Orthorexia: The ‘healthy eating’ disorder

There are a lot of food trends gaining popularity at present: paleo, gluten free, dairy free, clean eating, the 5:2 diet. But information about what is considered healthy comes from a variety of sources, and they aren’t always credible. This can have damaging consequences for people at risk of developing Orthorexia Nervosa.

‘Orthorexia Nervosa’ is a term coined in the mid ‘90s to describe ‘a fixation on righteous eating’. The term comes from the Greek ortho (‘correct’) and orexis (‘diet’). In orthorexia, what initially starts out as a pursuit for healthy eating slowly turns into an obsession. People develop strict rules and forbid themselves from eating food they consider to be ‘impure’, ‘unclean’ or ‘polluted’. Orthorexia goes beyond enthusiasm for healthy eating, as the relationship with food becomes emotionally disturbed and leads to distress and negative consequences in the person’s day-to-day life.

People with orthorexia may start to cut out whole food groups – for example, meat, dairy, or gluten – that they consider ‘unhealthy’, or eliminate anything with additives or artificial flavours. They may also hold the belief that doing so can prevent or cure particular diseases. Their dietary restrictions may escalate over time, and may include more frequent or severe ‘cleanses’ aimed at ‘detoxifying’ or ‘purifying’ their bodies.

Ironically, this drive for healthy eating can lead to poor health outcomes such as malnutrition and other medical complications due to the restricted diet.

Orthorexia Nervosa is not yet listed in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM), the book used by psychologists to assess and identify problems experienced by their clients. However, many people find it a useful term to describe the difficulties their obsession with ‘healthy’ eating is causing, and it has been suggested that it be included in future editions of the DSM. Below are some common behaviours and signs which may indicate someone is struggling with orthorexia:

  • Excessive worrying about or preoccupation with food;
  • Feelings of shame, anxiety, or guilt after breaking a self-imposed ‘rule’ about food;
  • Spending extreme amounts of time and/or money in preparing meals;
  • Avoiding social activities involving food due to a fear of being unable to comply with self-imposed food ‘rules’;
  • Positive body image, identity, or self-worth are tied up with sticking to this ‘healthy’ diet;
  • Criticism or feelings of superiority toward others who don’t follow the same diet;
  • Regarding food as a source of health rather than pleasure.

If you or someone you know is experiencing negative side effects of a preoccupation with ‘healthy’ eating, you should know that treatment is available to help build a healthier relationship with food. Treatment usually benefits from a partnership with several professionals, such as a psychologist to help develop skills to manage difficult thoughts and feelings, and a dietician to provide accurate, scientifically-supported information about food and diet.

Our clinical psychologists are experts in helping people with difficult eating and dieting behaviours, and are passionate about helping people live full, healthy, values-driven lives. Please get in touch if we can help you in this area.