orthorexia

orthorexia diagnoses and treatment

If you or someone you love is overly conscious of eating “pure” foods, to the point of diet affecting your daily life, orthorexia may be the cause. Contact Galen Hope for comprehensive treatment programs that identify orthorexia symptoms and result in thorough treatment.

what is orthorexia?

Simply put, orthorexia refers to an obsession with “healthy” eating of the “right” food. In fact, orthorexia often begins as a desire to eat healthier. Depending on the individual, this could be limiting processed food, or not eating foods that are high in sugar or sodium, or that contain preservatives, animal products, and so on. These choices are often encouraged and supported by family, physicians, and society at large.  

Orthorexia is common in individuals who have not fully recovered from their eating disorders. In many ways it can be viewed as a “bargain” with their eating disorder and their treatment team so that they feel less overwhelmed by the demands of treatment. In doing this, they hope to resolve their current eating disorder by replacing it with orthorexia.  

Although people around them may see these individuals eating, what they don’t see is that the person continues to eat in a way that is highly driven by rules and labels (good food versus bad food, healthy versus unhealthy foods). These rules continue to create rigidity and often limitations in everyday life that diminish joy, freedom, and flexibility with eating. 

This is not an effective outcome, as it leaves the door open for a potential relapse. Replacing a fully symptomatic eating disorder with orthorexia is a partial recovery – and we know that full recovery is possible.  

orthorexia symptoms in adults and adolescents

Orthorexia develops when eating healthily progresses into an obsession or extreme preoccupation with what they believe to be healthy eating. Individuals may fixate on details associated with meal prep and nutrition, such as by excluding entire food groups or refusing to eat anything that is not organic.   

Orthorexia may also be accompanied by other mental health conditions, such as:

  • Obsessive-Compulsive Disorder
  • Anxiety
  • Depression

identifying orthorexia

Orthorexia can be one of the more challenging conditions to identify because, so often, it presents as being very “health conscious.” Who would argue with the idea that taking care of your health is a bad thing? And, how is this an eating disorder? It’s understandable that this may be confusing, but there are clear indicators that a person’s interest in healthy eating may have crossed over into disordered eating. 

People with orthorexia are quite rigid about the way they need to eat. While their eating patterns may appear to be based in a certain food philosophy that is popular in our culture, such as vegan, low-carb, or gluten free, the degree to which they adhere to this diet goes way beyond what would be required for their health. (Note: this would not be true for someone who actually has a disease, like celiac disease.)  

These individuals may believe that they are preventing future health consequences by being quite strict about what they eat but it interferes with their daily functioning and it can also impair the experience of others who regularly eat with them. Additionally, although they are eating what appears to be 3 meals a day, their food rules are so restrictive and rigid that, over time, they become malnourished. In everyday terms, what clinicians may consider to be a “sub-clinical eating disorder” is actually orthorexia. 

One way to know if your beliefs and behaviors related to “eating healthy” have become disordered is to identify whether you experience fear or anxiety when faced with foods that you consider to be unhealthy or off limits. Food is not something that is inherently harmful and the idea that it would cause emotions like this suggests that the thinking around good foods versus bad foods may have become much too rigid.  Furthermore, if your need to eat healthy leads you to decline social invitations, prevents you from eating in restaurants, receives complaints or criticisms from others, or if you will only attend events or travel if you can bring your special foods with you, then this has probably reached a disordered level of behavior. In general, if your food rules are interfering with your ability to engage in everyday activities or if they are reducing your ability to fully enjoy your life, this is disordered. 

treating orthorexia

The challenge in treating orthorexia centers around our culture, one that is constantly filled with information and messages about the “right way to eat” and often regards individuals with orthorexia as highly health-conscious people who are doing the right thing for their physical well-being. During treatment, then, we begin by examining functional impairment, asking questions such as: 

  • To what degree does eating this way prevent you from fully enjoying your life? 
  • Does your current diet and/or restrictions around what you can eat prevent you from being fully present?   
  • Does deviating from your prescribed diet cause you stress, fear, anxiety, or shame?   

If so, this is evidence of orthorexia. Once identified, we educate clients on principles of mindful eating and strategies to help them become more aware of their own thought processes around food, while helping them loosen the grip of disordered eating and live in a more spontaneous and flexible way. This includes building in weekly nutrition education and counseling along with extensive food exposure work in order challenge our clients’ belief systems related to food. They are encouraged and supported by their entire team to explore these beliefs and take risks in order to reduce the burden created by living with intense rules related to food, weight, and eating. Through this education, exposure, and psychotherapy, clients can examine the true roots of this kind of thinking and how it is impacting their experiences today.