Written by Andrea Clares
We live in a world where we are constantly bombarded with extreme health messages, contradictory dietary advice, fitness apps, health foods and miracle supplements. The marketing of the wellness industry portrays health as a "quick fix" and something that can be bought or earned. It isn't surprising that many people are feeling confused and overwhelmed with what they should or should not eat. What is problematic, is when an emotional response towards food and health develops, leading to extreme and destructive behaviours.
Orthorexia was coined by Stephen Bratman and is characterised by an unhealthy obsession with eating correctly and clean. People with orthorexia are unable to detach from a set of rigid and restrictive rules which dictate what they can and cannot eat in an attempt to "purify" or "detox" their body. People with this condition will scrutinise the quality of each and every food they buy, how it is prepared and the way it is cooked.
Read our thoughts on The Best Detox Diet.
This form of disordered eating has not yet been formally recognized in the Diagnostic Statistical Manual (DSM-V) - the bible for the diagnosis of psychological and psychiatric conditions - due to its novelty and lack of treatment and diagnostic standardisation. Currently, the most common diagnostic tools are the ORTO-15 questionnaire and BOT (Bratman Orthorexia Test).
Whilst not yet officially recognised as a a standalone diagnosis, orthorexia falls under the umbrella of OSFED (Other Specified Feeding or Eating Disorder). Orthorexia has many similarities to anorexia nervosa, so someone could be diagnosed with this as well if they meet the criteria, or have anorexia which morphs into orthorexia during recovery or their behaviours change.
Warning signs of orthorexia
People suffering from orthorexia are often applauded and complimented by their peers for their disciplined and constant effort at sticking to and never failing at their good health habits - a social response to be expected in a society obsessed with health and dieting. It has almost become a new level of normal. The following are some red flags which can help recognise when healthy eating has been taken to the extreme and become a risk for physical and mental health:
Eliminating entire food groups or foods (e.g. carbohydrates, sugar, fat, gluten or dairy), in an attempt to make the diet healthy
Obsession with eating in a healthy way which may interfere with other aspects of life e.g. Relationships
Spending a long time reading food labels, grocery shopping and meal prepping
Avoiding social events involving food to prevent breaking dietary rules
Watching, researching and copying fad diets
Feelings of guilt, anxiety or low mood, especially about eating “clean” foods
Extreme daily exercise regimes - read more on How To Overcome Unhealthy Exercise
Low energy levels, weight loss, poor concentration, recurrent colds
Consequences of orthorexia
This obsessive and compulsive way of eating can impact all areas of someones life including their psychological, emotional and physical health. Malnutrition can result from cutting out specific foods and food groups with nutrient deficiencies, digestive issues (such as constipation), amenorrhea (lack of menstrual periods), and osteoporosis all common side effects.
Anxiety, depression and social isolation can also develop. Social isolation can happen as individuals avoid attending any events which involve food due to fear of eating certain foods and not having control of cooking methods used.
Where to get help for orthorexia
If you are concerned or know of anyone who may be experiencing orthorexic signs, speak to your GP or contact the BEAT helpline. Seeking help can be scary but it is definitely not a sign of failure. It is an opportunity to learn, grow and recover to live a truly healthy and fulfilling life!
If you would benefit from specialist 1 to 1 support from our eating disorder dietitians, please get in touch to book a free 15 minutes discovery call.
Andrea Clares, ANutr
Andrea is a Registered Nutritionist and Intern at TCN! Her mission is to empower and equip you with all you need to live a healthy and fulfilling life, diet and guilt free. You can find Andrea on instagram @andreacm_nutrition and check out her website here.
Talia Cecchele Nutrition is a team of registered dietitians that specialise in eating disorder recovery, disordered eating, digestive issues and sports nutrition. We aim to bring balance back to nutrition, help you to break free from food rules and find food freedom. We offer virtual consultations and group programs so whether you are based in London, the United Kingdom or around the world we would love to support you. To enquire about a private consultation please fill out a contact form.