Understanding Orthorexia: An Emerging Eating Disorder

Orthorexia might not be a term you’re familiar with, but it’s becoming increasingly relevant. It’s an eating disorder marked by an unhealthy fixation on eating only “healthy” foods. Sadi Fox, a licensed psychotherapist who specializes in eating disorders, highlights its rising prevalence.

We all know that one person who can’t stop raving about “clean eating” or is adamantly avoiding certain foods — carbs, sugar, gluten, you name it. The issue here is that orthorexia can lead to serious nutritional deficiencies, mental health issues, and even social isolation. According to Fox, it can also open the door to other eating disorders.

Yet, recognizing orthorexia can be tricky. The societal perception of healthy eating as a virtue means those with the disorder often get praise instead of help. In some cases, individuals don’t even realize how deeply entrenched they are in their eating patterns. Fox says, “Many people are surprised to find out just how much their eating habits have spiraled.”

So, what should you know about this subtle but concerning mental health condition? Here’s an overview from experts.

What is Orthorexia?

At its core, orthorexia transforms the pursuit of healthy eating into an obsession that warps the very concept of “healthy.”

People with orthorexia become so fixated on steering clear of what they see as harmful foods that they neglect essential nutrition. Kelli Rugless, another expert in eating disorders, points out that many of the food choices folks make are often based on questionable information they encounter on social media. This is not necessarily founded in science.

Nutritionists assert that cutting out entire food groups can lead to an imbalanced diet that lacks vital nutrients and calories needed for everyday bodily functions. Emily Van Eck, a nutritionist, notes that those with orthorexia may face issues like constipation and other digestive problems.

While orthorexia is not formally classified in the DSM-5 (the standard diagnostic manual for mental disorders), its cases have greatly increased in recent years. Without robust diagnostic criteria, it’s hard to pinpoint how many in the U.S. grapple with this condition. A 2021 review indicated varying prevalence rates in different regions—from 6.9% in Italy to a staggering 88.7% in Brazil. Other studies suggest higher rates among specific groups, such as Instagram users and nutrition students.

Beyond physical health concerns, orthorexia can drive mental and emotional challenges. Relationships with food may become obsessive, leading to shame and guilt. Rugless mentions that people may even avoid social situations where they cannot exercise control over their food choices, which can severely hinder their quality of life.

In contrast to other eating disorders like anorexia and bulimia, where the focus may primarily be body image, orthorexia typically begins with the intention to eat as healthily as possible. However, this good intention often gets twisted. Fox describes it as a new form of attack from diet culture, fueled by media and social media promoting various restrictive eating practices.

Signs and Symptoms of Orthorexia

Distinguishing between healthy eating and orthorexia can be challenging. Rugless suggests looking for signs of rigidity. If someone is categorizing foods as “good” or “bad” and eliminating entire groups without medical reasons, that might indicate a deeper issue. They might decline invitations to dining out or carefully bring their own meals. A heavy focus on food research or spending beyond what’s feasible on health foods can also raise red flags.

Individuals struggling with this disorder often concentrate on avoiding anything they deem “harmful” and instead prefer foods they consider “pure” or “clean.” Fox notes a tendency for individuals to become quite moralistic about food choices. If a friend displays judgment about what you or others eat, that might signal an unhealthy mindset.

If you suspect you or someone you know might be dealing with orthorexia, it’s wise to consult a therapist. Here are a few reflective questions recommended by Fox:

• Does your diet cover a variety of food groups?
• How does your diet affect your overall feelings?
• Does food consume a substantial part of your thoughts?
• Is the cost of your diet reasonable?
• Can you enjoy social events that involve food?

Diagnosing and Treating Orthorexia

Since orthorexia isn’t officially recognized, there aren’t set clinical guidelines for its diagnosis. However, behaviors like fixating on “harmful” foods and avoiding specific restaurants can suggest the presence of this eating disorder.

Working with a mental health professional and a dietitian can provide valuable guidance for managing orthorexia, according to Fox and Rugless. Therapists may employ cognitive behavioral therapy (CBT) to help individuals challenge harmful beliefs about food and establish a balanced diet.

When to See a Doctor

If you think you might struggle with orthorexia or another eating disorder, it’s a good idea to consult an expert. Look for therapists who specialize in eating disorders, or seek certified professionals. Resources are available through organizations that focus on eating disorders.

If you’re experiencing symptoms like anxiety around food, fatigue, or obsessive thoughts about eating, reaching out for assistance is crucial. Additionally, if there are physical concerns, checking with a doctor can ensure you’re receiving necessary nutrients.