What is Orthorexia? What do you need to know? Is this a new trend or a disorder?
Do you only choose foods labeled as "clean" or "all natural"? Or, have you skipped a meal with friends because the menu wasn't "healthy"? Have you noticed that your mind is constantly on food? Is it about your next meal or do you follow on social media groups that focus on it all the time?
While there is no harm in choosing nutritious foods or engaging in eating habits that promote our body's basic functions, it can become harmful when the rigidity of these choices becomes so extreme that a person's mental and physical well-being is compromised. When food choices are made solely by "purity" over pleasure, it can lead to dysfunctional behaviors in everyday life.
What exactly is orthorexia?
The term "orthorexia" was first described by Steven Bratman, in 1997, in his book "Health Food Junkies". The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t classify orthorexia as a separate eating disorder, like anorexia nervosa. This appears to be due to the difficulty of differentiating between what are considered healthy eating practices or maladaptive eating behaviors.
How did the term "orthorexia" come about?
The term orthorexia comes from the Greek word “orthos” which means correct and “oreksi” which means appetite. It is characterized by a pathological obsession with biologically "pure" or correct, healthy food which leads to significant dietary restrictions. Its main characteristics are the avoidance - at the level of compulsion - of "unhealthy" foods, such as sugar, salt, caffeine, alcohol, sweets, fried foods, wheat, animal fat, soy, corn, dairy.
A person with orthorexia may follow a strict diet that includes only "pure" foods, such as organically grown fruits and vegetables. Obsessing over clean eating can be detrimental to the individual. These strict rules about food can lead to social isolation, malnutrition and mental distress.
It is important that our society and nutrition culture don’t praise restriction or accept rigidity as "self-discipline" so that this confusion is not created. Regardless of the diagnostic criteria, any time thoughts or behaviors around food begin to control aspects of your life, it's a sign that you may need professional help.
Possible signs of orthorexia:
- Compulsive control of ingredients and nutrition labels
- Increased concern about the quality or health of ingredients/foods
- Elimination of specific foods or entire food groups if they are not considered “healthy”
- Inability to eat or increased distress when eating foods that are not considered 'pure', 'clean' or 'healthy'
- Unusual interest in what others eat and feelings of judgment about others who do not eat similarly to you
- Excessive time spent thinking about food (worrying about the next meal, how meals are prepared, reading blogs or books about nutrition, etc.)
- Stress or anxiety is present when "safe" foods aren’t available or you can’t prepare them yourself
- Obsessive watching of 'wellness'/'health' content.
- Body image concerns may or may not be present
- Orthorexia can easily go unnoticed, as nutrition culture considers many of the behaviors above to be simply "adoption of a healthy lifestyle."
Food Culture & Eating Disorders
Food culture is confusing. It suggests that there is a "right" and a "wrong" way to eat. It normalizes eating disorder behaviors such as restriction or excessive exercise. It suggests that a slim body is the epitome of health. From social media to grocery aisles to even casual conversation with friends about the latest "superfood" or the latest nutrition plan, these toxic messages seep into every aspect of our lives, making it difficult to navigate.
Orthorexia & Eating Disorder Rehabilitation
As a result of these messages and society expectations, it is understandable that differentiating between an eating disorder and health awareness can be confusing. The goal of any dysfunctional eating behavior rehabilitation is to create flexibility so that you can regain the joy and pleasure of eating. To honor both your taste buds and your health. No single food or meal is going to have a detrimental impact on your health. However, following strict rules, thinking of foods as 'good' or 'bad' and depriving yourself of the rewarding experiences that food can provide can and will be harmful.
When the line between health and eating disorder becomes blurred, take a step back and ask yourself:
What is the position of the dietitian and the mental health professional?
The dietitian undertakes the nutritional re-education of the orthorexic person in what is healthy, nutritious and safe, and also the regulation of biological imbalances, while the mental health professional will help the person to redefine thoughts and emotions, to orientate towards behaviors without compulsions and through cultivating healthy interpersonal boundaries, to gain self-confidence.
Journal reference:
McComb, S.E & Mills, J.S. (2019) Orthorexia nervosa: A review of psychosocial risk factors. Appetite. doi.org/10.1016/j.appet.2019.05.005