As an Eating Disorders therapist, a phenomenon I run across more and more in my work is clients who take ‘healthy eating’ to the extreme. There’s actually a name for this disorder: Orthorexia. I even suffered from it myself.
What is Orthorexia?
Steven Bratman, M.D., coined the term “Orthorexia Nervosa” in 1997 from the Greek word ortho — which means “straight, correct and true” — in order to distinguish this eating disorder from the better-known anorexia nervosa. In his book, Orthorexia: Health Food Junkies: Overcoming the Obsession with Healthful Eating, Dr. Bratman describes Orthorexia as a disease in which people fixate on eating healthy food.
At this time, Orthorexia is not categorized in the DSMIV as an actual eating disorder but many mental health professionals consider it a sub-clinical form of an eating disorder. Statistics on Orthorexia are hard to pin down because it’s still a relatively recent concept. In time, I expect we’ll be hearing a lot more about this disorder and will learn more not only about the condition itself, but also about the thousands of people who, in my estimation, are being affected by this illness. Dr. Bratman states that orthorexia is similar to anorexia and bulimia with this one difference: “Whereas the bulimic and anorexic focus on the quantity of food, the orthorexic fixates on its quality.”
While eating healthy foods is a great idea, like any other, it can be taken to extremes; overtaking one’s life and turning into a habit that is decidedly not healthy. I think the greatest example of this is in our current Zeitgeist is the promotion of ‘plant-based’ diets.
Orthorexia in Action
A real-life example of Orthorexia comes from a therapy client of mine who was a strict vegan who wouldn’t eat anything containing animal foods or which came from an animal. For those of you who are unfamiliar with this diet, it means that you can’t eat any meat, eggs, dairy and even honey. She had convinced herself that she could only be healthy if she was 100% vegan.
As her eating regime became stricter and more rigid, she found herself increasingly isolated because she wouldn’t share meals with the people she loved because they weren’t vegan. As well, she found that she had to avoid restaurants and most other forms of social dining. In this particular case, her extreme focus on “healthy eating” made her world smaller and smaller and left her feeling lonely and depressed. Through the course of therapy, she made the connection between the choice to be a staunch vegan and the profound social implications that come along with it.
In recovery, she worked on finding a middle ground where she could eat healthfully while also maintaining the close social connections she had previously enjoyed. She became more flexible about eating a few non-vegan foods such as fish, dairy and eggs which allowed her to easily go out to restaurants and eat with non-vegans and she really enjoyed feeling connected to others again.
Looking back on her orthorexic days, she realized that when she was a strict vegan, she felt righteous and superior to others and couldn’t understand why other people were “killing themselves” by eating ‘inferior’ food which boosted her ego temporarily and made her feel powerful.
However, she also realized that this came with a cost — it meant being cut off from others. She told me, “I can’t imagine that I was much fun to be around. I was so serious and obsessed with what I was eating. Little wonder, I spent much of my time eating alone during that period of my life”.
Orthorexia Risk Factors
The following comes from a wonderful article on Healthline:
Research on the precise causes of orthorexia is sparse, but obsessive-compulsive tendencies and past or current eating disorders are known risk factors. In some cases, orthorexia may manifest as a more “socially acceptable” way to restrict food.
Other individual risk factors include tendencies toward perfectionism, high anxiety, and a need for control.
Social factors such as nutrition knowledge, higher income, access to “clean” foods (e.g., organic produce), use of social media, and weight stigma or bias are also associated with orthorexia-related behaviours.
In university settings, students in health-related majors (such as nutrition and dietetics, biology, and kinesiology) may be more likely to demonstrate orthorexia symptoms than those in other majors — although orthorexia can affect any student, regardless of their major.
Further, the rapid increase in the promotion of “clean eating” lifestyles on social media may also play a role in the development of orthorexia.
Proponents of clean eating promote whole, minimally processed foods, which are healthy. But the phrase “clean eating” moralizes food by painting other foods as “dirty” or undesirable. Moralization stigmatizes some foods, contributing to eating disorders such as orthorexia.
How Do I Know if I Have Orthorexia?
Dr. Steven Bratman provides a very helpful questionnaire in his book, “Health Food Junkies: Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating” (pp.47-53). The following signs and symptoms are based on the questions in his book:
- Spending more than three hours a day thinking about healthy food
- Planning tomorrow’s food today
- Caring more about the virtue of what you eat than the pleasure you receive from eating it
- As the quality of your diet increases, the quality of your life diminishes
- Getting stricter with yourself around what foods you will eat
- Sacrificing experiences you once enjoyed to eat the food you believe is right
- Feeling an increased sense of self-esteem when you are eating healthy food and look down on others who don’t
- Feeling guilt or self-loathing when you stray from your diet
- Social isolation as a result of your diet
If you think, based on what you’ve read here, that you may be suffering from orthorexia, I strongly suggest you read Steven Bratman’s book. It’s a wonderful resource full of invaluable information for the Orthorexia sufferer. There is little doubt in my mind that this gem of a book has already helped countless people to rid themselves of their health food obsessions and return to the human fold.
Contact me to set up a free 15-minute phone consultation to explore doing counselling sessions.