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What is Orthorexia?


What is Orthorexia on burlap with pink flowers

By: Rachel Dodson, RD, LDN


The other day, I was listening to a podcast episode of a Registered Dietitian explaining that if our relationship with food was on a spectrum of a healthy/intuitive relationship with food — disordered eating — a full-blown eating disorder, sadly most people would fall in the middle floating around having a disordered relationship with food. The dictionary definition of disorder is, “a state of confusion.” Unfortunately, so many of us probably resonate with having a confusing relationship with food and our bodies. Someone’s pursuit of “health” can quickly become unhealthily striving for perfection.


What is Orthorexia?

Orthorexia nervosa is not yet recognized as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but is a term used to describe an unhealthy obsession with healthy eating. Orthorexia nervosa is an eating disorder that involves a fixation on healthy eating. A person with the disorder may focus so much on optimal nutrition that it impacts other aspects of their life. Obsessiveness is the very nature of orthorexia and it’s disabling. The word "orthorexia" is derived from the Greek words "orthos," meaning "right," and "orexis," meaning "appetite." Essentially, it's an obsession with eating "right" or "clean" foods to the point where it becomes detrimental to someone's physical and mental health.


The proposed diagnostic criteria include:

  • dietary theory or set of beliefs about healthy foods

  • exaggerated emotional distress in relationship to food choices that are perceived as unhealthy

  • clinical impairment because of compulsive dietary behaviors and mental preoccupation


Signs and Symptoms of Orthorexia

Identifying orthorexia nervosa can be difficult because the behaviors associated with it often mirror those of what our society may glorify as a “health-conscious person.” Some common signs and symptoms include:


  • Obsessive concern with food quality

This may look like spending excessive amounts of time researching and sourcing the “purest, healthiest” ingredients or spending unusually large amounts of time planning, buying, and preparing meals they perceive as healthy, to the point that it interferes with other areas of life

  • Strict dietary restrictions

This may look like following a highly restrictive diets or eliminating entire food groups despite having no medical, religious, cultural, or ethical reason for doing so or categories that make it challenging to dine out or eat socially

  • Anxiety and guilt when eating foods they perceive as “unhealthy” and social isolation

This could be avoiding social gatherings or situations that involve food, fearing they won't be able to adhere to their strict dietary rule or spending an unusual amount of time reviewing menus or thinking about the foods served at events; someone may bring premade meals to events as a result of the belief that other people’s food will not meet their standards of “healthy”

  • Over time, orthorexia can lead to physical symptoms such as malnutrition, extreme weight loss as a result of food restriction, fatigue, and other health issues due to a lack of balanced nutrition


pink flowers

Causes and Risk Factors of Orthorexia

Several factors may contribute to the development of orthorexia nervosa:

  • Individuals struggling with perfectionism may be more prone to developing orthorexia, as they strive for an idealized version of health

  • Pressure from diet culture and wellness influencers on social media can exacerbate an individual's obsession with healthy eating

  • Individuals who have a history of anorexia nervosa or bulimia may be at a higher risk of developing orthorexia

  • Individuals struggling with high levels of anxiety or OCD, may increase the likelihood of orthorexic behaviors


Impact on Mental Health of Orthorexia

Orthorexia nervosa can take a significant toll on an individual's mental health. The constant preoccupation with food and dietary rules can lead to anxiety, depression, and social isolation. Someone’s self-worth becomes intrinsically tied to their adherence to a specific diet.


Treatment and Recovery for Orthorexia

Recovery from orthorexia nervosa often requires professional help with a variety of treatment approaches that may include:

  • Psychotherapy: Cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) can help individuals address their unhealthy thought patterns and behaviors related to food

  • Nutritional counseling: Working with a registered dietitian can help individuals establish a balanced and sustainable approach to eating

  • Support groups: Connecting with others who have experienced orthorexia can provide a sense of community and understanding


What is the definition of “healthy?”


happy smiling plus size woman

I think it’s important to acknowledge that we have a very skewed definition of what it means to be “healthy.” Health goes far beyond just what you eat and how you move your body. Do these things matter? Of course, they do, but they are not the only things that matter. Your mental and emotional well-being matter. Are you getting enough sleep? How are you managing stress these days? Do you have a supportive community? If you are saying no to dinner with friends or a date because of what foods may or may not be served, that’s not healthy. If you are sacrificing sleep in order to meet your demanding workout regimen, that’s not healthy. When we broaden our horizons on what it means to pursue health - physical, emotional, mental, spiritual, and social health - I truly think we can become who we were created to be. You are a whole person and deserve to be cared for as one. You are much more interesting than the foods you are and remember, ALL foods are part of a healthy diet.


References:


Other Mental Health Services Offered in PA, NJ, DE, SC, and FL


We offer a wide variety of services related to eating disorder recovery including trauma therapy! We offer Weekly Support Groups, Nutrition Services, and Family and Parent Therapy as well as Coaching, all tailored to meet the specific needs of the individual. We offer our services for Anorexia, Bulimia, Binge Eating, and Orthorexia online in New Jersey, Delaware, South Carolina, and Florida! We are here to offer our support and understanding in a safe and non-judgmental environment.


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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


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