Orthorexia: When The Pursuit of Health Goes Too Far

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An Introduction

When I first heard the term “orthorexia”, I felt confused. I knew the suffix ‘orexia’ meant appetite, and I always associated the prefix ‘ortho’ with orthodontist. Could this be a condition where people can’t eat because of tooth and jaw problems?

Well, after doing a bit more digging, I found that this was not the definition of orthorexia, though linguistically speaking, it would make sense. No, orthorexia is a form of disordered eating hallmarked by a need to eat “healthy” or “clean” foods and avoid “unhealthy” or “impure” foods as often as possible.

This condition is surprisingly common, and I’d be willing to bet at least $5 that most people know someone who has some degree of orthorexia. It could be the person who only eats raw fruits and vegetables, or the person who cannot let go of their paleo diet for even one meal. This isn’t an invitation for you to get out your binoculars and find all the people you know who deal with orthorexia, but it is a call for you to be aware of its prevalence.

Of course, there are people who do need to adhere to some diets through medical nutrition therapy because their bodies need to limit certain nutrients. A person who limits their intake of potassium because they have chronic kidney disease would likely not have orthorexia, unless they became obsessive and anxious about their food options at every turn.

It’s unclear how many people suffer from orthorexia- some studies say as many as 20-70% of Americans display orthorexic tendencies, and others say less than 1% would have “official” orthorexia. The severity of it varies widely, but any amount of obsession about a diet is too much in my mind.

As you go through this post today, check in with yourself to see if any of this resonates with you. It sure would have with me just a few short years ago.

So What is Orthorexia?

For starters, orthorexia is a form of disordered eating, but it has not yet been recognized as a clinically-diagnosable eating disorder. It does not sit in the DSM-5 like anorexia and bulimia, but that doesn’t mean it isn’t serious.

Simply put, orthorexia is a term to describe highly restrictive eating behaviors based on the “quality” of the food over the quantity. Other forms of eating disorders and disordered eating focus on the amount of food or calories being eaten, burned, or purged, where people with orthorexia tend to subscribe to a set of beliefs that certain foods or food groups should be limited or avoided altogether because they are “toxic” or too “unhealthy”.

Orthorexia is also not as much about weight and weight loss as other forms of disordered eating, either. Instead, orthorexia is often about the pursuit of pureness and health from foods, while being free from “contaminants” like toxins or pesticides. It can also be the avoidance of entire food groups because they are thought to be less “pure” in some way.

Of course we try to encourage Americans to eat more fruits and vegetables and lead a healthy lifestyle, which is all well and good until they take it too far and suffer physically and mentally from their “healthy” lifestyle. Unfortunately, the relentless pursuit of health takes its toll on the body and mind, typically in the form of anxiety and/or depression, especially when they find themselves in situations where they cannot adhere to their diet.

How it feels when you’re on an extreme diet, and it seems like everyone else can eat freely

What are the Signs of Orthorexia?

Sometimes, orthorexia can just look like an ultra-healthy lifestyle, and many people don’t see the problem with that. In fact, it’s often viewed as admirable, and people are praised when they adopt and adhere to a restrictive diet. There is nothing wrong with a person wanting to eat a nutritious diet, but a “healthy lifestyle” becomes a slippery slope when a person feels no sense of flexibility with their food choices.

A person who only eats the foods on the right and NEVER allows themselves to enjoy the foods on the left may have orthorexia

According to the National Eating Disorders Association and Psychology Today, these are the following signs to be aware of when it comes to orthorexia:

  • Increasing restriction and cutting out foods or food groups
    • For example, all sugar, all grains, all dairy, etc.
  • Atypical fascination and judgement with what others are eating
  • Constant fixation on food and meal planning
  • Obsessive food & nutrition label checking, as well as concerns about a food’s ingredient’s list
  • Relentless anxiety when foods deemed “safe” or “clean” enough are not available
  • Continual avoidance of meals at restaurants or food not prepared by themselves
  • Compulsive following of fitness or fitspo accounts on social media
  • Constant fear certain foods, diseases, or illnesses
  • Persistent body image issues

Orthorexia can create all kinds of physical and mental problems for a person struggling with it. For starters, cutting out entire food groups like grains or dairy in the name of food morality and purity can lead a person to malnutrition and major nutritional deficiencies. If given the choice to eat a food they don’t deem “safe” or “healthy” enough or not eating at all, people with orthorexia often choose the latter.

Behold: lettuce instead of a bun, a common substitution for people who cut out grains.

On top of that, constant worrying about what foods to eat or what foods conform to their chosen diet can lead to lots of stress and anxiety, which also take their toll on a person’s body and mind. Additionally, people with orthorexia are incredibly vulnerable to falling into the trap of “don’t eat these foods because they are ‘impure’, but purchase my expensive supplements that make sure you get what you are missing from the foods you cut out.” In other words, they often purchase expensive supplements to “fill in the gaps.”

Socially, those with orthorexia tend to turn down invitations to attend meals at restaurants or participate in potlucks. This may leave them feeling isolated and alone, causing them to further withdrawal from their friends and family. This can become a vicious, lonely cycle that gets worse and worse until proper interventions take place.

What can I do if I Have Orthorexia?

If you have personally identified that you may be struggling with orthorexia, the best thing you can do is seek professional help. Perhaps those with more mild cases can overcome orthorexia on their own, but due to the tricky nature of the orthorexia beast, seeking mental health care is your best bet.

A registered dietitian who specializes in eating disorders can work with you to confront body image issues and tackle the obsession with healthy eating. An RD that is a certified intuitive eating counselor can be another great option, as they are trained in helping people let go of food rules by listening to their body. Other mental health professionals, like therapists or psychiatrists may also be helpful, and a great first step is asking your primary care physician for a referral.

The Diabolical Dietitian now has an anti-diet merch store. Click the image above to check it out!

If you don’t currently have access to a primary care physician, and you are in need of care, check out one of my favorite resources, Aunt Bertha. Aunt Bertha is a website that allows you to find all kinds of resources in your zip code, including physical and mental healthcare. Their listings are geared toward people of lower incomes, and many people who use this directory find exactly what they are looking for.

Thankfully, interventions like Cognitive Behavioral Therapy with a counselor or therapist can help people overcome disordered eating behaviors like orthorexia. Cognitive Behavioral Therapy is the practice of identifying and changing thought patterns to see real-life results.

Additionally, support groups can be especially helpful for people recovering from disordered eating. The Center for Discovery offers free online support groups (over Zoom) for anyone who has been affected by an eating disorder. It costs nothing to give them a try, and you may find that talking about these matters with people who understand what you are going through can be incredibly healing.

If you have a loved one suffering with orthorexia, and you want to help, aim to approach the topic as delicately as possible. Many people with orthorexia don’t realize that their “healthy” lifestyle qualifies as disordered eating, and they may even believe that people who feel freedom around food are just trying to sabotage their “progress”.

Orthorexia, and all other eating disorders, are tricky topics to bring up, but crucial conversations with a loved one about disordered eating can eventually lead them to treatment. If you decide to approach your loved one about their concerning “healthy lifestyle” pick a comfortable time and place, and voice your thoughts in a loving way.

Seize the Awkward is a website that provides resources to help you talk to a loved one about their mental health.

Before this conversation takes place, be prepared to offer resources, like a phone number for a counselor or a website with more information on orthorexia. Some people may shut down any attempts to have this conversation, and pushing it further may just make things worse. Use your best judgement, and above all, let them know you love and care for them, and that they can talk to you if they ever decide they want help.

In Conclusion

Orthorexia isn’t a light or fun topic to talk about, but it is an important one, especially in a blog whose first priority is bringing down diet culture. While there are people in our country and across the world who don’t care about their diet or health and make choices reflective of that, I’d argue that the opposite is no healthier.

In fact, I would argue that being obsessed and relentless about a “healthy” or “clean” lifestyle to the point where it takes the joy out of eating and harms a person’s mental and physical health can be as bad or worse for a person than not paying attention to what they eat.

Either way, orthorexia is serious and prevalent, and I believe we have diet culture, supplement salespeople, and internet “health authorities” to thank for it. Despite it all, disordered eating comes down to a person’s mental health and self-perception. Taking gentle care of your mind should always be a priority, especially once people start to notice they are taking their diet or body’s appearance much too seriously.

As Always, a Book Recommendation

This week’s recommendation is a bit different than most others, but that’s because I believe in the power of this particular work. This week’s book recommendation is The Intuitive Eating Workbook (affiliate) created by the OG IE ladies, Elyse Resch and Evelyn Tribiole. I am recommending this book because it’s an amazing reflective tool that can help you recognize your current habits and reliefs, which enables you to gradually work toward a more intuitive lifestyle.

This workbook is filled to the brim with deep questions and thought-provoking exercises, and I truly believe it can help you understand yourself in a more profound way. The Intuitive Eating Workbook (affiliate) can be helpful, but it shouldn’t serve as a substitution for mental health care or counseling.

If you don’t need a workbook, but you know a young adult that may struggle with their eating habits, these ladies have also released an Intuitive Eating workbook for Teens (affiliate)! I have not used this one myself, but if it’s anything like the regular version, it’s something I wish I would have had when I was a teen. It may have saved me from years of a disordered relationship with food, exercise, and my body.

As an Amazon Associate, I earn a small percent off qualifying purchases from products linked on my website. It costs you nothing, but it helps keep my website running. I only recommend things I genuinely love.

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