By: Hannah De Groot MEd.
Hello beautiful blog readers and happy holidays! This is a busy time of year for many, so we are so grateful that you are spending your precious time reading our blog. While the holidays are a time of cheer and joy for many, others experience this time of year with loneliness, stress, and anxiety. If you resonate more with the latter, know that we are here for you and are sending you compassion.
The Struggle with Food-Centered Holidays
If you or someone you love struggles with holiday meals, check out November’s post by our wonderful clinician Abby. Many of the tips she discusses can be applied to meals throughout December and into the new year. We understand that holiday meals and extra family time might be stressful for some. Remember to show yourself love and practice self-care!
Orthorexia, What is it?
In today’s post, I will be discussing orthorexia, an eating disorder that is characterized by an obsession with foods deemed “healthy” or “pure”. While an interest in nutritional value alone may not be problematic, those with orthorexia often find themselves sacrificing their mental health and well-being to meet their criteria for “health”. Despite not being clinically recognized in the DSM-5, orthorexia can be just as harmful as other known eating disorders.
Some common signs of orthorexia are:
compulsively checking ingredient lists and nutrition labels
cutting out food groups without diagnosed allergies
distress when “healthy” options are not available
excessive meal planning
an unusual interest in the health content of other peoples’ meals
Individuals with orthorexia may also struggle with excessive exercise and distress when they are unable to meet exercise goals for the day. The term orthorexia was coined by Dr. Steven Bratman, and means “fixation on righteous eating”. True to the name, people with orthorexia might use strict eating habits to unsuccessfully compensate for other shortcomings.
Shared Characteristics with Anorexia but Different Features
Orthorexia and anorexia share some similarities, however, there are a few distinguishing features. People with anorexia restrict their food intake in order to lose weight, while people with orthorexia typically eat to feel healthy or pure.
My Personal Relationship With Orthorexia
I have a personal relationship with orthorexia. When I was in college, I struggled a lot with my relationships with food and exercise. I was known as a “healthy” person, and I prided myself in being extremely devoted to my interest. I enjoyed the positive attention and the sense of identity my eating disorder gave me. For example, I would go for runs before tailgating football games and would be complemented by family and friends for how “dedicated” I was.
Inward Struggles
People often told me that they wished they could develop habits like mine. Despite the image I was portraying, outsiders did not understand the sacrifices I was making to maintain my image of health. My relationships with loved ones were suffering and I was experiencing extreme stress all the time. Skipping a day of exercise or eating outside of my strict diet made me feel guilty and unworthy. Thinking back to this time reminds me of black bean brownies, salads for most meals, and exercise with little rest - all things that make me cringe now.
Praise for the "Healthy" Lifestyle Creates Barriers to Treatment
As I mentioned, one of the biggest barriers to the treatment of orthorexia is the praise that individuals may receive for their “healthy” lifestyles. On the outside, one might conform to and exceed societal expectations of achieving wellness by strictly adhering to their diet and exercise regimen. We can all picture that social media influencer who has it all together - think “clean girl aesthetic” meets fitness influencer meets “wellness guru”. People portraying these lifestyles craft their images carefully in order to appear flawless.
This lifestyle is glorified.
Not pictured: the skipped meals with friends, the disappointment when tasting a “healthified” version of a cookie, and the stress of failing to meet unrealistic expectations of perfection.
Furthermore, receiving positive attention for behaviors leads to reinforcement, which makes habits even harder to break. When “healthy” becomes central to one’s identity, it can be hard to imagine lifestyles and relationships without it.
Holidays Can Exacerbate Eating Disorders
While battling eating disorders at any time of year is hard, the holidays seem to exacerbate them. Thanksgiving and Christmas bring up a lot of diet discussions, good vs. bad food comments, and guilt. When New Year's comes around, social media and everyday conversations seem to be full of resolutions involving weight loss and diet goals. If your experience with orthorexia is anything like mine, well-meaning family members and friends may even ask for dieting and exercise tips.
Orthorexia Therapy Can Help
Treating orthorexia is similar to treating obsessive-compulsive disorder and other eating disorders. If you have access to therapy, then cognitive behavioral therapy (CBT), exposure response prevention (ERP), and dialectical behavior therapy (DBT) can be successful methods.
CBT as a Treatment for Orthorexia
CBT can be used to identify the cognitive distortions regarding perfectionism and health that had led to orthorexia. CBT utilizes evidence-based strategies to challenge cognitive distortions and reform new beliefs about health.
ERP as A Treatment for Orthorexia
ERP is a behavior therapy that gradually exposes a client to situations that provoke anxiety. The goal of ERP is to gradually increase the intensity of exposures while treating the anxiety that occurs. This helps clients understand their resiliency and ability to face fears. Interventions from ERP might include gradually adding variety to clients’ meals, and reducing and eventually eliminating time spent reading nutrition labels.
DBT as a Treatment for Orthorexia
Lastly, DBT helps clients develop new coping strategies and positive relationships. Exposing clients to fears, such as foods previously deemed unhealthy, can trigger challenging emotions. Skills from DBT such as half smile and TIPP teach clients to accept and tolerate stress in a healthful way. Successful recovery typically involves using multiple approaches from a variety of modalities. In addition to mental health services, working closely with a registered dietitian can be beneficial for myth-busting beliefs about health, and redefining one’s relationship with food.
Closing Thoughts
If this article reminds you of yourself or someone you love, know we are sending you compassion and empathy. Recovery is possible and you are stronger than your eating disorder! If you’d like additional information on orthorexia, please feel free to reach out or check out the resources below. We wish you peace and joy during this holiday season, and are honored to share in your recovery journey!
Information on orthorexia
Cited:
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Recovered and Restored is an eating disorder therapy center founded by Gabrielle Morreale. We specialize in helping teens and young women heal from eating disorders such as anorexia, bulimia, orthorexia, and binge eating disorder and treat disordered eating, anxiety, depression, and PTSD. We provide eating disorder therapy in the towns of Horsham, Upper Gwynedd, Lower Gwynedd, North Wales, Lansdale, Hatfield, Blue Bell, Doylestown, and nearby towns with eating disorder therapy. Also providing virtual eating disorder therapy in New Jersey, Delaware, and Florida. Some towns served virtually but are not limited to Pittsburg, Lancaster, Harrisburg, Center City, Cherry Hill, Haddonfield, Mount Laurel, Cape May, Avalon, Brick, Dover, New Castle, Bethany Beach, Marydel, and Oceanview.