path of recovery.

 

Lorilee Keller