Health / Expert Advice

Everything You Need to Know About Orthorexia

How to identify when following a clean diet goes too far.

It seems like we’re always admiring people who can stick to strict diet plans, whether it’s clean eating, paleo, sugar-free, vegan and so on. They have amazing willpower and are doing so much good for their bodies, right? Well, it depends. In fact, an obsession with healthy eating can actually be detrimental, both to your wellbeing and to your health. It’s called orthorexia and here’s what you should know about it.

What is orthorexia?

Orthorexia is an unofficial eating disorder. It’s when dieting or “healthful” eating becomes a fixation that consumes a person’s thoughts and actions. According to the National Eating Disorders Association, doctors aren’t clear on whether orthorexia is its own eating disorder, whether it’s a type of anorexia, or whether it’s a type of obsessive-compulsive disorder.

The term “orthorexia” first came about in the ‘90s, so it’s relatively new and still being studied. And, it’s unclear as to whether or not a healthy eating obsession is more widespread than it was in the past or whether people are just more aware of it now.

One thing that’s for certain though: Today’s diet culture can definitely contribute to the problem. “Today, the ability to access information about ‘clean eating’ is easier than ever before,” notes Neeru Bakshi, MD, FAPA, medical director of Eating Recovery Center, Washington. “And, for people who may already have anxiety about their health and wellness, the information online may further propagate how they choose to act regarding their eating, even though the validity of the information being presented may be questionable.”

Dangers of Orthorexia

This obsession shouldn’t be confused with willpower; in fact, it often debilitates the person. “People with orthorexia can become consumed with what and how much to eat,” says Dr. Bakshi. “This develops into a rigid eating style with a fixation on eating ‘well,’ which can crowd out other activities, interests, and relationships, and can cause health issues.”

In fact, orthorexia can be downright dangerous. It can lead to malnutrition since food restriction will prevent the person from getting enough nutrients. Many of the health consequences are similar to those of anorexia: heart trouble, gastrointestinal woes, neurological problems, anemia, and more. Orthorexia can also lead to overeating during times of stress or “cheating,” since the body has become so deprived.

Causes of Orthorexia

There aren’t specific risk factors for orthorexia, but it’s important to know that it can begin when someone enters a severely restrictive diet with an expectation that it will change their life. “Orthorexia often starts out as an innocent attempt to eat more healthfully, but this attempt can take a turn to a fixation on food quality and purity,” says Dr. Bakshi. “[It] appears to be motivated by health, but there are underlying motivations, which can include safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.”

Symptoms of Orthorexia

How would someone know they’ve crossed the line past healthy eating into orthorexia? The short answer is that it starts to interfere with their lives. In some cases, they may start experiencing health problems because of their food restrictions. They might exhibit compulsive behaviors, such as checking nutrition labels obsessively. They might be spending too much time worrying about food or reading “healthy lifestyle” blogs or social media accounts. Or, they might get stressed out when healthy foods aren’t available, or they may stop attending social events because of the food that will be served.

“Someone’s self-esteem can get tied up in the purity of their diet,” says Dr. Bakshi. “Often, people with orthorexia think of themselves as being better than others who cannot eat similarly to themselves and will punish themselves for ‘slip-ups.’”

Dr. Bakshi recommends that anyone who is concerned that they have or are developing orthorexia ask themselves the following questions:

If you answer the above with more yeses than noes, your eating habits may be hurting your health and well-being.

Help for Orthorexia

Like with other eating disorders, the first step in healing orthorexia is to acknowledge that it’s a problem. “The next step is reaching out for help from trained eating disorder professionals,” says Dr. Bakshi. “Trained therapists, dietitians, and physicians can help figure out the underlying causes of the illness and then [suggest] steps to deal with those.”

Even though there’s still much research to be done on orthorexia, trained professionals can help a person with orthorexia understand their obsession with food and make a plan to gradually re-introduce foods into their diet and get them on a path to truly healthy eating.

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