The growing popularity of “clean” eating and Instagrammable lifestyles imitating the likes of models and celebrities like Miranda Kerr or Shilpa Shetty can make healthy eating seem trendy and beneficial. But for some, finding the nutritional values of food and being aware of the minute details of what they put in their body can become a cause of extreme fixation and unhealthy obsession. “I could fly under the radar because of the value placed on healthy eating: to an outsider it just looked like I was into eating super clean and fitness,” says Emily Fonnesbeck, registered dietician based in the USA, who recognised her signs of orthorexia after an uphill battle of over five years, in the podcast Food Psych. “Even when the physical symptoms of undereating caught up to me in the form of fatigue, headaches and digestive issues, I didn’t take it as a red flag. I saw it as a result of not eating perfectly enough.”

 

Coined by Colorado physician Steven Bratman, MD, in 1997, orthorexia (Greek for “correct appetite”) nervosa (Latin for “nervous”) is an unhealthy obsession with healthy eating. Orthorexia is not yet recognised as a clinically diagnosed eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but that does not mean it is any less harmful. Unlike other eating disorders which show themselves through controlling the quantity of food eaten, orthorexia places value on the quality, as explained by research shown at the Indiana University ScholarWorks Conference, 2015. According to this study, orthorexia is an obsession with the purity of what you eat, and weight loss is not a goal but an unintentional consequence. Those with orthorexia focus on eating foods that make them feel healthy to such an extent that they tend to avoid all foods containing the following:

 

• Pesticides or herbicides
• Artificial colours, flavours, or preservatives
• Unhealthy fat, sugar, or added salt.

Although being aware of and concerned with the nutritional quality of the food you eat is not a problem in and of itself, people with orthorexia become so fixated on so-called “healthy eating” that they actually damage their own well-being.

 

How Orthorexia Affects Your Health
The negative ways in which orthorexia can affect your health can fall under these two categories:

• Physical Health: It is likely to cause similar medical complications to other eating disorders. Cutting out essential food groups can cause a shortage in nutrients, which can lead to malnutrition, anaemia or slowed heart rate, as seen in a study titled Microthinking about Micronutrients published in 2016. Nutritional deficiencies can lead to digestive problems, hormonal imbalances and even impaired bone health.

 

• Mental Health: Those with orthorexia can experience frustration when their desired quality of food is unavailable. This is associated with feelings of shame and guilt when their own dietary rules are broken. People can get extremely preoccupied with researching, cataloguing or measuring food, and spend most of their time doing so. Eating out and social gatherings lose their fun, and this can lead to feelings of social isolation. According to psychiatrist Nancy S. Koven’s research, it can also give people feelings of moral superiority based on their “better” eating habits, which can make social interactions hard, and affect their overall mental wellbeing.

 

Warning Signs of Orthorexia
Orthorexia does not have any validated tools for diagnosis as of yet, which is why it is difficult to say conclusively how frequently it affects people. Research on the precise causes of orthorexia is very limited, although it has been linked to risk factors like tendencies towards perfectionism, anxiety, a need for control and even recovery from other forms of disordered eating. So how do you understand when your concern with healthy eating has crossed a line? The National Eating Disorders Association, USA, lists the following warning signs to look out for:

• Compulsive checking of ingredient lists and nutritional labels.
• An increase in concern about the health of ingredients.
• Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products).
• An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’.
• Feeling shame or guilt when “unhealthy” or “impure” foods are consumed
• Unusual interest in the health of what others are eating
• Spending more than 3 hours per day thinking about what food might be served at upcoming events
• Showing high levels of distress when “safe” or “healthy” foods aren’t available
• Obsessive following of food and “healthy lifestyle” blogs on Twitter and Instagram

 

How to Prevent Patterns of Unhealthy Eating
If you find yourself identifying with the symptoms of orthorexia, it is important to seek professional help. Treatments of orthorexia can include working together with a mental health professional and a nutritionist to come up with the best solutions for your health. But challenging unhealthy “healthy” eating habits can begin on a personal level.

 

• Practice intuitive eating: Intuitive eating is a lifestyle that rejects dieting mentality and places importance on the satisfaction found from eating foods that we want. It removes the focus from “perfect” eating and differentiating between “good” or “bad” foods, and chooses instead to focus on satiating hunger.

 

• Detox your social media: A 2017 study published in the journal Eating and Weight Disorders found a link between Instagram use and orthorexia. Healthy eating and diet-related posts are rampant on social media, and they can affect your perception of nutrition. Unfollow people and accounts who might be negatively affecting your body image and making you feel judged for your food choices.

 

• Use mealtimes to connect with family and friends: Social isolation is a common effect of strict diets. Make meals interactive and fun by eating with others. Save some time in your day or week to spend catching up with your friends and family, where you can fully enjoy what you like to eat.