Written by Andrea Clares
We live in a world where people are constantly being bombarded with extreme health messages, contradictory dietary approaches, fitness apps, health foods and supplement miracles which portray health as a quick fix and something to be earned. It isn't surprising many people are feeling confused and overwhelmed over what they should eat and what's problematic, is when an emotional response towards food and health develops and leads 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/detox their body. People with this condition will scrutinise the quality of each and every food they buy, how it's prepared and cooked.
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). Orthorexia has many similarities to anorexia nervosa (AN) and so someone could be diagnosed with this as well if they meet the criteria, or have AN which morphs into orthorexia as someone recovers of their behaviours change.
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
Low energy levels, weight loss, poor concentration, recurrent colds
This obsessive and compulsive way of eating can impact all areas of someones life including psychological, emotional and physical health. Malnutrition can result from cutting out specific food groups 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 ingredients and not having control of cooking methods used.
Where to get help
If you’re concerned or know of anyone who may be experiencing any orthorexic signs speak to you GP or contact the Beat helpline. Seeking help can be scary and is definitely not a sign of failure. It is an opportunity to learn, grow and recover to live a truly healthy and fulfilling life!
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 is a registered dietitian working in private practice and as an eating disorder specialist dietitian in London's leading private mental health hospital. As a freelance dietitian, Talia not only offers 1:1 consultations but can present at your workplace, create recipes or articles or host a cooking demonstration. To enquire please fill out a contact form.