How To Recognize and Understand Orthorexia

When people hear the term “eating disorder,” they may commonly associate this phrase with one of the illnesses that is more commonly known, such as Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder. However, Orthorexia is a much lesser known eating disorder making it more difficult to understand Orthorexia.

To Understand Orthorexia Know What It Is?

The Academy of Nutrition and Dietetics defines Orthorexia as an unhealthy fixation on eating healthy or “pure” foods [1]. This disorder is typically characterized by an extreme obsession with avoiding foods perceived to be harmful or unwholesome. Literally translating from the Greek to mean “correct diet,” this phrase was first presented by Steven Bratman, M.D. in 1997 to describe this condition that resembles other eating disorders [2].

Unlike Anorexia and Bulimia, however, Orthorexia differs in that its preoccupations concern the quality of food rather than the quantity of food [3]. Another difference between Orthorexia and the more common eating disorders is the underlying motive which makes it hard to understand orthorexia.

For example, Anorexia is characterized by significant weight loss and a fear of weight gain, whereas with Orthorexia, weight loss might not necessarily be the goal but rather the desire to establish feelings of health, cleanliness, and pureness, particularly through their eating habits and food choices.

While Orthorexia is not listed as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders or recognized as a mental disorder by the American Psychiatric Association, it is largely used by health practitioners who have observed the conditions characterized by this eating disorder [4].

The Effect of Diet Fads on Orthorexia

With the ongoing saturation of new diet fads promoted through the media and the often contradictory dietary advice, this disorder is, unfortunately, becoming more common in our society today.

While the notion that the preoccupation with eating “healthy” could potentially develop into an eating disorder, it is important to understand what distinguish this disorder from just simple healthy living.

Orthorexia exhibits an obsession with wholesome eating to the point where health may become compromised or jeopardized.An individual who may be struggling with orthorexia typically experiences an intense fear of food, viewing food as something that should be controlled with rigid rules and behaviors.

While an individual who is struggling with Orthorexia may initially begin a diet fad with the intention of becoming “healthier”, it can progressively become extreme, leading to potential health consequences, as with other eating disorders.

Orthorexia will also jeopardize a person’s overall quality of life, potentially impacting their relationships, social life, career and ability to fulfill their normal, daily responsibilities.

Related Reading

• Who Is at Risk for Orthorexia?
• Utilizing the Resource ChooseMyPlate.gov
• Should We Think Poorly of the Word ‘Diet’?
• The Concerns of “Fitspiration”
• The Rate of Orthorexia In Men Is Growing
• Could You Benefit From Nutritional Counseling
• Maintain Nutritional Balance at University

How to Understand Orthorexia?

Common behaviors to be aware of include the following:

• Elimination of entire food groups in attempt for a “clean” or “perfect” diet
• Severe anxiety regarding how food is prepared
• Avoidance of social events involving food for fear of being unable to comply with diet
• Thinking critically of others who do not follow strict diets
• Spending extreme amounts of time and money in meal planning and food choices
• Feelings of guilt or shame when unable to adhere to diet standards
• Feeling fulfilled or virtuous from eating “healthy” while losing interest in other activities once enjoyed

These extreme behaviors go beyond attempts to live healthily or lifestyle changes as they can negatively influence a person physically, emotionally, and mentally. As Orthorexia progresses and develops, it can truly mimic damaging effects seen in Anorexia and Bulimia, such as malnutrition from dietary restrictions, social isolation, and emotional instability.

Seeking Treatment for Orthorexia

Though a lesser known and understood disease, Orthorexia is indeed a form of disordered eating that can result in irreversible health difficulties if left untreated. Many individuals who suffer from Orthorexia may benefit significantly from eating disorder treatment to address underlying issues that may be fueling this disorder. Treatment for Orthorexia can occur at various levels, depending on the severity of the eating disorder.

In order to determine the most appropriate level of care for treatment, it is important to have an assessment completed by an eating disorder specialist. Some individuals may initially require care in a more acute environment in order to achieve medical and/or psychiatric stabilization. Having comprehensive treatment is also necessary for addressing the many complex factors that may be involved with orthorexia.

As with Anorexia, Bulimia, and Binge Eating Disorder, there is hope for recovery and freedom from the bondage involved with Orthorexia. The battle for recovery and freedom can often feel isolating, but you must first understand Orthorexia to begin the healing.

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References:

[1] Hobart JA, Smucker DR. The female athlete triad. Am Fam Physician.  2000 Jun 1; 61 (11): 3357-64, 3367.
[2] De Souza, Mary Jand. “The Female Athlete Triad”. Powerbar. Accessed 10 September 2013.
[3] Hobart, Julie A., et al. The Female Athlete Triad. Am Fam Physician 2000 Jun 1;61(11);3357-3364

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About the authors:

Jacquelyn Ekern, MS, LPC – President and Founder of Eating Disorder Hope

Jacquelyn founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her golden retriever “Whisky”, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.

Crystal Karges, MS, RDN, IBCLC

Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. Combining clinical experience with a love of social media and writing,

As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her work with EDH and nutrition private practice.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Reviewed And Updated By: Jacquelyn Ekern, MS, LPC on April 16, 2019.
Published June 13, 2017, on EatingDisorderHope.com