What is Orthorexia?
Orthorexia (also known as orthorexia nervosa) is a condition defined by an intense commitment to eating a healthy diet. The term – meaning ‘righteous diet’ – derives from the Greek – ‘orthos’ meaning upright or correct, and ‘orexis’ meaning appetite. The person with orthorexia follows a ‘clean’ and ‘proper’ diet, avoiding the consumption of ‘toxins’ and ‘impurities’. What are considered impurities will depend on the parameters of an individual’s chosen diet. The person with orthorexia’s diet may be vegan, vegetarian, pescatarian, paleo, keto, raw food, and so on. However, merely following one these diets does not fit the definition of orthorexia. Instead, it is defined by the extreme measures taken to maintain the purity of whatever diet is chosen.
Think of it this way; if anorexia is an obsession with the quantity of food eaten, orthorexia is an obsession with its quality.
The person with orthorexia divides food into two categories; clean or dirty, pure or impure. Removing impurities requires understanding of nutritional and calorific values, plus the effects of certain food-types on the body. Next, the person with orthorexia checks ingredient lists, and scans food labels. Meals will be prepared meticulously, in precisely the right proportions, and eaten in exactly the correct order. All of these activities are taken to an extreme.
Whatever diet an individual follows, if they are someone who enjoys their food – if preparing and eating it brings their health and happiness – the label of orthorexia is unlikely to apply. If, however, following a particular diet begins to cause their stress; if dieting becomes an ever more complicated set of rules; if breaking these rules causes their guilt, anxiety, or shame; or if strict adherence to their diet interferes with their relationships or social life, then they may be bordering on orthorexia.
Therapy for orthorexia is very effective in treating this issue and improving the individual’s relationship with food.
Similarities between Orthorexia and Anorexia
Anorexia and orthorexia share some characteristics in common. While their outward motivation may be different, both involve restriction of diet with an emphasis on control and perfectionism. Intrusive thoughts relating to food feature in both anorexia and orthorexia. Both result in significant weight loss, and both can result – with the avoidance of social events – in isolation. However, there are differences. The person with anorexia often goes to great lengths to hide their eating disorder. The person with orthorexia, on the other hand, is neither ashamed of their eating habits, nor does they hide them. The purity of their diet – and their dedication in maintaining it – form an integral part of their identity. Their diet is a badge of honour.
In some cases, it can be difficult to tell the difference between the two. For example, the case of the person with anorexia who – at the surface level – appears to have orthorexia. They uses it exclusively as a more socially acceptable means of shedding calories. This differs from the case of the person with orthorexia – though they may lose weight – is more concerned with maintaining their dietary purity.
In other cases, there can be overlap with bulimia, for example, in the case of the person with orthorexia who engages in vomiting. However, it is more often the case that you will find the person with orthorexia engaging in excessive exercise. Indeed, there is considerable overlap between orthorexia and excessive (or compulsive) exercise.
Similarities between Orthorexia and OCD
OCD, as the name suggests, comprises two main components; obsession and compulsion.
Obsession relates to thinking. The obsessive-compulsive finds it difficult to cope with negative emotions. To cope, he follows a rigid belief system – whether pre-existing or one of his own creation – a belief system with a set of rules. If he breaks a rule, he feels either anxious and/or is highly self-critical. The better he sticks to the rules, the less anxiety he feels. His cognitive preoccupation with his belief system offers him a means of controlling his emotions. His obsessive thinking, as it were, keeps feelings at bay.
Researchers view orthorexia as a similar means of coping with negative emotion. Like the obsessive, the person with orthorexia links their identity with their dietary belief system, their self-worth with their capacity to adhere to its tenets. They are similarly strict in maintaining their purist diet, similarly self-judgemental in failing to adhere to it. Failure to follow their dietary code results not just in extreme self-criticism, but in a mixture of guilt and anxiety. In order to banish these emotions, the person with orthorexia puts in place even more stringent measures. This new set of rules – like obsessive thinking -occupies their mind – thus neutralising their anxiety – and the cycle begins anew.
If obsession relates to thinking, compulsion relates to action. The person with orthorexia spends inordinate amounts of time on research, buys an excessive number of books on nutrition, trawls health stores for the latest organic foodstuffs, scans every list of ingredients and every label on every food item, and so on. These compulsive actions perform the same function as obsessive thinking. By never sitting still for long enough, the person with orthorexia never allows uncomfortable feelings to creep up.
The Costs of Orthorexia
A further component of OCD is its moral flavour. The person with orthorexia assigns foods a moral character; there are ‘good’ foods – which are revered – and ‘bad’ foods – which are rejected. Friends of the person with orthorexia – if they eat certain foods and if they refuse to be lectured – may be assigned negative character traits and avoided. The person with orthorexia must maintain their purity, even at the cost of straining relationships. At home, they may argue with loved ones. Their social life suffers when they stop visiting the friend who uses the wrong type of ingredient. Or, they avoid a certain social occasion because the menu on offer offends. Or, they decline to go on holiday because maintaining their diet in a foreign country would be bothersome.
Their life narrows when the hobbies they previously enjoyed are replaced with nutritional research and time spent on online forums. Their diet becomes more expensive, eating up more of their budget, when it requires rarer, more faddish ingredients. And, ironically, their physical health suffers when – avoiding whole food types – they starve themself of vital nutrients, causing malnutrition, severe weight loss, or other health issues.
The person with orthorexia not only restricts their diet, but – in losing their moderation and balance – restricts their capacity to enjoy life. If the border dividing a healthy diet from orthorexia is crossed, what began as a noble path to health and happiness may have ended up at the wrong destination.
Therapy for Orthorexia
Therapy and counselling for orthorexia is a very effective way to treat the disorder. At Centric Mental Health, we offer a range of treatments to help cope with orthorexia and its underlying causes. Our team of psychotherapists and psychologists are trained in dealing with orthorexia – and other forms of disordered eating. By offering strategies that target the surface manifestations of the disorder – and a space in which to explore its root cause – therapy for orthorexia can restore moderation, ensuring a more balanced path to wellness.