What is orthorexia?

It seems that now more than ever society is keen on ‘clean eating’. While taking an active interest in your diet and health is largely a positive movement, for some it can become an inhibitive and even harmful preoccupation. This is known as orthorexia nervosa. It is not clearly defined whether orthorexia is classed as an eating disorder or a form of OCD. Orthorexia is characterised by obsessive thoughts about food, strict categorising of foods into ‘healthy’, ‘clean’, ‘good, and ‘unhealthy’, ‘toxic’, and ‘bad’.

People with a history of disordered eating may be more susceptible to developing orthorexia. Orthorexia can be viewed as an escape from other eating disorders, a way of maintaining the control and self-discipline that often characterises conditions such as anorexia nervosa, under the guise of a healthy lifestyle. In reality, orthorexia supports these harmful thought processes and behaviours.

Signs of orthorexia

If you are living with orthorexia, you may feel a sense of control in healthy eating, and equally a sense of shame at the idea of eating foods you deem to be unhealthy. Words like ‘toxic’, ‘bad’, ‘unclean’, ‘impure’, ‘contaminated’ come to be associated with the person rather than the food, and self-esteem becomes reliant on sticking to permitted foods.

You may exhibit obsessive behaviour, satisfied by sticking to a strict diet, and experience exaggerated emotional responses if you deviate from this diet, or even think about doing so. These strict self-imposed rules may create fear and anxiety revolving around ideas of disease, impurity and a lack of discipline.

‘Clean eating’ in people with orthorexia has the potential to escalate, to the point where you may eliminate entire food groups, avoid eating socially or even being in situations where others around you are. Your relationships and social life may become impaired, as you begin to judge others on their food choices and struggle to connect with them authentically.

You may find most of your day is taken up with thoughts about food and get stuck into a cycle of reward and punishment, where your sense of self and body image is entirely dependent on your adherence to your self-imposed diet. Orthorexia can eventually lead to malnutrition, and resulting cognitive impairment; this is harshly ironic considering healthy eating is meant to be just that, healthy.

Orthorexia is understandably inhibitive and harmful to one’s mental health. It is becoming more common, and if you recognise yourself or a friend or loved one as exhibiting these signs, it may be time to consider getting help.

Is it wrong to eat a healthy diet?

The short answer is no. Ensuring your body receives enough energy for your daily activities is important; it’s also important to take pleasure in eating. Studies have shown that our expectation of enjoying food actually affects the amount of nutrients we absorb from that food when we eat it.

Healthy eating might have become unhealthy if you answer yes to some of the following questions:

• Do you spend a large portion of your day planning, preparing, analysing food?
• Do you find it difficult to maintain social relationships because of intrusive thoughts about food inhibiting conversation and relaxation?
• Do you feel good about yourself when you stick to your diet and experience self-loathing when you deviate?
• Do you wonder how people around you could possibly eat the food they eat?
• Does it seem difficult to you to eat a meal prepared by someone else?

Dr Bratman, who coined the term orthorexia in 1996, and also suffered from the condition, said: “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong. The poetry of my life was disappearing. My ability to carry on normal conversations was hindered by intrusive thoughts of food. The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach. I was lonely and obsessed…I found it terribly difficult to free myself. I had been seduced by righteous eating. The problem of my life's meaning had been transferred inexorably to food, and I could not reclaim it.”

How can counselling help with orthorexia?

In a society that increasingly reveres ‘wellness’ and ‘clean eating’, a person with orthorexia can feel justified in their actions, believing that everyone else has the problem, and not them. Once a person with orthorexia is happy to seek help, recovery is entirely possible. A professional therapist could help, by working on the emotional triggers and responses that may have become entrenched, helping eliminate harmful patterns of thought and behaviour, and working with the client to resolve issues around anxiety, fear, guilt and shame.

A therapist will support a person with orthorexia to develop a kinder relationship with food, elevate their sense of self-worth and find ways better ways of feeling in control. 

Find a therapist who specialises in disordered eating

Last updated 5 April 2022