Do you have a friend who counts every calorie, makes sure that everything in their refrigerator is organic, reads every single food label and requests a list of ingredients when you go out to eat (if they’re willing to go out)? Do they obsess about what you use to cook food when they come over for dinner and feel the need to tell you the nutrient breakdown of everything you prepare? Do they refuse to ever have a treat because it will sabotage their clean-eating streak? I’m talking even on their birthday. If this sounds familiar, your friend might have orthorexia nervosa.
What is it?
As stated on the Academy for Nutrition and Dietetics website eatright.org, “ Orthorexia is an unhealthy fixation on eating only healthy or “pure” foods.” *
The term “orthorexia” was coined by Steven Bratman, MD, author of Health Food Junkies — Orthorexia Nervosa: Overcoming the Obsession With Healthful Eating. He used this term to refer to an eating disorder characterized by an obsession with eating foods deemed healthy. Bratman gained interest in this disorder out of personal experience. He told 20/20 that he “suffered from a psychological obsession with food.” Bratman explained that his obsession “took way too much of his life experiences when there were other things he could have been doing.”
Though orthorexia usually begins with a genuine desire to eat healthy, it can quickly become all-consuming.
Like anorexia nervosa, orthorexia is a disorder rooted in food restriction. However, orthorexia differs in that the quality instead of the quantity of food is severely restricted. This happens when an individual desires to make their diet increasingly more pure by eliminating foods they perceive to be unhealthy. As they “purify” their diets, they tend to eliminate entire food groups. As we’ve discussed before, the elimination of entire food groups without a medical necessity can result in nutrient deficiencies, which can compromise health. In extreme cases, an individual might chose to forgo food altogether rather than consuming something they perceive to be unhealthy.
In addition to depriving the body from essential nutrients, orthorexia can deprive individuals of basic human interaction. According to Marjorie Nolan, MS, RD, CDN, ACSM-HFS, former spokesperson for the Academy of Nutrition and Dietetics, “A defining characteristic of orthorexia is if they’re missing out on social occasions or not participating in certain functions because of the food being offered there. A patient with orthorexia also spends a lot of time thinking, planning, and organizing their food—when they’ll eat it, how they’ll eat it—and meticulously measuring things.”
It’s important to remember that:
- health includes mind and body.
- Positive social interactions contribute to decreased stress levels (less cortisol
- which can lead to weight gain, blood sugar problems, muscle breakdown to name a few)
- and an improved outlook on life.
Today’s Dietitian notes that orthorexia can sometimes be difficult to recognize because these individuals spend most of their time at home. Dietitian, Nolan further explained that “to the coworkers at the office, it might seem incredibly healthy that someone is bringing in a beautiful salad each day but, if the individual is taking an hour to prepare it each night and is obsessive about the exact ingredients, there may be an issue.”
What do we do for someone who has orthorexia?
Orthorexia shouldn’t be taken lightly. It is a serious disordered eating pattern that can have severe mental and physical health consequences. Professional help is necessary in order to help those suffering regain a healthy perspective. It might seem that those suffering from orthorexia are “nutrition experts.” While they might know a lot about food, their resources aren’t always credible (magazines, blogs, etc) and their information isn’t always accurate. **
How does this differ from healthy eating?
- Here is an excellent chart from Understanding Orthorexia — When Healthful Eating Becomes an Obsession written by Lindsey Getz and published in Today’s Dietitian Vol. 16 No. 11 P. 18
General Healthy Eater Someone with orthorexia nervosa
|Consistently chooses the healthiest items on a menu||Doesn’t eat out due to lack of control over every ingredient on the menu|
|Packs lunch instead of choosing unhealthful fast-food choices||Spends hours meticulously prepping food|
|Skips dessert most of the time||Won’t treat themselves to dessert even on special occasions|
|Reads ingredient labels||Fixates on ingredient labels while shopping at the grocery store|
|Avoids unhealthful items that contain trans fat or sugar||Avoids certain food items to the point where the individual barely eats or doesn’t eat at all|
|May make specific dietary choices such as going gluten-free or vegan||Spends inordinate amounts of time thinking about healthful food choices|
|May feel bad about making an unhealthful food choice||Expresses emotional turmoil because of an unhealthful choice and can’t forgive himself or herself|
|Contemplates making healthful food choices but still socializes with friends and enjoys life||May withdraw from friends and experience decreased quality of life|
So how do we find a balance?
We live in a very “health conscious” society. Most food products have some sort of label drawing attention to various nutrition claims: “gluten free,” “non-GMO,” “all-natural,” “grass-fed,” etc. Magazine articles and blogs are dedicated to reporting on the healthiest foods. We’re subjected to this information whether it interests us or not. It’s important to check the source and be sensible. Don’t automatically omit (or include) a particular food from (or into) your diet based on one article. Use credible sources to ensure that the information you receive is evidence-based and scientifically supported.
While a concern for health is important, and we should make an effort to make healthy choices, it shouldn’t become an obsession. Yes, planning ahead is important, but not if reading ingredients and measuring food is all you can think about. It shouldn’t become a chore or burden. You shouldn’t experience a sense of panic if you’re at a family function and you don’t know the caloric content of the meal you’re being served. I’m sure some of your best memories involve social-food situations. Birthdays, Christmas, Thanksgiving, Graduations, the 4th of July, block parties, etc are all centered around food and fellowship. These should be enjoyable, not cause for anxiety.
When you find yourself at social gatherings that include food (I hope you do!), be mindful of how you build your plate, but focus more on the conversations and overall experience rather than the food.
- Spot the protein on the table, choose whichever veggies are available and start with those.
- Then, for the other dishes that might not be as healthy, decide what you’ll really enjoy.
- If you absolutely love potato salad and macaroni and cheese, allow yourself to have a small amount of each.
- If you’ve filled up on protein and veggies already, then a little bit will satisfy!
- If the dessert looks good, go for it! Just be sure that you’re not overdoing it.
- The same principle applies: if you’ve started with satisfying protein and veggies, a small amount will satisfy that craving.
On the other end of the spectrum, don’t feel pressured to indulge if you really don’t find the food particularly appetizing. Many of my Dietitian friends like to use the “80/20” Rule to strike the perfect balance. This means, if most days of the week you focus on whole, natural food, you can enjoy a slice of cake at a friend’s birthday, or a slice or two of pizza with your kids and it’s not going to derail you. It’s often the notion that you “can’t” have something and/or the belief that it is “forbidden” that causes the obsession. When you tell yourself that you can have something in the context of an overall balanced diet, it gives you the freedom to evaluate whether or not you really want it.
Be a responsible eater and educate yourself about the true health benefits of the foods you consume.☺
*For a full explanation of the definition go to http://www.orthorexia.com/
** For more information on orthorexia including signs/symptoms and appropriate treatment options, go to https://www.nationaleatingdisorders.org/orthorexia-nervosa