It can sound counterintuitive but it’s something that is more common than most people believe: an individual becomes obsessive with “healthy eating” and finds themselves binge eating. Notice the term obsessive, this is when it becomes problematic. The thinking around healthy eating becomes dogmatic with little to no flexibility.
[Note: You’ll notice I put “healthy eating” in quotes because the term is relative and everyone thinks of something different when they hear “healthy eating”. Also, if it’s leading to binge eating and involves restricting foods, guilt, shame and impacts your mental health, it’s not truly healthy for your body or mind.]
Let’s break it down.
What is Orthorexia?
In short, orthorexia is an unhealthy obsession with healthy eating.
Common characteristics of orthorexia include:
- Food that is deemed “unhealthy” is a source of fear and often people experience intense anxiety or guilt after eating the unhealthy food.
- There is little to no flexibility to what the individual is allowed to eat. This makes eating out and traveling very difficult and anxiety provoking.
- Orthorexia causes one to be isolated and miss out on social events in fear of being exposed or tempted to eat the food that they fear is unhealthy. (A common example includes: not going to a restaurant with friends out of fear that they will eat “unclean”, this leads to isolation and missing out on fun social activities).
- Obsessive thoughts about health, and a great deal of time and/or money spent on researching health and nutrition.
- Avoiding eating an “unhealthy food” as a way to manage anxiety.
- Any deviations from what they deem as healthy is followed by extreme guilt, self-loathing and anxiety.
Orthorexia interferes with relationships and causes a lot of stress and pressure on the individual suffering from it, which in turn can impact their health. Research shows that increased stress and cortisol levels are not good for your overall health and having fear around food can be extremely stressful to suffer from.
Orthorexia vs. Anorexia
Orthorexia is not an official diagnosis in the DSM-5. Yet.
Many believe it will be included in the DSM-6.
In the meantime, without it being an official diagnosis this eating disorder can be hard for health professionals to catch.
In fact, more people who have suffered from orthorexia were praised along the way for being so intent on “healthy eating”, when in reality it was doing a lot harm.
Orthorexia is focused on “health”
- Food Quality
Anorexia is focused on thinness & weight loss
- Food Quantity
How This Leads to Binge Eating
The thought pattern behind orthorexia is very rigid. “If I’m not following my clean eating plan 100% that I am unhealthy, bad and unpure”.
So when you break a rule (which is bound to happen) you starting thinking, Well since I already had [insert fear food here]_____ I might as well have everything else I don’t allow myself to eat and I’ll start over again tomorrow. This is often labeled “last supper mentality” because you are swearing up and down that tomorrow you’ll start over and this will never happen again.
Orthorexia behaviors —> binge eating –> back to orthorexia behaviors to “make up” for the binge –> binge eating.
And the cycle continues.
What Recovery Looks Like
In therapy focusing on the anxiety behind the orthorexic behaviors is often the first place to start.
Once “healthy eating” is no longer obsessive or dogmatic, and you allow for more flexibility the body doesn’t have to respond with a binge.
Plus, you are happier because you don’t have to constantly think about food. You’re social life improves because you are able to go out to eat with more ease, have lunch dates with friends and eat desert when you want desert without feeling guilty or it leading to a binge. Once the orthorexia behaviors are worked through the binges are no longer needed.
Recovery looks different for everyone. However, flexibility around food, no obsessive thoughts, no binge episodes and reduced anxiety are all key goals.
Resource for Orthorexia
The book I’d recommend to start with is Health Food Junkie By Dr. Steven Bratman (he coined the term orthorexia). He also has a self-test on his website, linked below.
One of my favorite podcasts, Nourishing Women’s Nutrition has a podcast episode speaking to orthorexia, linked below
Help for Riding a Binge Eating Urge
Here’s NEDA’s (National Eating Disorder Association) summary on Orthorexia
Set up An Appointment to Get Help for Orthorexia
***During COVID-19 all sessions are online, via a HIPPA compliant video platform. For those struggling with body image and find video too triggering, it is possible to do video without seeing the reflection of yourself during the session. Or phone sessions are available as well.
Learn more about Danielle Swimm, eating disorder therapist in Maryland.
About Danielle Swimm, LCPC: Danielle is a therapist in Annapolis, MD. She enjoys helping others improve their relationship with food and their body. Her areas of concentration include eating disorders, anxiety, and body image improvement for adults and adolescents. She also works with a variety of disordered eating and has a passion for mind-body health. Interested in setting up a consultation? Click here to request an appointment.
Disclaimer: This is in no way a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are looking for a local professional feel free to use the contact tab to request an appointment or search Psychologytoday.com for local eating disorder therapists in your area.