From the outside, she appears to have everything together. She recently discovered a passion for nutrition and “healthy eating.” She frequently posts pictures on Instagram of her elaborate juices and her perfectly arranged, colorful meals. She seems to be the picture of health and happiness.
What no one sees is that she is filled with intense anxiety at the thought of eating out, which is causing her to isolate from people. They don’t know that she is constantly thinking about food. Or that she paces down grocery store aisles for hours, analyzing nutrition labels and doing calculations in her head. Her friends and family applaud her for how “healthy” she is eating. However, she is not choosing to act and behave this way. She has become a prisoner to her own mind. What started out as an interest in “healthy eating,” has transformed into an eating disorder, orthorexia nervosa.
Dr. Steven Bratman coined the term “orthorexia” to describe “an unhealthy obsession with healthy eating.” Although it is not yet formally recognized as a diagnosis, it is believed to be an emerging eating disorder that health professionals are starting to see in their practices. For individuals with the underlying genetic predisposition, a decision to “eat healthier” may trigger them to spiral out of control. So how do you know if your interest in “healthy eating,” has become unhealthy?
At the Food & Nutrition Conference & Expo of 2016, which was held on October 15-18 in Boston, MA, Jessica Setnick, MS, RD, CEDRD, a senior fellow at Remuda Ranch, Marci Evans, MS, CEDRD, LDN, a registered dietitian in private practice, and Steven Bratman, MD, MPH, presented on the topic of orthorexia nervosa to a packed room of over 3,000 health professionals.
The size of the crowd and the fact that this session trended on Twitter, indicates that health professionals are developing an increased interest in this topic. This is likely driven by the common belief that orthorexia is on the rise in our society. The following are some of their expert tips for identifying when someone’s interest in “eating healthy,” may be an eating disorder in disguise.
1. Increased fixation on “healthy” food and rigidity surrounding food choices.
In the presentation, Bratman discussed how often orthorexia begins as a strong interest in “healthy food.” However, he noted that this trait alone does not signify that someone is struggling with an eating disorder.
According to Bratman, individuals with orthorexia often develop an obsessive focus on food choices, planning, preparation, and consumption. Additionally, they might start to develop an exaggerated belief system around certain foods as being able to either cause, cure, or prevent a variety of health conditions.
Marci Evans explained that in her practice when she sees someone who is struggling with orthorexia, often they spend a great deal of time thinking about food and nutrition. For instance, they might spend hours each day reading about health and fitness.
It’s important to note that enjoying kale doesn’t mean that someone is struggling with orthorexia. Rather, it’s critical to examine an individual’s level of rigidity in regard to their food choices. For instance, are they able to eat other foods when their “preferred foods” are not available? If they are unable to, or it causes them intense anxiety, they could be struggling with orthorexia.
2. Talking about “purity” and morality in conjunction with food.
Individuals struggling with orthorexia might start to speak about food in terms of morality and “purity.” For instance, Bratman explained that they may start to believe that food is the primary source of happiness, self-worth, and meaning.
Additionally, individuals struggling with orthorexia often start to cut out entire food groups and label foods as “good” or “bad.” For instance, individuals with orthorexia may become fixed on only eating “organic” or on the concept of “clean eating.” Evans says that, “progressively cutting out more and more foods from your diet may be an indicator that you are slipping into orthorexia.”
3. Withdrawing from social relationships due to anxiety around food.
Both Evans and Bratman spoke about how individuals who are struggling with orthorexia might notice that their social relationships are suffering. People who are struggling may develop anxiety about being in social situations where food will be served. Often when an individual is struggling intensely with an eating disorder, it becomes their primary relationship. Thus, individuals with eating disorders can start to feel increasingly isolated.
Jessica Setnick says it’s important to ask yourself, “Is the way that you eat supportive to your lifestyle, or is it taking over your life?”
Full Recovery Is Possible
If any of these signs resonate with you, it’s critical that you reach out to a licensed professional so that you can undergo a clinical evaluation. For a list of the full proposed criteria for orthorexia nervosa, check out this link.
With access to evidence-based treatment and support from a therapist, registered dietitian, and other professionals, individuals with orthorexia can recover and live meaningful and fulfilling lives. It is truly a sign of strength, to seek out help if you are struggling. No one should have to recover from an eating disorder alone.
No one makes the choice to have an eating disorder, but you can choose to take the steps towards recovery. Ultimately being trapped in an eating disorder is not a happy place to be. You deserve a full life. One where you can enjoy get-togethers with friends, travel, and spend time strengthening your relationships and pursuing your passions. If your fixation on “healthy eating” is getting in the way of living a meaningful life, it’s important to reach out for help and support.
Lastly, it’s important to note that food is not “good” or “bad,” it’s neutral. Additionally, all foods can fit into a healthy diet. You deserve to mindfully nourish yourself with food that you enjoy.
Marci Evans sums it up best when she says, “Your food choices are not a reflection of your morality, value, or goodness. Healthy eating includes joy, pleasure, and connection. It’s not all about nutrients.”
Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in Rockville, Maryland. Jennifer has a private practice specializing in working with adolescents and adults struggling with eating disorders (including binge eating disorder, anorexia, bulimia, orthorexia, and OSFED), body image issues, anxiety, and survivors of trauma. Jennifer provides eating disorder therapy in Rockville, MD. Jennifer offers eating disorder recovery coaching via phone/Skype. Connect with Jennifer through her website at www.jenniferrollin.com
If you’re struggling with an eating disorder, call the National Eating Disorder Association hotline at 1-800-931-2237.