Beyond “Clean Eating”: A Look at Orthorexia and 8 Warning Signs You May Be at Risk

If you tune into diet culture for more than five minutes (even unintentionally… because, let’s be honest: it’s hard to dodge it), you’ll notice that there is a constant stream of conflicting messages telling us that everything we consume – from our favorite dessert to the type of water we choose to drink – is actually *bad for us,* may contain *toxins,* and is detrimental to our future health and wellbeing, too. These kinds of messages can make it daunting and confusing for anyone to make informed, individualized choices about the foods and drinks they consume. 

And let’s start there. There is not an inherent problem with wanting to consume foods and drinks that make you feel good. Orthorexia begins to be a concern when there is an obsession or fixation on “eating clean” or consuming what one perceives to be “healthy foods.” Sometimes this fixation is accompanied by fear of what will happen to one’s health if they consume an “unhealthy” or “impure” food. Because “eating clean” and latching onto restrictive diets is widely accepted as being “disciplined,” orthorexia can be a) challenging to identify and b) easily be overlooked and misattributed as someone leading a “healthy lifestyle.” This obsession, though, can have serious implications on our physical, mental, and psychological health.

Understanding Orthorexia: Who's At Risk?

One primary difference between orthorexia and other eating disorders is the drive behind the mindset and behaviors. The desire to be healthy or to “avoid toxins/impure foods” that may be in foods and drinks, not necessarily by the desire to lose weight or change the appearance of your body, is the primary driving force behind the consumption or avoidance of certain foods is primarily. 

There are many flaws in the diet culture messaging that leads many of us to question our food choices to begin with: labeling foods as “good” and “bad,” villainizing entire food groups, assuming that what may be the best decision for one body is automatically the best decision for another. Internalizing this messaging in conjunction with other psychological, biological, social, and emotional factors could lead to the development of orthorexia.

Those who have a history of another eating disorder or disordered eating patterns may be at an increased risk for orthorexia. Sometimes those with another eating disorder can develop orthorexia either concurrently or during their recovery journey. When in recovery from another eating disorder, orthorexia can initially feel like a “safe” and acceptable way to relate to food, but some of the psychological impacts are the same of those associated with anorexia, bulimia, and binge-eating disorder.  Athletes are also at an increased risk for orthorexia due to the hope to optimize athletic performance by means of diet control. Perfectionism and OCD are also risk factors for developing orthorexia.

Warning Signs You May Be at Risk for Developing Orthorexia

1. Cutting out entire food groups

Eliminating entire food groups that are deemed as unhealthy is very common with orthorexia. Some of the common food groups people eliminate include processed foods, sugar, meat, dairy products, carbohydrates and/or gluten. This is not to be confused with those who cut one (or more) of these because of an allergy or other medical reason. But if the food elimination is driven by fear or obsession with health or purity, it may be an indicator that there is an unhealthy pattern developing.

2. Fixating over the quality of the food you’re eating

This is often at the core of orthorexia; the focus is not so much about the quantity of food that you’re eating, but about the quality of the food that you’re eating. This can be to the point where someone will only eat foods that are whole, raw, vegan, or refined-sugar free in an attempt to maintain the purity or level of health of the food that you are consuming. The fixation becomes obsessive in nature, and it can lead to daunting grocery shopping trips, extensive (and expensive!) meal planning routines, and feeling overwhelmed when in a situation where the quality of food is in question.

3. Inflexible eating patterns

 Rigidity with food consumption is a common characteristic of one who is suffering from orthorexia. There is often no desire or allowance for flexibility in the foods that someone with orthorexia eats. When struggling with orthorexia, someone may avoid anything that is  “bad” or “unhealthy,” OR any foods that they have not carefully assessed for purity or health benefits. Tracking, assessing, and avoiding foods that are “not allowed” can cause significant distress.

4. Obsession over health consequences of eating certain foods

There can be an  excessive amount of research about the impacts of certain foods, ingredients, or food groups when someone is struggling with orthorexia. Someone with orthorexia may spend a large amount of time gathering research about and trying to anticipate the health consequences of the foods in question.

5. Heightened Anxiety When Breaking a Food “Rule”

Experiencing a strong emotional reaction when either intentionally or accidentally breaking a food rule is another characteristic of orthorexia. Straying from self-prescribed food rules can lead to shame, guilt, intense anxiety, or depression. In my own personal experience, I once cried for an entire weekend about the health consequences I may incur due to the nitrites in the turkey bacon I had consumed. I became so fixated on the potential impact of the nitrites that I could not do anything other than research, seek out the advice of my doctor and nurse friends, and try to believe that I had not done irreversible damage to my body by eating nitrites. It sounds extreme, but for someone in the throes of disordered eating – orthorexia in this case – it feels rational.

6. Social Isolation

Food rules and fears can become paramount in the life of someone with orthorexia, leaving them feeling socially detached from others even when they are in social situations. It can also lead to someone physically retreating from social situations for a multitude of reasons: attempts to avoid situations where there are not “safe” food options or because of the mental health impacts of the orthorexia itself. As is often the case with other eating disorders, those with orthorexia may find that their desire to “be social” diminishes at the hand of their fixation on food, food choices, and the pursuit of attaining or maintaining a certain “level of health.”

7. Feeling powerful or experiencing a self-esteem boost when eating “healthy” foods

Feeling good about our food choices is not a bad thing, but deriving our self-esteem or sense of worth because of food choices may be a warning sign that someone may be struggling with orthorexia. Our self worth does not fluctuate with the type of food we consume, so dismantling this association is necessary to engage in the healing process.

8. Thinking critically or others who don’t follow the same diet(s) or rules

When our brains convince us that food is hierarchical, it can become instinctual to start feeling critically about the food someone else does (or doesn’t) eat the same way we do. Many times, this thinking is unintentional, but if you are struggling with orthorexia, you may find that you are “grossed out” by someone else’s food choices when you go out to eat, or you may feel an overwhelming desire to provide some insight as to how and why someone else’s food decisions are unhealthy. 

Seeking Help for Orthorexia: You Are Not Alone

If you find yourself identifying with any of the orthorexia warning signs mentioned above, consider talking to a therapist or dietician about your concerns. Remember, it is not inherently wrong to want to consume foods that make you feel good and support your health, but an obsession with consuming only "pure," "clean," or “healthy” foods can actually end up being detrimental to your physical and mental health. If you are riddled with feelings of uncertainty or shame, or even reluctance at the idea of connecting with someone about getting help, know that you are not alone, and you don’t have to walk through the unpacking and healing journey alone. A life on the other side of food rules, obsession, and fixation is possible for you, and, when you’re ready, we are here to walk alongside you on that journey.

By: Erika Muller, Assistant for Wildflower Therapy LLC

All images via Unsplash

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