Orthorexia: An Eating Disorder
By Lisa C. Andrews, MEd, RD, LD
Psychologists are starting to see patients with an eating disorder known as orthorexia nervosa. You’ve likely heard of anorexia nervosa, an eating disorder involving self-starvation, excessive exercise and the refusal to maintain a normal/healthy body weight.
Bulimia nervosa is another commonly-known eating disorder that involves binging on large quantities of food and then purging in some fashion in order to control weight.
What is Orthorexia?
Orthorexia Nervosa means a “fixation on eating healthy or pure.” With nearly 70% of our population being overweight or obese, this may sound like a good thing, but it’s not. Someone with orthorexia is obsessed with eating healthfully 24/7 and may suffer from bouts of low self-esteem if s/he eats foods deemed unhealthy or unclean. Feelings of guilt, depression and disgust often accompany those with orthorexia.
The fixation becomes a concern when it develops into an obsession over “pure” food consumption. Major disruptions to well-being and social life are occurring. Malnutrition can sometimes develop, along with heart issues, loss of menses, osteoporosis and other problems related to malnutrition.
Some eating disorder specialists believe that patients with orthorexia symptoms are actually suffering from anorexia. People who suffer from orthorexia and anorexia may show the same types of symptoms such as:
They want to control their life through control of food intake
They want to have self-esteem through control of food intake
They believe that they have one or more undiagnosed food allergies and use that as a reason for avoiding certain foods
They have additional disorders such as OCD or obsessive-compulsive personality disorder
This obsession with healthy foods could come from family habits, such as parents placing an undue importance on healthy food. Others may have had a childhood illness involving digestive or diet issues. Perhaps there is economic hardship or a medical problem that was not able to be resolved.
Orthorexics may be trying to avoid bad health, feeling a compulsion for complete control over their lives, escaping from fears they have developed, or wanting to be thinner. They may even be trying to improve their self-esteem or trying to create an identity through food choices. Other causes can include a tendency toward perfectionism and a high level of anxiety.
Eating healthfully is not only trendy, it’s good for you! Research studies linking a clean diet with disease prevention hit the news practically daily, while healthful recipes flood social media. But can this go too far?
Here are some symptoms of orthorexia:
Being anti-social. In order to avoid eating something unhealthful, an individual with orthorexia may not make or will cancel plans with friends and family. They may begin looking down on those who don’t follow the same restrictive lifestyle.
Low self-esteem. With overly restrictive behavior, the urge to binge or eat something “not so healthful” may prevail. An orthorexic may degrade themselves and suffer low self-esteem when they eat something that’s off their normal menu.
Preoccupation with calories and healthful food. It’s one thing to plan meals or count calories, but when this activity becomes compulsive or all-consuming, then it may be time to get help. Compulsively checking ingredients lists and Nutrition Facts labels on product packaging can be a symptom.
Eating causes anxiety and is no longer pleasurable. Most of us look forward to food and enjoy eating. Not orthorexics. The need to control the type and quality of food consumed can become overwhelming. Those with this condition may feel stress and anxiety and in turn, skip meals. Straying from the rigid eating patterns or exercise regimens results in severe anxiety, distress, shame, guilt or depression.
Avoiding certain foods. A sign that someone may be suffering from orthorexia is avoiding whole food groups. They may avoid many foods based on one or more factors such as artificial colors, flavors or preservatives; pesticides or genetic modification; fat, sugar or salt; animal or dairy products. This is another way to control their eating habits.
Medical conditions. Obsession with the effects of the food being eaten on medical conditions they think they may have or want to avoid, such as asthma, anxiety, allergies, or digestive disorders.
Over-supplementing. Use of significant amounts of probiotics, herbal remedies, and other supplements thought to have healthy effects on the body.
Food preparation. Orthorexics may have irrational concerns about the way that foods are prepared, such as food washing techniques and sterilization of utensils.
Weight loss. Following an orthorexia diet can result in malnutrition. They can deplete their own nutrition by the limits they place on food choices. They typically do not intend to lose weight.
Orthorexia nervosa can go unnoticed because it’s not unusual these days to be “obsessed” with healthy eating. Researchers, health professionals, marketers, and the media seem to be constantly focusing on the latest definition of a healthy diet.
Treatments for Orthorexia
At the time this article was written, there are no official treatments specifically for someone suffering from orthorexia. The National Eating Disorders Association says that mental health care professionals usually treat the condition the same way as they treat anorexia or other obsessive-compulsive disorders.
Psychotherapy can be helpful by changing the obsessive thought patterns that orthorexics have about food. It can also be used to treat any co-existing mental health conditions, such as panic attacks, anxiety, depression, panic disorders, PTSD, OCD, bipolar disorder, substance abuse disorders and stress. It’s important to have regularly scheduled sessions with the therapist in order to improve.
Meeting with a registered nutritionist can help determine whether the information and guidelines they are following are correct or not. They may learn what a healthy eating program is made up of, begin to improve their relationship with food.
The increasing number of fad diets may be the reason that orthorexia is on the rise. Foods are being labeled “good” and “bad” with no real basis in fact. If you or someone you know is suffering from an eating disorder, ask a doctor or mental health professional for help.
This information is for educational purposes only. The statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Consult your physician if you have any question regarding a medical condition
See References below.
Orthorexia: An Obsession with Eating “Pure”. The Academy of Nutrition and Dietetics.
Hill, Amelia (16 August 2009). “Healthy food obsession sparks rise in new eating disorder.” The Guardian. Accessed 7 August 2013.