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Orthorexia

coverwebWhen healthy eating takes an unhealthy turn

It starts out healthy enough—or seemingly so. Maybe someone started by cutting out processed foods. Then desserts. Then sugar. Then meat. Maybe they switched to all organic and, while they were at it, went gluten-free and wheat-free. In a culture that has gone health-food crazy, it’s easy to see how some people can take a “healthy” diet to an unhealthy extreme.

For some, it’s a short-lived stage that ricochets into a junk food rebellion. Others find their way back to the middle of the road. But for many, this so-called, “healthy” way of eating can become a true obsession and, at its most extreme, an eating disorder known as orthorexia. Derived from the Greek words orthos, meaning “correct,” and orexis, meaning “appetite,” people who suffer from orthorexia become obsessed with eating foods they deem healthy, safe or pure.

Unlike anorexia, people with orthorexia do not usually set out to lose weight. They set out to be as healthy as they can be. The problem is that being too healthy can become unhealthy. Unlike the distorted body image that accompanies anorexia, people who suffer from orthorexia often know that they are too thin. However, the rigid eating rules they impose on themselves, along with their excessive exercise regimes, keeps them at an unhealthy weight.

People with orthorexia appear to be motivated by improving their health, but there are underlying motivators that drive their obsessive behaviors. Oftentimes there is a fear of illness or death, which can lead someone to embark on a seemingly healthy diet. There is often a need to seek control of something when life or relationships feel out of control, as well as a need to create safety, which attempts to be found through a false sense of rigid rules and routines, i.e., “If I just eat this way and exercise this amount, everything will be OK.” Orthorexia can also provide someone with a new identity whereby they become known for, and feel proud of, their willpower and seemingly healthy choices.

These days, it’s pretty commonplace to find an article spouting the dangers of just about any food. So someone who has taken a healthy eating kick to an unhealthy extreme can latch onto many different sources of information that feed into the disorder and advise what food or food group to cut out. Add our culture’s fitness craze to the mix, along with a “more is better” philosophy and it’s easy to see how some people can unintentionally develop orthorexia.

Whether someone has a full-blown disorder or a lesser-degree preoccupation, what is unhealthy about being too healthy? It is extremely limiting, very time-consuming and, counterintuitively, it can lead to malnutrition. It can also become a replacement and a distraction for finding healthy ways of dealing with anxiety or grief.

A truly healthy eater is moderate. They usually eat what we know of as “healthy” food approximately 80 percent of the time and, with the other 20 percent, enjoy desserts, snacks or quick meals.

When recipe browsing, meal preparation, food shopping, and thinking about eating become an obsession or a part-time (unpaid!) job, it might be time to ask yourself if your healthy eating is really healthy. When a slice of pizza with friends or an occasional piece of birthday cake is unthinkable, it might be time to take a closer look at your patterns. When taking a day off from exercise feels terrifying or unacceptable, it might also be time to examine your so-called “healthy lifestyle.” When the list of what feels safe to eat becomes smaller than the list of what is off limits, it might be time to admit there is a problem.

So what do you do if you suspect that you have orthorexia?

Start by taking a look at when it all began. What was going on for you at the time? Many of the people I have treated in my counseling practice have discovered that it started when something painful happened, perhaps a loss, trauma or difficult situation in their lives. Feeling out of control with their painful life situation, they turned to perfecting and purifying their eating. Throw in a crazy culture that glorifies sugar-free, wheat-free, gluten-free and meat-free diets, and a sensitive person who has difficulty tolerating and expressing emotions, and the recipe for orthorexia is created, featuring perfectionism, food-obsession and emotional avoidance.

Many people who feel out of control with life will latch onto food, exercise and weight control in an attempt to try to control something. It’s easy enough to do in a culture that promises us Nirvana if we eat, exercise or look a certain way. Wouldn’t it be wonderful if it were true? If we could purify our eating, exercise rigorously, and attain the perfect body, then everything in our lives would magically be OK! It’s a great

idea in theory but the real power in life comes from learning how to manage, communicate difficult emotions, and face life’s challenges rather than avoid them with food preoccupation and body obsession.

cov girlUSEOne client in my local counseling practice got teased about her looks when she was young. Rather than deal with her emotions and learn how to strengthen her sense of self, she embarked on a health food diet she had read about online. It started out innocently enough and she received a lot of praise for how “good” she was and how much weight she lost. But her healthy lifestyle slipped into the realm of being unhealthy when it became more and more rigid and limiting. No longer willing to go out to eat with friends, she began to turn down more and more social invitations. No longer willing to eat what her family ate, she spent an increasing amount of time pouring through recipe books and watching The Food Network. No longer casual about exercise, she stopped doing the walks and bike rides she had previously enjoyed with her family, replacing them with hard-core, rigidly timed runs.

Another client had a death in her family and turned to so-called healthy eating and “getting in shape” rather than dealing with her grief. It took a near-death experience from malnutrition to get her to turn inward and face the original grief she was literally and figuratively running from. Once she did, she learned it was necessary and healing to cry, and that grieving—and eating some foods that were not on her “safe” list—was not going to kill her. It was a shock to her that her so-called “healthy” lifestyle was what almost killed her.

Checking In

I asked one client what the disorder gave her and she said, “A false sense of feeling better about myself for a while, but what it really got me was into the hospital.”

I asked another client what he thought caused his orthorexia. He said, “It was people feeding into it and praising me for losing weight and exercising so much, plus all the things on the Internet. There are so many websites about having a super muscular six-pack and I guess I just got caught up in it. I felt better about myself at first but in the long run it didn’t really work.”

When asked what he was getting out of improving, a client who is new to the recovery process told me, “I’m happier, my mood is better. I was essentially starving myself and I didn’t know it.”

I asked a college student who is on the recovery side of orthorexia what she would tell someone else who is struggling. “Figure out a goal to make you want to be balanced and truly healthy. For me it was graduating college and having a family. It’s not bad to be healthy but just don’t take it too far.”

To another client, I posed the question: Is there anything anyone could have said to you that would have helped prevent this? “I was warned, I just didn’t listen. My parents, other family members, even my coaches said they were worried about me but I didn’t listen. But I’m more reasonable now. I know now that I’m not going to be able to be my best self unless I eat and eat all kinds of food—and eat enough food.”

Like any disorder or disease, recovering from orthorexia takes desire, willingness, help, and time. Imagine food, weight and exercise as the tip of an iceberg above the surface of the water. That’s all you can see and it’s what becomes easiest to focus on. But if you go deeper underneath the water and take a look at what you’re avoiding, you will find the real issues. For most people it’s good old human emotions that they’re afraid to face. Whenever an obsession is running the show, it’s easier to focus on the tip of the iceberg—in this case food, eating and exercise—and ignore the emotions floating underneath the surface.

Oftentimes it’s only when the problems caused by food and body obsession get big enough or difficult enough in and of themselves that some people become willing to go deeper to reveal, feel and heal their pain.

The good news is we can heal our unresolved pain, make peace with difficult life situations and learn how to effectively cope with emotions. Obsessing on recipes, food, cooking, and exercise is a never-ending cul-de-sac since we still have difficult life situations occurring while we are cooking, baking and running. The only real solution is to gain emotional coping skills.

If you have orthorexia, take a look at how isolated and limited your life has become. See if you would be willing to step out of your comfort zone just a little bit. Consider taking a class you have been interested in—one that has nothing to do with food or exercise. Try connecting with an old friend, reaching out to someone new or seeking professional help.

The next time you find yourself obsessing on food or exercise, try asking yourself what you might be thinking or how you might be feeling if you weren’t thinking about food or exercise.

Consider challenging yourself to eat a food that is not on your “safe” list and see that nothing bad will happen if you do. You might have some big feelings but you will not get big from one food item. You can learn to ride your emotions out until they pass and become stronger and more equipped as a result.

You might start by adding one new food a week, continually testing the safety of the water. If you are having a free-range burger with organic aioli, try adding a few fries. The next time your friends are going out for pizza, try one slice with your salad instead of a salad only or staying home. Afterward, try writing down all your thoughts and feelings, and then reassure yourself that you are not unsafe, just emotionally full. The next time you are at a birthday party, consider having one piece of cake, even if it’s not organic.

See if you can begin to speak more kindly to yourself. Your self-doubting thoughts led you into these rigid patterns in the first place, they will not be what get you out. Just like a child who is afraid to go to their first day of school, you will need a lot of kindness and compassion as you step out of your seemingly safe rules. You can begin to find safety, value and worth in yourself that is unrelated to your exercise output or your food intake.

A quote I like sharing with clients is: “Ships are safe inside the harbor but is that what ships are for?” It is safe to venture out. You don’t have to set sail for months. Simply taking one small step outside of your safe, self-made comfort zone can help you develop new skills and prove to yourself that your safety does not come from food control and exercise routines but from self-care and self-soothing.


Andrea Wachter is a Licensed Marriage and Family Therapist with a private practice in Soquel, co-founder of InnerSolutions Counseling Services, and co-author of “The Don’t Diet, Live-It Workbook.” For more information on her book, her online course or other services, visit innersolutions.net.


Comments (2)Add Comment
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written by Observer, April 04, 2014
I am fascinated by this because I observed a co-worker who fits this description to the letter. I had even found the term Orthorexia online because the behavior baffled me and in a quest to understand the extreme behavior I did some research. The problem is that someone with this disorder (or from what I observed) thinks they are so very RIGHT. It's like listening to someone with extreme religious or political beliefs. They become a zealot and everyone else is wrong, so I don't think you can help by gently pointing it out. In fact this particular gal is studying to be a nutritionist so she can sway others to eat as she does. I often wondered what she sees in the mirror because to the rest of us it was a very emaciated, aged beyond her years, sallow look. The body dysmorphia is astounding. I truly hope that someone breaks through at some point and says, "You are killing yourself." So far even doctors have not broken through. On a last note an unfortunate side effect of all this is that no one wants to be around that person because the constant talk of food, what's bad for you, what allergies she had, and on and on are very off putting. I truly hope the best for anyone who has this and that they learn to regain control in a healthy manner.
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written by Erick of Soquel, April 02, 2014
This is an opening salvo here in Santa Cruz. You could be run out of town in an all electric car.

I would point out that, like other forms of obsessive-compulsive behavior, that it is not the act itself that is the pathology but it's being done with extreme intent... (to assuage the anxiety).
Let's not throw out the baby with the (non-chlorinated) bathwater.

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