Break Free From Orthorexia: Signs, Symptoms, and Treatment

Navigating the fine line between balanced eating and an unhealthy obsession with healthy eating can be incredibly challenging, especially in today’s society in which we are bombarded with the latest diets and nutrition trends. 

This blog will walk you through everything you need to know about orthorexia, including warning signs, diagnosis, treatment, common FAQs, and more. If you or a loved one is struggling with orthorexia, we encourage you to reach out for support. 

What is Orthorexia?

The term ‘orthorexia’ was introduced in 1997 by Dr. Steven Bratman, MD, which was defined as a pathological fixation on eating healthy food. In other words, an obsession with eating foods deemed ‘healthy’ or ‘pure’ by the individual. Although this condition is not yet officially recognised in the Diagnostic and Statistical Manual (DSM-5 TR), its recognition and understanding have grown throughout the years.

Individuals struggling with orthorexia can become overly preoccupied with the idea of ‘healthy eating’ to the extent that it starts to negatively impact their overall health, leading to issues like malnutrition, disruptions in their social and emotional life, and disordered eating behaviours. 

The absence of formal diagnostic criteria can make it challenging to determine the prevalence of orthorexia and where to draw the line between health consciousness and an unhealthy obsession. 

QUICK NAVIGATION

1. What is Orthorexia?
2. Understanding Orthorexia
3. The Impact/Symptoms of Orthorexia
4. Strategies to Overcome Orthorexia – Introduce some starting point practical steps on ‘how to stop Orthorexia.
5. Diagnosing Orthorexia: What to expect
6. How do I support someone with Orthorexia Disorder?
7. Treating Orthorexia/ Pathways to Orthorexia Recovery
8. The Natural Food Therapy Approach
9. Final Thoughts on Orthorexia Recovery
10. Frequently asked questions about Orthorexia

Understanding Orthorexia

How does Orthorexia differ from other eating disorders? 

Unlike other eating disorders that are often centred around the quantity of food consumed or an intense fear of weight gain (such as anorexia nervosa or binge eating disorder), orthorexia is rooted in a fixation on the quality and purity of food (although those with orthorexia can still have an intense fear of weight gain). This obsession can lead to restrictive eating patterns that exclude foods or entire food groups deemed ‘unhealthy’ significantly impacting physical, mental, and emotional health. 

Also, orthorexia can go hand-in-hand with exercise addiction, where the goal of a ‘pure’ and ‘healthy’ body through ‘clean eating’ is matched with compulsive, intense exercise routines, further complicating one’s relationship with health and self-image. 

Aspects that lead to/cause Orthorexia

Orthorexia often begins with a genuine desire to improve one’s health but gradually escalates into an obsession with healthy eating. Although there’s no exact cause of orthorexia, there are various factors that can play a role in development:

Psychological Factors

Orthorexia doesn’t always come on its own; it can be accompanied by other mental health conditions. For example, someone with obsessive-compulsive disorder (OCD) might focus their need for order and routine on their diet. Similarly, individuals struggling with anxiety or depression might turn to strict eating regimes as a way to cope with their emotions.

Sociocultural Influences

It’s no surprise that our society’s focus on health, fitness, and idealised body images significantly influences eating behaviours. Social media, magazines, and even conversations with friends can make us feel like we need to eat perfectly ‘clean’ or organic foods to be healthy or socially accepted. This constant exposure to health and diet messages can impact our relationship with food and push some towards orthorexia.

Additionally, research has shown that social factors such as nutrition knowledge, higher income, access to ‘clean’ foods (e.g., organic produce), use of social media, and weight stigma or bias are also associated with orthorexia-related behaviours.

Who does Orthorexia affect?

Orthorexia can affect anyone, regardless of age, gender, or background. However, some studies point to certain groups of people who are more likely to have orthorexia, such as college students (more specifically university nutrition students), and rates of orthorexia may be twice as high in women as in men. It’s important to note that since orthorexia has no universal diagnostic criteria, different studies may use different criteria for diagnosing it.

How can I tell if I suffer from an obsession with healthy eating?

Recognising orthorexia starts with observing one’s attitudes towards food and health. Warning signs include extreme anxiety over food choices, compulsive checking of ingredient lists, and avoiding social events where ‘approved’ foods might not be available. Also, if someone is too focused on the way food is prepared or can’t enjoy a meal without feeling guilt or shame afterwards, those are red flags. 

Orthorexia treatment plays a crucial role in helping to understand these triggers and finding effective ways to manage them.

The Impact/Symptoms of Orthorexia

 Behavioural signs

• Eliminating specific foods and/or entire food groups in the pursuit of a ‘healthier’ diet, with the list of excluded foods growing over time.
• Compulsive checking of ingredient lists and nutrition labels.
• Having rigid food rules and beliefs.
• Difficulty concentrating.
• Criticising others’ food choices.
• Fixation on eating foods that are considered ‘healthy’ or ‘clean’.
• Increased food thoughts may affect personal relationships and job performance.

 Psychological signs

• Obsession with following a ‘healthy’ diet.
• Difficulty breaking their food rules.
• Feeling anxious, guilty, or ashamed if they eat something they think isn’t ‘healthy’.
• Feeling down or depressed.
• Withdrawing from others.
• Perfectionism.

Physical signs

• Weight loss.
• Feeling weaker.
• Tiredness/fatigue.
• Taking a long time to recover from illness/ decreased immune system.
• Feeling cold.
• Low energy levels.

Source: Beating Eating Disorders [https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/other-eating-feeding-problems/orthorexia/]

Long-term Health Risks

Left unaddressed, the impacts of orthorexia can go beyond the immediate physical symptoms of weight loss and fatigue. Nutritional deficiencies are a significant concern, potentially leading to decreased bone density/ osteoporosis, anaemia, kidney issues, organ failure and a compromised immune system. 

Psychologically, the isolation and stress from maintaining such strict food rules can increase feelings of depression and anxiety, impacting overall mental health and potentially leading to increased suicidal thoughts and self-harming behaviours. 

Orthorexia treatment is a necessary step for recovery and often includes therapy to explore the roots of this obsession with healthy eating, nutritional counselling to restore a balanced approach to food, and support in rebuilding a positive self-image and coping strategies for food-related anxiety.

How Orthorexia Differs from Other Eating Patterns

Unlike standard balanced eating, orthorexia is characterised by an extreme, unhealthy obsession with food purity and healthy eating. This obsession leads to rigid dietary restrictions, unlike the more flexible approach seen in conventional healthy eating. Where balanced diets encourage variety and moderation, orthorexia limits food choices, often excluding foods or entire food groups, leading to a cycle of guilt and anxiety around food – a cycle not commonly seen in general health-conscious eating patterns.

If you see these patterns in yourself or a loved one, we encourage you to reach out to our team of multidisciplinary eating disorder specialists. At Natural Food Therapy, we’re committed to guiding you towards a healthy relationship with food and your body, where food is a source of nourishment, not anxiety.

Strategies to Overcome Orthorexia – Introduce some starting point practical steps on ‘how to stop Orthorexia.

Overcoming orthorexia, the journey away from an unhealthy obsession with ‘healthy’ eating, starts with small, intentional steps towards a more balanced relationship with food. Here are some practical, expert tips designed to guide you gently along this path: 

Step #1: Recognise Your Thoughts and Feelings Around Food and Body Image

Start by becoming aware of how you think and feel about food and your body. Notice when you feel stressed or anxious about eating certain foods or when negative thoughts about your body surface. It might be helpful to keep a notebook on hand or use your phone’s notes app to keep track of all of the negative thoughts that come up and fear foods. Being aware of these thoughts and emotions is the first step towards change.

Step #2: Reflect on the Origins of These Thoughts

Take some time to think about where these beliefs around food and body image might have originated. Was it something you read? Advice from someone you looked up to? Understanding the root of these thoughts can help you see them for what they are: beliefs, not truths.

Step #3: Challenge Your Food Rules

Here are some examples of food rules and how you can challenge them: 

• Rule: “I can only eat ‘clean’ foods.”
  • Reframe: “ALL foods can fit into a balanced diet. It’s about nourishment, not restriction.”
  • Challenge: Start by introducing one ‘forbidden’ food a week into your diet. Reflect on the experience, focusing on the enjoyment and satisfaction it brings, rather than guilt.
• Rule: “Carbs are off-limits.”
  • Reframe: “Carbohydrates are my body’s preferred source of energy! It’s okay to enjoy them.”
  • Challenge: Incorporate a carbohydrate you’ve been avoiding into one meal a day. Notice the energy it provides and how it affects your mood and hunger levels throughout the day.
• Rule: “I can’t eat after 7 PM.”
  • Reframe: “Listening to my hunger cues is more important than the clock. It’s okay to eat when I’m hungry.”
  • Challenge: If you feel hungry in the evening, permit yourself to have a snack, focusing on listening to your body’s needs rather than watching the clock.

Step #4: Let Go of the Trackers

Step away from the scales, food scales, food tracking apps, and fitness trackers. These tools often reinforce the obsession with control over food and body that’s central to orthorexia. Removing them from your daily routine can help reduce the fixation on numbers and allow you to focus more on how you feel.

Step #5: Seek Professional Guidance

Last but definitely not least, reach out for professional help. Overcoming orthorexia is not something you have to do alone. An eating disorder specialist can offer guidance on eating intuitively and finding a balance when it comes to food, while a therapist can support you in dealing with the psychological aspects of your relationship with food and your body.

Diagnosing Orthorexia: What to expect

Diagnosing orthorexia involves a deeply personalised approach, starting with an open discussion about your eating habits, emotional connections to food, and how these impact your life. As mentioned previously, there’s no formal diagnostic criteria for orthorexia. In fact, it’s unclear whether it’s a unique eating disorder, part of anorexia nervosa, or a subtype of obsessive-compulsive disorder. 

With that being said, there are several diagnostic tools that healthcare professionals use such as the ORTO-15, ORTO-R, the Bratman Orthorexia Test, and the Eating Habits Questionnaire. However, it’s important to recognise that each of these tools comes with its own set of limitations.

Bratman and Dunn suggested a clearer way to identify orthorexia with two main criteria: an intense preoccupation with healthy eating and behaviours that interfere with everyday life. 

1. Intense Preoccupation with Healthy Eating: This includes overwhelming distress over food choices, such as:

• Compulsive actions or constant worry over foods chosen for optimal health.
• Anxiety, shame, or fear caused by not sticking to self-made diet rules.
• Increasingly strict diets, possibly cutting out whole food groups, or adopting risky cleanses.

2. Behaviours Impacting Daily Life: This behaviour disrupts normal life through:

• Health problems like malnutrition or significant weight loss.
• Challenges in personal, social, or academic areas due to strict eating habits.
• An unhealthy reliance on strict diets for self-esteem or identity.

How do I support someone with Orthorexia Disorder?

Supporting someone with orthorexia requires a blend of empathy, patience, and understanding. Here are some tips to consider:

Educate Yourself on Orthorexia

Understanding the specific challenges of orthorexia is important. This disorder is less about the quantity of food and more about an obsession with the quality and purity of food. Familiarise yourself with the subtle signs and symptoms, which can empower you to offer support when you see needed. 

Encourage Flexibility in Eating Habits

This could be introducing a previously excluded food item once a week or experimenting with new recipes that don’t strictly adhere to their usual dietary rules. The goal here is not to challenge their dietary preferences abruptly but to softly introduce the idea of variety and balance.

Promote a Broader Definition of Health

Work on broadening the idea of health to include mental and emotional well-being, not just physical health dictated by diet and exercise. Discuss the importance of a holistic approach to health that values joy, social connections, and mental peace as much as food intake. 

Support, Don’t Push

It’s important to offer support without pushing too hard. Individuals struggling with orthorexia often hold their dietary rules very closely, and too much pressure can lead to resistance, stress, or rebellion. Offer gentle suggestions and be there to listen, rather than trying to control their eating habits. If you sense that your loved one isn’t up for talking, consider offering resources such as this blog so they can learn more when they’re ready. For additional advice, read our blog on Supporting Someone In Eating Disorder Recovery.

Seek Professional Help Together

Encourage professional support by researching specialists together, and offering to accompany them to an appointment. Sometimes getting help is scary, and knowing they don’t have to take that step alone can make all the difference. Make it clear that seeking help is a sign of strength and an important part of their journey to recovery.

Focus on Activities Unrelated to Food

Engage in activities that don’t involve food to help them find joy and fulfilment in other aspects of life. Whether it’s a hobby, visiting new places, or simply spending time in nature.

Remember, every individual’s journey is unique, and what works for one person may not work for another. It’s about finding the right balance between offering support and giving them the space to navigate their own path to recovery.

Treating Orthorexia/ Pathways to Orthorexia Recovery

Orthorexia treatment involves seeking professional help and crafting a personal recovery strategy. Both elements play a crucial role in transitioning from a cycle of restriction and anxiety around food to a life where eating is a source of joy and nourishment.

Seeking Professional Help

In orthorexia recovery, therapy, nutrition counselling, and coaching stand as pillars of support to address the psychological, nutritional, and social aspects of the disorder. Through Private Coaching, individuals receive one-on-one attention from eating disorder specialists skilled in addressing the unique challenges orthorexia presents. Cognitive-behavioural therapy (CBT) helps challenge and change unhelpful thought patterns and support groups help individuals to connect with others facing similar struggles.

This holistic approach ensures that individuals are not only recovering from orthorexia but are also building the skills needed for a fulfilling, balanced life beyond their eating disorder.

Personal Recovery Strategy

A cornerstone of overcoming orthorexia lies in establishing a healthy relationship with food. Our self-paced course, ‘Food Relationship Roadmap’ is designed with this goal in mind, offering practical tools, insights, and strategies to help individuals navigate away from strict eating habits towards a more intuitive, joyful relationship with food. 

It’s about learning to listen to your body’s needs, finding pleasure in nourishment, and freeing yourself from diet culture. While this course is not a substitute for professional treatment, it can be a helpful tool to build your foundation. This course is created for ANYONE looking to get a strong foundation in healing their relationship with food and body (not specifically designed for orthorexia recovery alone).

The Natural Food Therapy Approach

At Natural Food Therapy, we’re dedicated to guiding individuals through their recovery journey from orthorexia with empathy, expertise, and personalised care. 

We currently offer a range of treatment options tailored to your unique journey towards healing:

• 1:1 Coaching: Dive deep into personalised sessions where you’ll receive dedicated support, guidance, and actionable strategies to navigate your recovery path.
• Self-Paced Course: Designed for anyone seeking to foster a healthier relationship with food and their body, this self-paced course features 12 comprehensive modules, each equipped with engaging video lessons and thoughtfully designed exercises. 
• Loved One Sessions: Specially crafted sessions for parents, partners, and loved ones to answer your questions, provide understanding, and offer ways to support the journey to health.

Each of these offerings is designed to meet you where you are in your recovery, providing the knowledge, support, and tools necessary to rebuild a healthy relationship with food and yourself.

The Benefits of Working with Our Specialists

A specialist coach can provide motivation and practical strategies for overcoming daily challenges, while a therapist delves into the emotional and psychological factors contributing to orthorexia. Meanwhile, a nutritionist focuses on rebuilding a healthy relationship with food, helping you conquer your food fears and learn how to find balance in eating. 

Choosing Natural Food Therapy means you’re not just getting a nutrition expert; you’re gaining a partner in your recovery. Our specialists are here to provide you with the skills, support, and knowledge you need to break free from the grips of an eating disorder. With us, you’ll learn to listen to your body, respect its needs, and celebrate food as a source of energy, joy, and healing.

Final Thoughts on Orthorexia Recovery

As we wrap up our discussion on breaking free from orthorexia, it’s important to acknowledge the courage it takes to recognise and address this condition. If you or someone you care about is struggling with the fine line between healthy eating and orthorexia, know that reaching out for help is a strong and positive step towards healing. 

At Natural Food Therapy, our unique approach to eating disorder treatment combines specialised care with diverse techniques. Each of our practitioners is trained in nutritional therapy, counselling skills, and specialised eating disorder coaching, offering comprehensive support through a single expert provider.

Frequently asked questions about Orthorexia