What is orthorexia, and does your clean eating obsession mean you have it?

No more easy meals out. No more coffee. All my free time poured into researching acceptable foods and scrolling through Instagram nutrition accounts. I was following a special diet to keep my autoimmune disease in check, and it was working. But when I realized that my love of food had turned to dread surrounding food and eating, I asked my nurse practitioner: If this was healthy, why did it feel so disordered?

Her reply was illuminating — some patients thrive on specialized diets and some don’t. She also introduced me to the term orthorexia, which Dr. Steven Bratman coined in 1996. Orthorexia is defined as an obsession with food that one considers healthy. I realized my behaviors were orthorexic.

Photo: Getty Images
Photo: Getty Images

“It’s really an unhealthy obsession on healthy eating,” Dr. Judi-Lee Webb, a licensed psychologist, certified eating disorders specialist, and co-owner of private practice in the Atlanta area tells Yahoo Lifestyle about the term. “It’s like dietary perfectionism.”

When focusing on the righteousness of the food in your diet leaves you feeling isolated, all-consumed, superior to others, shameful, guilty, and anxious, or is affecting your self-esteem, there might be a problem.

On his website, Bratman makes sure to specify that paying attention to ingredients or any “nutritionally sound approach to eating healthy food” is not “in itself a disorder.” It’s when things tip over into obsession that it becomes a problem.

In honor of #nedaweek I’m sharing my story in hopes that it will reach just one person so they know that they are so much more than a number on the scale, the size of their clothes or how “skinny” they look. My first diet was in high school and over 15 years later I still face triggering moments but am able to recognize them and move forward with trust and love in myself. You name it, I tried it from juice cleanse, to cabbage soup cleanse, to fasting, to just skipping one meal a day because that’s how you lose weight right? But my reasons for dieting were all superficial. I wanted other people to see me as skinny because that’s what I associated being beautiful with. I didn’t understand that what people think of me is a reflection of what I think of myself. So I starved, deprived and restricted food to feel in control of how others saw me! I didn’t even want to quit smoking cigarettes because I feared gaining weight! I would only eat salads in public because that’s how I defined healthy eating. And then I would secretly binge late at night on candy because my body was craving sugar for energy to stay alive. I had adrenal fatigue so I had no energy during the day and was awake at night. I had no period because my hormones were not balanced. I couldn’t workout because I had no energy. And fear set in when I gained weight when I stopped binging eating because the years of damage I was doing to my body finally started to catch up. And it’s taken a long time to be okay with the weight gain and not go back to disordered eating habits. When people tell me they’re going to juice cleanse because they ate so much the day before, I remove myself from the convo because it triggers old thoughts of “well if they think they’re not good enough because of what they ate then I must not be good enough because I definitely ate more!” My mind has started to let go of being defined by food or comparing myself to others. I am allowing myself to enjoy the company I’m with and the process of making food. It’s nourishment and love and not something that should ever be held back! You’re perfect just as you are | #disorderedeating #neda

A post shared by Leslie McDonald (@balanced_life_leslie) on Feb 28, 2018 at 10:08am PST

Dr. Erica Claman, a licensed psychologist who specializes in eating disorders, says that like other disorders, orthorexia presents itself on a spectrum.

“It’s not unhealthy to think about your eating. It’s not unhealthy to want to eat in way that feels healthy to you,” Claman tells Yahoo Lifestyle. “I think it’s just a matter of understanding where it’s crossing that line and why it’s crossing that line.”

Though Webb emphasizes the proliferation of diets out there today and Claman echoes that “everyone thinks they’re an expert on food,” it’s not necessarily the result of a particular diet or dietary trend. Claman says it could start out as simply as wanting to avoid refined sugars or shop mainly at farmers’ markets; however, obsession and fear can drive it into disordered territory.

Both agree that social media — and all the perfect meals and bodies it features — can have a negative effect on people with orthorexia.

“If somebody’s more vulnerable to soaking in all that information and/or being anxious about it, that can certainly be a force for them,” Claman says.

Beautiful breakfast and such a powerful message! Thank you Bree for sharing! • Repost from @simplehealthyeats – I used to order my waffles with a side of GUILT But now… Waffle + Avo + Eggs + Bree = One amazing part of my Food Freedom journey has been removing the GUILT from eating delicious foods! Yup, even this healthy plantain waffle (recipe from @thepaleomom SO GOOD) with avocados and eggs would have given me anxiety a few years ago (the serious truth of battling #orthorexia ) I’m not perfect. I still struggle at times with wanting to be restrictive – and then I realize HEY, this isn’t what I want. And then you know what? I eat the dang food and feel 10X better . Releasing control and restriction only happens if you PRACTICE. ✨If you never change your routine, OF COURSE YOU’LL HAVE ANXIETY AROUND FOOD✨ So switch it up, even a little bit and THAT will give you the opportunity that feel comfortable with indulging and breaking routine. After all, Food Freedom is all about finding your unique balance of eating and living with health AND happiness . So what can YOU do today to break your routine and find some extra happiness in life and food? Take a walk? Take a rest day from the gym? Bake some banana bread? Call your mom? Say no to that extra shift at work and do nothing? HONOR YOUR NEEDS + WANTS! And if you need help doing so, you can totally grab my free library of Food Freedom resources in my bio! XO . #foodfreedom #selflove #selfcare #eatingdisorder #edrecovery #eatingdisorderrecovery #whatsonmyplate #recoveryisworthit #recoverywarrior #avocado #waffles #healthcoach #healthybreakfast #ibsdiet

A post shared by Sarah Ballantyne, PhD (@thepaleomom) on Mar 15, 2018 at 8:26am PDT

But this obsession can have dire results. Orthorexia can have social or even medical consequences, including malnutrition or other eating disorders, such as anorexia nervosa.

“Orthorexia can ruin your life. It can kill you,” Webb says.

It can impair relationships, she adds. “Say you’re at work, you’re celebrating a co-worker’s birthday, and cupcakes are brought in. You may feel that you can’t go to the break room,” Webb says.

Another orthorexia indicator may be that you have trouble eating intuitively. “Intuitive eating is really listening to your body — knowing when you’re hungry, knowing when you’re full, knowing how much food you need and knowing what your body’s asking for,” Webb says. “Folks with orthorexia may ignore this or may have difficulty being intuitive because they stick to their rigid plan or their rules.”

But what about people who have medical reasons to change or restrict their diets?

“There are lots of folks out there with food allergies or different medical conditions that don’t allow them to eat certain foods, and they have a healthy relationship with food. They don’t have anxiety around other foods that they are able to eat,” Webb says.

“I would really recommend that they follow their medical doctors’ recommendations for their diagnosis, then speak with a registered dietitian who knows about the issue.”

If the patient takes it further than the doctor or dietician recommends, “then that’s becoming a bit orthorexic,” Webb says.

If you notice you have symptoms of orthorexia, Webb recommends finding a therapist, psychologist, or registered dietitian with expertise in eating disorders, such as a member of the International Association of Eating Disorder Professionals. If you’re unable to find an eating disorder specialist near you, Claman says, a clinician would likely still be helpful.

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