In recent years, health and wellness have become central topics in everyday conversation. From clean eating to juice cleanses, there’s no shortage of information promoting the benefits of a healthy diet. While prioritizing nutrition is important, for some, the desire to eat “right” can spiral into an unhealthy obsession. This is where orthorexia nervosa comes in — a way of connecting with food that is gaining attention for its serious implications on both physical and mental health.
What is Orthorexia?
Even though orthorexia is not officially recognized in the Diagnostic and Statistical Manual DSM-5 TR, there is a growing awareness of this condition. The term 'orthorexia' was coined by Dr. Steven Bratman in 1997, and refers to an obsession with eating in a proper or 'healthful' manner. While being mindful of the nutritional value of food is not inherently problematic, individuals with orthorexia become excessively focused on what they consider 'healthy eating,' leading to negative impacts on their well-being such as malnutrition and impaired psychosocial functioning, increased anxiety, and a sense of guilt when they "fail to follow their rules" around food and eating what they consider "healthy." (NEDA, 2024)
Due to the lack of formal diagnostic criteria, it is challenging to determine the exact prevalence of orthorexia and whether it qualifies as a distinct eating disorder, a variant of existing disorders like anorexia nervosa, or a subtype of obsessive-compulsive disorder. Research indicates that many individuals with orthorexia also exhibit symptoms of obsessive-compulsive disorder and struggle with rigidity and increased anxiety.
This unhealthy fixation on eating foods that one considers healthy can create a lot of distress, rigidity, and nutritional restriction on the person. Unlike other eating disorders like anorexia or bulimia, orthorexia is less about the quantity of food consumed and more about the quality, leading to the person being often preoccupied with the purity of their diet, focusing on rigid rules about food selection, preparation, and consumption. Over time, these strict dietary practices can take a toll on a person’s mental, social, and physical well-being.
Signs and Symptoms of Orthorexia
While awareness of orthorexia is growing, it can be tricky to identify, as the behaviors often start with good intentions. However, the following signs may indicate a problem:
Preoccupation with food quality: Constant focus on eating foods deemed "pure" or "clean," often leading to cutting out entire food groups.
Fear of "unhealthy" foods: Avoiding foods considered unhealthy, even if they are generally safe or necessary for a balanced diet.
Rigid eating patterns: Sticking to strict dietary rules, with intense distress if these rules are broken.
Social isolation: Refusing to eat out or attend social gatherings because of concerns over food preparation and "what's in the food".
Nutritional imbalance: Ironically, people with orthorexia may become malnourished, as they eliminate so many foods from their diet that they miss out on essential nutrients.
Here's a list of Symptoms Orthorexia (NEDA, 2024)
Frequent checking of ingredient lists and nutritional labels
Heightened concern regarding ingredient health
Exclusively consuming "organic" and self-prepared foods
Eliminating various food groups such as ALL sugar, carbs, dairy, meat, fats, animal products
Restriction to a limited range of foods perceived as ‘healthy’ or ‘pure’
Unusual focus on others' eating habits
Increased preoccupation with food, ingredients, and cooking
Feeling of nutritional superiority and intolerance towards others' food choices and beliefs
Elevated levels of perfectionism and inflexibility
Spending hours daily contemplating potential food offerings at future events and expressing anxiety about attending them because of what might be offered
Experiencing significant distress when unable to access ‘safe’ or ‘healthy’ foods
Obsessively following food and ‘healthy lifestyle’ social media blogs
Body image concerns may or may not be present
Experiencing social and psychological difficulties in various areas of life
The Dangers of Orthorexia
While many people may not realize it, orthorexia can have serious health consequences. Since those with orthorexia often restrict their diet to only a few "safe" foods, they can develop nutritional deficiencies. For example, someone avoiding fats or carbs may lack critical nutrients like omega-3s, essential for brain health, or carbohydrates, necessary for energy.
On a psychological level, orthorexia can lead to increased anxiety, depression, guilt, and social withdrawal. The obsession with healthy eating can dominate thoughts and behaviors, leaving little room for spontaneity or pleasure in life. The once-positive relationship with food becomes a source of stress and fear.
Why Orthorexia is Hard to Spot
One of the reasons orthorexia can be difficult to identify is that our culture often praises those who make healthy eating a priority. Social media is filled with influencers promoting "clean" eating and strict diets, creating a fine line between health-consciousness and disordered eating. What starts as a well-intentioned effort to improve health can quickly escalate into a damaging obsession.
Addressing Orthorexia
Recovery from orthorexia involves addressing both the physical and psychological components of the disorder. Here are some steps that can help:
Seek professional help: A mental health professional or dietitian specialized in eating disorders can work with individuals to create a balanced, less restrictive approach to food.
Challenge food rules: It’s important to break down the rigid rules about food, learning that no food is inherently “bad” and that balance is key.
Focus on flexibility: Allowing oneself to eat a variety of foods and engage in social eating without fear can be a major part of recovery.
Cultivate self-compassion: Orthorexia is often driven by perfectionism. Developing self-compassion and cognitive flexibility as well as reducing the pressure to be perfect can significantly aid in healing.
While society often applauds healthy eating, it’s important to recognize when a focus on nutrition becomes unhealthy. Orthorexia is a condition that requires attention, compassion, and intervention. If you or someone you know is struggling with an obsession with healthy eating and an eating disorder, seeking support from a mental health professional can be a valuable step toward regaining a balanced, joyful relationship with food. Remember, all foods fit in balance and moderation! By shifting the focus from nutritional perfection to flexibility and nourishment, individuals with orthorexia can reclaim their lives and their health.
Home For Balance offers personalized care for individuals of all ages - children, adolescents, and adults - who struggle with food and their bodies. Our dedicated team of therapists creates a secure environment where you can explore your relationship with food an d address the underlying feelings connected to it. We offer services both online and in person. Reach out to us today at info@homeforbalance.com or call 561.600.1424 to schedule a complimentary 30-minute consultation! By seeking help early and receiving the right support, those facing challenges can begin their journey to recovery and regain their physical and emotional health.
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