From gluten-free to raw vegan, Paleo to pescetarian, restrictive “clean” diets are on the rise. Along with them comes a curious increase in references to a still officially unrecognized eating disorder: orthorexia.
While it's not in the Diagnostic and Statistical Manual of Mental Disorders (DSM), orthorexia is loosely used to refer to an obsession with healthy eating that takes over someone's life. But... shouldn’t eating healthy be, you know, healthy? Well, not always. Here’s what happens when trying to be healthy becomes bad for your health.
What is orthorexia?
The term “orthorexia” comes from the Greek words orthos (meaning right or correct) and rexia (meaning hunger or appetite). Put those two together and you have the official definition of orthorexia nervosa — an “unhealthy obsession with eating healthy food,” as coined by Dr. Steven Bratman in 1996, long before Instagramming kale salads and thigh gaps became A Thing. The reason it isn’t considered an official diagnosis yet, according to Martin Mental Health eating disorder counselor J. Casey Martin, is that there’s not enough research to support its official set of symptoms and treatment recommendations.
However, the term is getting more and more attention from medical professionals, possibly because of the public’s growing concern about what’s in their food. “Orthorexia is a rising issue, especially with information coming to the forefront about the dangers of unhealthy processed foods, hormones, factory farms, refined sugar, fast-food chains and so much more,” says blogger/author Jordan Younger, who’s recovering from orthorexia. For those who are interested in the provenance of their meals, this information can quickly turn food into a vehicle for toxins of vague origin, making eating healthy an almost impossible task.
I just started a juice cleanse. Am I orthorexic?
Probably not. The majority of people who follow clean diets do so in a healthy and balanced way. However, much like with other addictions, certain biological and psychological traits can lead people to develop rigid relationships with food. “We know that personality characteristics such as perfectionism, body dissatisfaction and low self-esteem are all correlated with disordered eating behaviors,” Martin says.
Younger describes herself as an “extreme” personality type. The longer she was vegan, the more she restricted her diet, and the more she restricted her diet, the worse she felt. “It was a vicious cycle, because my [B-12 and protein] deficiencies led to feeling imbalanced, and feeling imbalanced led to wanting to control my diet more and more,” says Younger, who tried raw veganism and “psychotically long” juice cleanses. “I let my fears about impure foods hinder my social life, academic life, and my overall well-being.”
When does eating healthy become orthorexia?
Orthorexia can show up differently depending on the person. For Younger, the physical symptoms stemmed from vitamin deficiencies: her period stopped for several months and she sustained an injury while exercising, which had never happened before. More than that, she was “obsessing” over food.
The National Eating Disorder Association suggests asking yourself questions such as, “Do you feel in control when you stick to the ‘correct’ diet? Do you feel guilt or self-loathing when you stray from your diet?” Younger suggests that when food starts to affect your life in a negative way, you might be showing signs of disordered thinking.
“If your passion for health turns into an obsession that hinders your social life and takes up more than 50% of your mind space, you know you’re developing an issue,” she says. “And if you have fears of your body becoming ‘impure’ due to foods that aren’t good for you, you may have a form of orthorexia.”
How do you treat orthorexia?
The “cold turkey” method might not work for someone with an eating disorder, even one that’s not classified in the DSM. Because of this, Martin warns that treatment can be “challenging.” At his eating disorder clinic, he first makes sure the patient is medically stable. Then he provides education and skill-based intervention to the individual and their family.
Younger’s recovery is going well, she says. She saw an eating disorder nutritionist and therapist, and in the early stages of recovery she followed a meal plan. “[It] restored my blood sugar levels, since my hormones had gotten all out of whack from my restrictive habits,” she says. “It took me about a year to level out and start feeling ‘normal’ again around food, and also for my body to balance itself back out.” She rebranded her blog (from “The Vegan Blonde” to “The Balanced Blonde”) and published a memoir, Breaking Vegan, about her experience.
So does this mean I need to put a trigger warning on my #vegangirl selfies?
Not necessarily, but you should be aware that the same personality traits that can lead to disordered eating behaviors may also be vulnerable to unrealistic social media comparisons. Martin advises those who might be prone to comparing themselves unfavorably to social media posts to “be conscious of how these idealized, Photoshopped and most probably commercially endorsed products, people, and messages in your social media feed are impacting you.” In other words, what you see on social media probably isn’t an accurate depiction of reality.
And if you or someone you care about are struggling with orthorexia, you’re not alone. Seek professional help if necessary, and consider Younger’s reassurance: “Remember that you are enough, and you will get through this.”