Orthorexia: Is It a Real Problem?

Wanting to eat healthily and make the right food choices is a good attitude — but can too much of a good thing actually do you harm? In the case of "orthorexia" the answer is a definite yes.

Key takeaways:

First brought to public attention in the 1990s, "orthorexia" is a detrimental and obsessive fixation on healthy foods that can ultimately lead to negative consequences. But, is this just another buzzword, or is "orthorexia" a genuine and legitimate mental health concern deserving of research and medical support? Let’s explore the concept, how it manifests in those who might have it, the current treatment options, and how it compares to anorexia.

Orthorexia definition

Let's take a look at what "orthorexia" means:

  • An obsession with eating foods that one considers healthy.
  • A medical condition in which the sufferer systematically avoids specific foods that they believe to be harmful.

While orthorexia nervosa can be detrimental to your health, it’s actually yet to be recognized as an eating disorder in its own right by the mental health establishment.

The term was first coined by Dr. Steven Bratman in 1997 and deals with what happens when healthy eating turns into a fixation — when the perceived purity of foods becomes obsessive and detrimental to a person’s overall well-being. For example, someone who has orthorexia might only eat food that they consider to be pure and healthy, no matter what anyone else says, or evidence to the contrary.

What causes orthorexia?

As with many mental health issues, the exact causes of orthorexia continues to confound sufferers and experts alike. Despite there being no one specific reason it develops, we can look to a few of the examples below for some insights:

  • Pressure from society. Every day, we are subjected to an unprecedented onslaught of information about healthy eating and ideal body shapes to adhere to. From billboards with photoshopped stick-thin models to social media and its never-ending diatribe of different diets and body-shaping techniques — it’s possible for some people to develop an obsession with food.
  • Perfectionism. People who lean towards perfectionism are at a greater risk of developing orthorexia. They may crave control over their diet, and will often try to maintain complete control over the purity and perceived healthiness of what they eat.
  • Anxiety. Sometimes, in the face of anxiety or highly stressful situations, a person might turn to a self imposed and strict dietary regime as a coping mechanism to claw back a feeling of control.
  • Diet culture. In a country that is obsessed with body shape and the attainment of the perfect physique, new diets and exercise hacks crop up almost daily. It’s become a social norm to be on a diet, talk about diets, and share everything about diets online. Seeing an influencer posting about a restrictive diet can potentially affect vulnerable people — leading to the development of unhealthy eating behaviors.

Risk factors for the development of orthorexia

Orthorexia can affect anyone, however there are certain factors which put people at a higher risk of developing this harmful relationship to food:

  • Age. Although not exclusively, orthorexia is noted in a higher percentage among young adults.
  • Gender. Orthorexia is more prevalent in women and girls.
  • Existing personality traits. People with anxious, obsessive-compulsive, and neurotic traits are generally more at risk for developing detrimental attitudes towards food — including orthorexia.
  • Occupation. Interestingly, people with performing arts, athletic, medical, fitness, and dietary related professions are more likely to suffer with orthorexia. This could be due to the close relationship between body shape, food, and their chosen line of work.
  • History of eating disorders. If someone has had an eating disorder in the past, such as anorexia nervosa or bulimia, they may be more susceptible to being affected by restrictive eating regimes that may lead to orthorexia.

Treatment for orthorexia

While it may seem like this condition is difficult to diagnose and treat, there are many therapeutic avenues a person can pursue to regain a healthy and balanced mindset towards nutrition.

Group support

For some people, bonding with others with similar health experiences can be very healing. Support groups are an excellent way for people to have they emotions validated and to learn from other people who are at different stages of the healing journey.

Nutritional guidance

Working with a registered dietitian can help those suffering with orthorexia separate fact from fiction. A qualified professional will be able to explain exactly what nutrients the body needs to function optimally and help work out a diet plan that feels nourishing and healthy.

Talking therapy

Working with a therapist may help a person with orthorexia get to the bottom of the feelings that lead to the condition. Cognitive behavioral therapy (CBT) has shown promising results for those suffering with eating disorders and could help someone with orthorexia.

Medication

There may be, in some cases, a need to use medication to address the underlying condition contributing to the development of orthorexia. For example, if the unhealthy eating habits are a result of severe anxiety, then medication to help the anxiety may help to reduce the symptoms of orthorexia too.

Can orthorexia lead to anorexia?

Any disordered and controlled eating habits can lead to anorexia, which is a severe and highly damaging eating disorder characterized by an extreme restriction on food. A person who has orthorexia may be at risk of the condition progressing to anorexia. The disorder may shift from an obsession with healthy eating to excessive calorie restriction, weight loss, and extreme thinness.

Suffering with an eating disorder is an extremely traumatic experience for both the person suffering and their loved ones. Proper care, gentle guidance, and professional help are essential to making a full recovery and regaining a healthy perspective on nutrition.

Orthorexia vs anorexia

In order to access the proper treatment modalities, it’s important to establish the key differences between orthorexia and anorexia.

OrthorexiaAnorexia
Characterized by a desire to eat foods considered to be healthy and pure.Characterized by a desire for total control of eating habits and extreme thinness.
May or may not involve issues with weight loss.Primarily focused on extreme weight loss.
Less concerned with body image and more focused on the quality of the food.Centered around body image and feeling fat despite being extremely thin.
Treatment options involve therapy and diet support.Treatment often involves hospitalization and/or medical intervention.

Othrorexia vs healthy eating

It’s important to know when a healthy regard for eating well becomes something more serious. Let’s take a look at the main differences between orthorexia and healthy eating

OrthorexiaHealthy eating
Involves rigid and strict ways of eating.Involves educated choices around proper nutrition based on what the body needs to function optimally.
Can severely impact a person’s social life and relationships.Improves overall well being and social relationships.
Mainly driven by an obsessive need to ensure all food is “pure” and being afraid of food that is perceived to be “impure”.Driving by the desire to give the body optimum nutrition for health and longevity.

How to help someone you think might have orthorexia

If you suspect someone you know has orthorexia, approaching them gently is key to assessing the extent of the issue. Here are some do’s and don’ts:

Final thoughts

There is no doubt that navigating the world of healthy eating is confusing with contradictory advice coming from all angles. It’s difficult to sort out fact from fiction and so it’s understandable why a person might develop an unhealthy obsession with healthy food and its purported “purity”.

Taking care of our bodies and finding our own path to health and vitality is a very personal journey, but when a preference for healthy eating becomes an obsession, it’s time to reach out for help. When it comes to food and dietary habits or exercise and recreation, a truly healthy lifestyle is characterized by a balanced approach to all aspects of wellness.

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