What is Orthorexia Nervosa? When Eating Healthy Becomes Unhealthy
By: Katherine Metzelaar, MSN, RDN, CD
Orthorexia Nervosa is often explained as an “unhealthy obsession with healthy eating” and while it is not recognized as its own eating disorder diagnosis with diagnostic criteria, the struggles and pain felt by those with orthorexia are very real.
How Do You Define Orthorexia Nervosa?
Typically people with orthorexia nervosa are hyper-focused on the quality of their food and view their diet as an indicator of their health and worth. They often have a mental list of food habits and practices that they obey including a set of foods or ingredients they intentionally avoid for fear of health repercussions. It’s characterized as an obsession with not only “pure” or “clean” foods but also a belief that the the body is a “clean" vessel and the foods (and sometimes products) you consume are what harms the body.
Signs and symptoms of orthorexia:
Cutting out foods or food groups (common ones are sugar, dairy, gluten, and meat) leading to limited variety in the diet
Focusing on food cleanliness and purity. Examples include “clean eating,” “whole foods” or only organic
Constantly reading nutrition facts and ingredient lists
Deep concern for food’s health and nutrient density (consumed by them and others around them)
Dedicating unusual amounts of time to meal planning and cooking foods that comply with their dietary restrictions
Anxiety at social events where food is served and/or refusing to go to these events because of the food served
Body image struggles
Getting really stressed out when “safe” or “healthy” foods are not available
Heightened interest in the health quality of food of others
Hard time eating anything but a limited list of specific foods
A worry, concern and/or deep fear about the ingredients in food products
Allowing food to revolve around your daily schedule
Isolation from others including family and friends
Eating only fruits and veggies or only consuming organic foods
Strict behaviors around preparation of food and meals
Most of us have been told the importance of “healthy eating” in one way or another, whether it was in schools, doctors’ offices, online, or in our social circles. Today’s diet culture promotes various wellness lifestyles (a.k.a. diets) as the pathway to longevity, boundless energy, and the pinnacle of health. Health-centric marketing messages are everywhere to mask an emphasis on weight loss in the diet industry. If you feel stuck in orthorexia-like eating disorder behaviors, please know you didn’t cause your disordered eating. The culture you live in breeds this kind of thinking and is part of what makes orthorexia so hard to spot and know that you’re suffering from it.
This is the culture you’re swimming in, so no wonder you internalize the dominant culture’s narrative that you should achieve “optimal health” through food. So, orthorexia is particularly difficult to address because modern-day diet culture not only normalizes but actively promotes orthorexic behaviors. Additionally, orthorexia has series health consequences and is just as damaging as other eating disorders.
What’s wrong with healthy eating?
There is nothing inherently wrong with wanting to eat to support your health. Everyone has their individual values, routines, medical histories and the ability to choose what works best for them given the resources they have.
However, the main distinction with orthorexia is that your food behaviors are jeopardizing your well-being. This could show up in a number of ways, but often people with orthorexia experience fraught emotions or lack of flexibility that prevent them from showing up to live the life they desire.
How do you know if you might be suffering from orthorexia?
Food Fear and Anxiety. In orthorexia, the food choices are made from a place of external influence, fear mongering, and thinking about food as “good” versus “bad.” Your food rules and patterns prevent you from connecting with your body, honoring internal desires, and making choices from a place of peace and authenticity. Consequently, if you have orthorexic behaviors you likely have a lot of emotions related to food. Some common emotions are fear, perfectionism, stress, or anxiety. You might also experience uneasiness and self-criticism as you try to craft the “perfect” diet. Tuning into the food thoughts and emotions you notice can provide insight into how your eating patterns are affecting your well-being.
Flexibility versus Control. Another element to consider are your reactions to the food environment. If you are struggling with orthorexia you might experience distress when you do not have full control over the menu. Social events or travel are particularly challenging because the foods accessible to you likely won’t meet the criteria for the foods you deem healthy enough to eat. The stress of the unknown combined with the additional food labor to prepare acceptable foods interfere with your ability to be spontaneous and enjoy foods in the moment. Your rigidity and commitment to your eating patterns might be detrimental to your relationship with food.
Headspace. With orthorexia, as in all disordered eating, a common theme is that food takes up lots of headspace. Reading the latest wellness articles, shopping for safe foods, meal planning among a narrow list of foods, daily cooking and preparation, researching restaurant and menu items all time up a lot of your time. if you are caught in orthorexic behaviors your food to-do list is never ending. Some people reach a point where they feel exhausted (rightfully so) and feel they can’t exert the same amount of mental and physical energy into their diet on top of all of the other commitments they encounter in their daily lives.
Orthorexia is a complex eating disorder to understand, especially since many of us have been told that diet is the “be-all-end-all” of health. In reality, true health encompasses mental, social, emotional, spiritual health, and more. Everyone may hold a different definition or view of health as well. It may take some time to practice some curiosity around your own patterns, critically examine your attitudes about health, and to consider how your relationship with food is serving you in this season of life. Please know that if healthy eating is stealing your time or headspace, you may be suffering from orthorexia and you deserve support to break free and redefine what health means to you.
References: Orthorexia. NEDA. Accessed August 16, 2021.
You’ll also love…
Meet with an Eating Disorder Nutrition Therapist in Seattle, WA
Are you struggling with food or body image? Our dietitians offer online therapy for those struggling with food and body image. It’s possible to change your relationship with food and your body. You can free up headspace, and live your life with more presence, abundance, and peace. We offer support with overcoming chronic dieting from our Seattle, WA-based practice. To start your therapy journey, follow these simple steps:
Schedule a free 15-minute phone consultation by clicking the button below.
Meet with one of our caring dietitians.
Create peace with food and feel better about your body!