Orthorexia: When "clean eating" & "food rules" start to RULE your life!


At what point does being health conscious or a fitness enthusiast morph from something positive and fulfilling into something problematic, or even physically dangerous?  Or, more simply put, when does your focus on health become unhealthy?  We all like to look good, eat healthy, and feel strong.  Therefore, it’s often difficult to recognize and confront when you’ve passed the tipping point and need to find a way to rebalance, or seek help.  Many of my clients are intelligent, strong, and motivated people who have simply lost control and allowed diet and exercise to dominate their existence.  On a personal level, I’ve also struggled with periods where I allowed my originally well-intentioned plans to eat healthy or stick to an exercise program to cross the threshold.  If you feel the same way, you might be dealing with some form of a disorder called Orthorexia.  In this blog, I define orthorexia and help you spot some common behaviors and warning signs associated with the disorder.

What is Orthorexia?

The simplest way to understand orthorexia is when the focus on eating healthy becomes unhealthy.  Orthorexia is a condition marked by an extreme fixation over the quality and purity of food.  It commonly results in highly inflexible eating patterns, with individuals creating rigid “food rules” which usually consists of segmenting foods that they will eat into categories “good” and/or “healthy” foods and “bad” foods, which are sometimes completely avoided.  While some people struggling with eating disorders may focus on limiting the quantity of food with which they consume, people who struggle with orthorexia typically are far more concerned with the quality of the food they intake.

By therapy/scientific standards, orthorexia is still a somewhat new and developing area.  In fact, the term “orthorexia” was not introduced until the late 1990’s.  Even today, and despite significant studies and literature addressing the disorder, orthorexia is not recognized as an eating disorder by the American Psychiatric Association and, therefore, is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). 

With that said, however, my experience as a therapist (and also as someone who has been involved with and knows many people involved with the health/fitness world and culture) is that orthorexia is becoming far more prevalent, especially among people who count themselves as healthy-eating and fitness enthusiasts.  As diet and exercise regimes become more extreme and complex, I have seen a shift away from more traditional eating disorders to new forms of disordered eating, including orthorexia, that often cloak themselves (at least initially) as being healthy.  Many people may start out feeling physically and emotionally good about their “clean eating” goals, but over time, their relationship with food becomes one that is self-punishing and driven by fear, anxiety, and shame.  Before they know it, their strict food rules dominate their daily thoughts and activities, resulting in social isolation, depression, and sometimes worse.

Signs of Orthorexia

Not everyone who “eats clean” or diets suffers from orthorexia (or any other form of disordered eating or an eating disorder, for that matter).  For some, they can still maintain a relatively healthy and balanced relationship with food, despite dieting or following some clean eating regime.  But for many among us, food – and the need to eat clean and abide by rigid rules – has the ability to take control of our lives.  If you feel that thoughts of food/food rules are interfering with your life, but you aren’t sure whether you’ve crossed the line to orthorexia, here are some warning signs and common behaviors of those suffering from orthorexia:

·  Feelings of guilt when deviating from strict diet guidelines;

·  Increase in amount of time spent thinking about food;

·  Regular advance planning of meals for the next day;

·  Feelings of satisfaction, esteem, or spiritual fulfillment from eating “healthy”;

·  Thinking critically about others who do not adhere to rigorous diets;

·  Fear that eating away from home will make it impossible to comply with your food rules;

·  Distancing yourself from friends or family members who do not share similar views about food;

·  Avoiding eating food bought or prepared by others;

·  Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies;

·  Increasing avoidance of foods because of food allergies, without medical advice;

·  Noticeable increase in consumption of supplements, herbal remedies or probiotics;

·  Drastic reduction in opinions of acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods;

·  Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils; and

·  Worsening depression, mood swings or anxiety;

I hope you’ve found this blog helpful.  As a therapist who is also certified personal trainer, and someone who has a history with health/fitness world, I strive to help clients achieve a healthy, balanced relationship with food and exercise based on the theory of intuitive eating.  I know many people struggle in silence with orthorexia, and are searching for a way to take back control.  It’s an area that I am very passionate about.  Therefore, I will be posting more on this topic in the coming months.