Orthorexia

When Healthy Eating Becomes an Obsession

Orthorexia is a term coined by Dr. Steven Bratman in 1997 to describe an unhealthy obsession with healthy eating. Although not officially recognized as an eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), orthorexia is a growing concern among mental health professionals.

Orthorexia is derived from the Greek words "ortho," meaning correct or right, and "orexia," meaning appetite. It is characterized by an extreme fixation on the quality and purity of food, often leading to rigid food rules, social isolation, and significant distress. The prevalence of orthorexia is difficult to determine due to the lack of standardized diagnostic criteria. However, some studies suggest that it affects around 1% to 7% of the general population, with higher rates among certain groups such as dietitians, athletes, and individuals with a history of eating disorders.

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In line with the transdiagnostic approach to eating disorders, at Exhale Psychology Centre we do not see orthorexia as a distinct diagnosis but instead as a different manifestation of restrictive eating (anorexia). In our clinical experience, individuals presenting with orthorexia are highly preoccupied with food ‘purity’ but this purity is arbitrary, often related to calories, and ultimately unrelated to actual health guidelines.

It is worth noting that in popular culture (Instagram influencers, TikTok, YouTube vloggers, celebrities etc.), othorexia or clean eating is presented as a status symbol, with its lead influencers being thin, wealthy, and white (caucasian). This betrays the true associations with othorexia as not being about health and wellness but about being wealthy, white, and on trend - having a body that is on trend, eating on trend orthorexic foods, on-trend clothes, living an on-trend lifestyle etc.

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Signs and Symptoms of Orthorexia

Individuals with orthorexia may exhibit the following symptoms and signs:

• Rigid adherence to a specific diet, often involving the elimination of entire food groups
• Preoccupation with the quality and purity of food, including organic, non-GMO, and pesticide-free products
• Excessive time spent researching, planning, and preparing meals
• Feelings of guilt or shame when deviating from the prescribed diet
• Social isolation due to the avoidance of situations involving food
• Significant weight loss or nutritional deficiencies
• Impaired functioning in daily life due to the obsession with healthy eating ‍

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Orthorexia Causes and Contributing Factors

While the exact causes of orthorexia are not fully understood, there are several contributing factors that may play a role in its development. One potential cause is societal pressure to conform to a certain standard of beauty and health. In a culture that idolizes thinness and equates it to success and self-worth, individuals may become obsessed with eating "clean" as a means to achieve a desired body image. Additionally, individuals with perfectionistic tendencies may be more prone to developing orthorexia. The need to control and achieve perfection in all aspects of life, including diet, can lead to an unhealthy preoccupation with food. Moreover, personality traits such as anxiety, OCD, and low self-esteem have also been associated with orthorexia. It is important to note that orthorexia can occur in both men and women of any age, and it often coexists with other eating disorders and mental health issues.

• Societal pressure to maintain a healthy lifestyle and ideal body image
• Exposure to social media and other sources promoting extreme dietary practices
• A history of eating disorders or body image issues
• Perfectionistic personality traits
• Anxiety or obsessive-compulsive tendencies

To learn more about the causes of eating disorders and treatment options available, go to Eating Disorders.

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Recovery and Treatment of Orthorexia

If you or someone you know is struggling with orthorexia, consider the following tips:

• Seek professional help from a mental health professional experienced in treating eating disorders
• Develop a support network of friends and family who understand, are anti-diet culture, and support your recovery
• Practice self-compassion and challenge perfectionistic tendencies
• Limit exposure to social media and other sources that promote extreme dietary practices
• Focus on the enjoyment and social aspects of eating, rather than solely on the nutritional value of food as mental health is part of health too

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Frequently Asked Questions

Q: What is Orthorexia?

A: Orthorexia is an eating disorder characterized by an excessive preoccupation with eating healthy or "clean" foods. People with orthorexia have rigid and obsessive eating patterns and often exclude entire food groups or specific ingredients they deem as unhealthy.

Q: What are the risk factors for orthorexia?

A: The exact causes of orthorexia are still unknown, but there are several factors that may contribute to its development. These include having a history of anorexia or other eating disorders, personality traits like perfectionism and obsessive-compulsive tendencies, societal pressure to eat a certain way, and a strong desire for control.

Q: What are the symptoms of orthorexia?

A: Symptoms of orthorexia may include an obsessive focus on healthy eating, strict and inflexible eating patterns, severe distress or anxiety when deviating from these patterns, avoidance of social situations involving food, malnutrition or nutrient deficiencies, and an impairment in daily functioning.

Q: Can orthorexia lead to other eating disorders?

A: Although orthorexia itself is not officially recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it shares similarities with anorexia nervosa, bulimia nervosa, and binge eating disorder. Some people with orthorexia may develop other eating disorders if their rigid eating patterns become more extreme.

Q: What are some warning signs of orthorexia?

A: Warning signs of orthorexia may include an obsession with food choices and ingredients, a preoccupation with health and nutritional information, avoiding social events that involve food, a sense of superiority over others when it comes to food choices, and a decline in overall well-being due to restrictive eating habits.

Q: Can orthorexia be harmful?

A: Yes, orthorexia can be harmful both physically and mentally. The obsession with eating healthy can lead to malnutrition, nutrient deficiencies, and social isolation. It can also create a constant state of anxiety and distress around food, impacting a person's quality of life.

Q: Is orthorexia the same as "clean eating"?

A: While orthorexia shares some similarities with the concept of "clean eating," they are not the same. Orthorexia involves an unhealthy and obsessive focus on eating only "pure" or "clean" foods, whereas clean eating is a more general and flexible approach to choosing wholesome and unprocessed foods.

Q: Can orthorexia be identified as being "health conscious"?

A: It is important to differentiate between being health conscious and having orthorexia. While being health conscious involves a balanced and informed approach to food choices, orthorexia is characterized by an excessive and rigid obsession with eating only specific foods that are perceived as healthy.

Q: Can orthorexia be easily identified as "healthy eating"?

A: While orthorexia may initially appear as healthy eating, it goes beyond making nutritious food choices. Orthorexia involves obsessive and rigid eating patterns that can lead to nutrient deficiencies, social isolation, and a decline in overall well-being.

Q: Can orthorexia be linked to other mental health conditions?

A: There is evidence suggesting that orthorexia may be related to conditions such as obsessive-compulsive disorder (OCD) and generalized anxiety disorder. However, more research is needed to fully understand the connection between orthorexia and other mental health conditions.

Q: How can one develop a better understanding of orthorexia and eating disorders?

A: To develop a better understanding of orthorexia and eating disorders in general, it is helpful to educate oneself about the subject. Resources such as books, articles, and reputable websites, including the National Eating Disorders Association, can provide valuable information and insights.

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