The eating disorder spectrum is far-reaching. Most of the general public understand what anorexia, bulimia, and binge-eating disorder are. However, there are other eating disorders that affect men and women, too. One of those less common disorders is orthorexia.
What is orthorexia?
Orthorexia is a condition where "healthy eating" goes too far and becomes a preoccupation, explains Dana Harron, PsyD, clinical psychologist at Monarch Wellness and Psychotherapy. “This is not simple ‘clean eating’. Food preferences often become so rigid that the sufferer is not able to enjoy every day social interactions, such as going out to a restaurant.”
I understand this preoccupation first-hand. After I began to recover from anorexia, I easily slipped into orthorexia without realizing it. And apparently, according to Harron, orthorexia and anorexia are quite similar.
“Someone with anorexia is focused on calories and fat and fears weight gain,” says Harron, “but somebody with orthorexia is focused on other aspects of food, such as preservatives, pesticides, or allergic potential."
Harron explains that people following all kinds of diets can be orthorexic when there is not enough flexibility in eating. "Even eating organic can be taken too far if it prevents you from functioning in other parts of life,” she says.
Similar to what Harron describes, I, too, feared going out to restaurants. I also was obsessed with foods’ contents, and feared that I wasn’t eating healthy enough. I basically switched one control-based eating disorder for another.
Why orthorexia is dangerous
Ironically, orthorexia, even though it's focused on healthy food, often has negative health effects for the sufferer. “They [the sufferer] may have difficulty obtaining an adequate range of food-based nutrients,” says Harron.
“One of my patients had OCD. Choosing foods she thought were healthy was a driving force for her,” adds Dr. Gladys Frankel, an expert in eating disorders. “She wouldn't eat stir fry because she didn't know every ingredient and every ingredient in a sauce.”
Dr. Steven Rosenberg, a psychotherapist and behavioral specialist, says that orthorexia is tough to beat because in order to overcome a healthy eating disorder, the sufferer must learn how to eat in a healthy way instead of eating healthy foods.
Kimberly Wick, an eating disorder expert at Walden Eating Disorders Treatment, adds that orthorexia is so dangerous because of its defining factor: If given the choice between eating something they’ve identified as healthy and going without food, they would choose the latter.
“Those impacted often have such strict food rules that they eliminate consumption of entire food groups. This often includes processed foods, sugar, meat, dairy products, carbohydrates, and gluten,” says Wick. “When individuals stray from their self-imposed diet, severe anxiety, distress and self-punishment—restriction, purging or excessive exercise—can result.”
Rosenberg says that the first step to overcoming an eating disorder is to get the patient to recognize that they have an illness. “This is usually extremely hard for someone to accept because they don’t understand the concept [that] eating too healthy can be unhealthy.”
I can vouch that this was the most difficult thing to get over. I had to relearn that cheese isn’t bad. Also, that eating a piece of cake would not make me gain weight, or warrant an immediate gym visit.
Eventually, I learned how to truly eat healthy and was able to reincorporate food into my diet. And although I still struggle with body image and body dysmorphic disorder, the tools I learned in therapy, which was primarily cognitive behavioral therapy-based (CBT), help me keep my food related control issues at bay.
Frankel adds that dialectical behavior therapy (DBT), and mindfulness with exposure therapy can help someone manage orthorexia, as well as helping a patient understand that flexibility and underlying emotional issues also can help people learn to be less dogmatic about their food choices. Because no food is truly a “bad” food.
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