Orthorexia – is it an eating disorder?


Orthorexia nervosa has gained increasing attention in the press in recent years, but what is it?  Sometimes described as orthorexia nervosa, it describes those who may be seen as having “unhealthy obsessions” with otherwise healthy eating.  Orthorexia usually starts out as a harmless attempt to follow certain healthy eating rules.  However, in some cases, these rules start to become all consuming obsessions.  At this point, a person may be referred to as having orthorexia.  ‘Healthy’ dietary rules will be  followed to an extreme, and the person will become fixated on  food quality and purity.  Deviations or  ‘slip ups’ from these rigid food rules become highly distressing, and are often taken as evidence that the person is a failure, or has no will power. ‘Punishment’ is often used following any deviation from these very rigid rules, and may include fasting, increased dietary restriction or strict exercise.  Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.

Is Orthorexia An Eating Disorder?

Orthorexia is a term coined by Steven Bratman, MD to describe his own experience with food and eating.  It is not an officially recognized disorder in the DSM-V, but is similar to other eating disorders – those with anorexia nervosa or bulimia nervosa obsess about calories and weight while orthorexics obsess about healthy eating (not about being “thin” and losing weight).

Why Does Someone Get Orthorexia?

Orthorexia appears to be motivated by health, but there are often additional underlying motivations, which can include safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.

Do I Have Orthorexia?

Consider the following questions.  The more questions you respond “yes” to, the more likely it is that you may be suffering from orthorexia:

  • Do you ever wish you could spend less time on food and more time living or doing things you enjoy?
  • Do you wish that occasionally you could just eat and not worry about food quality?
  • Does you find it very difficult or anxiety provoking to eat a meal that has been prepared by someone else and not to try to control what is served?
  • Are you constantly looking for ways foods are unhealthy for you?
  • Do you spend a lot of time thinking about food or planning what you can and can’t eat?
  • Do you feel guilt or self-loathing when you stray from your diet?
  • Do you feel in control when you stick to the “correct” diet?
  • Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?

Why is orthorexia unhealthy?

When food choices become so restrictive, in both variety and calories, health suffers.  The diet of orthorexics can actually be unhealthy, with nutritional deficits specific to the diet they have imposed upon themselves.  These nutritional issues may not always be apparent as a person may continue to ‘feel’ healthy.

Social problems are often more apparent.   A person with orthorexia can easily become socially isolated, often because they plan their life around food.  They may have little room in life for anything other than thinking about and planning food intake.  Orthorexics lose the ability to eat intuitively – to know when they are hungry, how much they need, and when they are full.   Instead of eating naturally they are destined to keep “falling off the wagon,” resulting in a feeling of failure familiar to followers of any diet.

In the long term, obsessions with healthy eating will start to crowd out other activities and interests, impair relationships, and become physically dangerous.

What does Recovery from orthorexia look like?

Recovered orthorexics will still eat healthily, but they will achieve a different understanding of what healthy eating is.  They will realize that food will not make them a better person and that basing their self-esteem on the quality of their diet is irrational.  Their identity will shift from “the person who eats health food” to a broader definition of who they are – a person who loves, who works, who is fun.  They will find that while food is important, it is one small aspect of life, and that often other things  are more important!

Orthorexia, being a relatively newly recognised condition, will rarely be diagnosed by a GP however, professional help is usually required. Psychologists at The London Centre are skilled in helping people overcome the limitations of orthorexia and CAN help you.

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