Orthorexia- the “socially acceptable” eating disorder

My eating disorder like many, has been a shape shifter over the years, meaning at various times I would have met criteria for more than one diagnosis besides anorexia nervosa.

We are all human beings. Fitting into criteria or a neat little box isn’t congruent with being human. And so whilst diagnostic criteria can be useful to help identify or guide which treatments may or may not work for you, I think that’s where their relevance ends.

What is Orthorexia?

The Diagnostic & statistical Manual of Mental Disorders (DSM-V) does not currently hold a separate diagnosis for Orthorexia. Instead it technically fits under the diagnosis Avoidant Restrictive Food Intake Disorder (ARFID) , although not perfectly, we return to my point about us being humans and not fitting neatly under one set of criteria.

This is a disorder characterized by an obsession with eating “healthily” or “clean” foods. A person becomes fixated on eating only foods they deem to be “pure”, meaning they can adopt strict rules and restrictions around foods and how they are consumed. I called it the “socially acceptable” eating disorder because it can be hard to detect in a society that praises restriction and demonizes anything else. People often reward people for eating “cleanly”. No eating disorder is ok. Orthorexia is when a persons focus on eating healthily actually becomes detrimental to their health, as a result of the obsessions, restriction, nutritional deficiencies and effect on the body.

It wasn’t until I started recovery for anorexia I realised I needed to challenge this too.

Orthorexia complicated my recovery, as I mentioned eating disorders are shape shifters, my way of “coping” with recovery became focusing on nutrition for a short while. If you are trying to recover by eating only “healthy” foods, you need to challenge this.

You cannot recover from a restrictive eating disorder holding on to ANY rules around foods. My obsession with eating healthily also preceded my development of anorexia and at some points other ED symptoms.

It is generally accepted that people experiencing orthorexia are not always driven by a fear of weight gain or drive to be thin, unlike anorexia. It can result in body dissatisfaction but weight loss it is not the driving factor (usually). It is about feeling clean and pure. I have no doubt that it could lead to anorexia in those of us with the genetic susceptibility because it can result in energy deficit.

Some of the warning signs of Orthorexia may include:

• Unhealthy obsession with checking ingredients or contents of food (not driven by a fear of weight gain)
• Cutting food groups because they are deemed “unhealthy”
• Rigidity, not being able to eat foods not prepared by themselves or consume foods they do not know the ingredients (again not as a form of intentional energy deficit)
• Distress, obsession impairing well being

If you think you have a problem, any concern with disordered eating, it is always good to seek help. Talking to a GP, a health at every size aligned dietician or therapist would be a good place to start. You deserve to have mental freedom.

Helplines/websites:

• USA: National Eating Disorder Association (NEDA) https://www.nationaleatingdisorders.org/
• UK: BEAT: https://www.beateatingdisorders.org.uk/support-services/helplines
• Australia: https://butterfly.org.au/who-we-are/contact-us/
• NZ:https://www.ed.org.nz/
• International: https://www.eatingdisorderhope.com/treatment-for-eating-disorders/international/india
• A really good Instagram account:https://www.instagram.com/OrthorexiaBites/