I have met with an astounding number of clients recently that fall into the category of orthorexia. Orthorexia is the obsession with eating only “healthy” foods. It is not currently recognized in the DSM-5 (the clinical handbook for mental health diagnoses) as an actual eating and feeding disorder; however, I suspect it will be added during the next update.
Orthorexia is still very serious and is problematic because the person becomes fixated on only eating “clean” or “healthy” foods. This creates a negative relationship with food that is not considered safe, an unhealthy mentality around food, and potentially weight loss and malnourishment.
Individuals suffering from orthorexia become obsessed with only putting the highest quality food into their bodies, food ingredients, and what and how much to eat. This kind of obsession about and around food is disordered, as the person is not eating intuitively or allowing themselves to enjoy any fun foods. This can create a very stressful and hostile environment, especially when an event or activity is ruined because the individual cannot find anything healthy to eat. There are many food rules and oftentimes, weight loss is inevitable.
Orthorexia can stem from anywhere; however, I have found a significant link between weight-based sports and the diagnosis. I have worked with gymnasts, wrestlers, cross country, and figure skating athletes, who have all suffered from this issue. Orthorexia usually starts by wanting to eat more whole, unprocessed foods, in order to be healthy; however, can quickly turn into a problem when their eating choices are affecting their every thought and behavior around food.
The problem with eating so “clean” is that this can actually create nutritional deficits. For example, if an individual will not eat bread and other grains because they may be too processed, the person may be missing out on fiber, prebiotics, and carbohydrates. This healthy eating also becomes a problem when the individuals’ relationships and daily life activities become compromised. My goal for all of my eating disorder clients is for them to be willing and able to go out with friends and enjoy a slice of pizza or two without it ruining their entire day or week. I know my clients are not going to eat pizza every day, but they do need to realize that food is extremely social and if their social life is being stunted because of being afraid to eat, this becomes a real problem.
It is okay to eat a healthy diet – dietitians want everyone to do this! However, when weight loss, malnourishment, or social isolation occurs, we know this healthy diet is taking it a step too far. So, how do you know if you have orthorexia and how is it treated? Ask yourself these questions:
- Are you preoccupied with food?
- Are you constantly thinking about getting the most nutrient-rich foods to stay healthy?
- Does it seem impossible to enjoy food prepared by someone else, because you do not have control of what is going into your food?
- Do you feel guilty when you stray from your diet?
- Do you feel in control and like a good person when you stick to your healthy diet?
Treatment for orthorexia is the same as most diagnosable eating disorders, because it can take the same toll on the body and brain. Working with a dietitian and a therapist are the best treatment options. The dietitian may help set-up a meal plan and complete food challenges with the individual. A therapist will work on the thoughts and feelings around food; and will challenge the individual to face their fears about eating an “unhealthy” food. If you or someone you love is suffering from orthorexia, please reach out. You are not alone!