What Is Orthorexia?

If you're overly obsessed with healthy eating, then you may be at risk of Orthorexia - we look at what it is, and how to cope with it...

'I don't remember college,' Katie Horwitch writes on her blog. 'I remember bits and pieces, sure, but what frightens me the most is that while I should remember the details of things like play rehearsals or nights out, I remember the times I calculated out how much I would eat and what I would eat. I remember the omelet I ordered for breakfast out with friends. I remember the wrap that was “safe.” I remember eating a pear past 8pm and feeling like I’d cheated.'

We've heard of Anorexia and Bulimia, as well as Binge-Eating Disorder and Compulsive Overeating Disorder, but now there's a new addition to the list that's been making headlines recently. Orthorexia isn't officially recognised as a disorder, and there are no stats surrounding the amount of people it affects, but, according to the eating disorder charity Beat it's characterised as 'a pathological fixation with healthy food and has been described as “a disease disguised as a virtue”'. Why a virtue? Because it's not a fixation on being thin, but a fixation on being healthy - from organic to GMO free, Orthorexics will start out just avoiding stuff that's bad for them, but this quickly spirals into obsession.

American blogger Jordan Younger made waves on her then-blog The Blonde Vegan when she found her supposedly healthy lifestyle had meant she'd walked an extra mile because the juice bar they'd gone to didn't stock the exact juice she felt safe drinking. 'Things continued to spiral downward for a few more weeks,' she writes in her blogpost Why I'm Transitioning Away From Veganism (that crashed her site). 'When my mom and sister were in town, I don’t think I enjoyed a single meal with them. I ate before or after seeing them, panicked that the food at the restaurants we were going to was going to make me feel like crap and throw off my system.'

Healthy eating is one thing, but it's only when it starts impacting your day-to-day life, that an interest in nutrition becomes a pathological obsession. 'The quality of the foods they consume becomes more important than personal values, relationships, career plans and social life, causing the individual to give up his or her normal lifestyle,' a spokesperson at Beat told us. It's about control, as Katie told us, and while she's now overcome her problems with Orthorexia, she can remember it all too well.

'I knew I wanted to lose some weight to be comfortable in my own skin again, and when I finally did, my form of “maintenance” was to shift my focus on not my weight, but instead how “healthy” my meals were,' she told The Debrief. 'Ironically, it was after I made that shift that I dropped down to my lowest weight and lost track of my outgoing, bubbly, leader personality. Nothing felt safe unless it was in my control.

How does it relate to body image?

In Katie's case it was more to do with control - control wasn't just to do with food, but extended to - and damaged- other areas of her life: 'I wouldn’t go out if I didn’t know when I’d be home, I wouldn’t do projects in class that I hadn’t been outright told by my professors were “right” for me, and I certainly wouldn’t go out to eat with friends if I couldn’t focus solely on the food,' she continues. 'A healthy eating practice is to eat “mindfully” without distraction, but Orthorexics take that idea to an extreme. It felt like everyone was watching me, and while in hindsight I know they weren't, at the time it felt like harsh judgement.'

This all sounds fairly similar to Anorexia but the main differences are that Orthorexia isn't focussed on not eating, or restricting, but on the content of the food which subsequently can lead to starvation. First it's all-organic, then it's avoiding GMO, then it's lactose, meat, gluten, then fruit with pesticides, then the mercury in certain fish, then you're left with very little that an extreme Orthorexic is able to eat - as you can see, it shares a lot of similarities with Obsessive Compulsive Disorder and arguably remains unrecognised medically mainly because of this. 'One school of thought is that it ought to be treated as a disorder concerning abnormal eating behaviour inseparably linked with obsessive-compulsive symptoms around the consumption of healthy food,' Beat told us. 'but because it isn't concerned with body image, a lot of people believe that it shouldn't be paired with Anorexia and Bulimia.'

Of course, body image isn't necessarily the reason people suffer from Anorexia and Bulimia, either, so this argument doesn't quite hold up (come on doctors, get it together), and Katie strongly believes that there should be better education surrounding the different disorders. Thanks to the growing press attention, and the misinformation, people on Twitter are tagging pictures of smoothies and lightheartedly hashtagging them #Orthorexia, as if this disorder is just about eating healthily and nothing more. Until it's taken seriously by doctors, it's unlikely these misconceptions will change for the better.

'Should it be recognised as a disorder? Yes, yes a million times over. And I think that more than just being recognized as a disorder, there needs to be immense education on it for the average person,' she says. 'We like to make generalizations about eating disorders and get them mixed up all the time – I’ve heard or read comments generalizing Orthorexia and it hurts my heart. If someone is being mindful about what they are eating, or lives off a “clean” diet rich in whole, real foods, there’s absolutely nothing inherently wrong with that. Orthorexia is not about what’s going on in your stomach – it’s about what’s going on in your mind.'

Is it just healthy eating?

If you've got a mate who is starting to become obsessed with healthy eating, it's probably not helpful to barrel up to them and start preaching about the dangers of Orthorexia. Like with any mental health issue, people often don't realise - or won't admit - they have a problem, and being too overbearing can do more harm than good. Instead, watch out for the symptoms - Beat tells us it involves preparing food in a certain way, regularly forgoing social occasions because of food preferences and avoiding whole groups of food that they believe could be harmful for their health, as well as behavioural changes. 'Firstly, listen and support in a non-judgemental way so that your friend or family member will learn to trust you and the support you are giving, and secondly, try not to give advice or criticism, but give time – and listen,' the charity suggests. 'You don’t have to know all the answers but just being there is the key.'

As Jordan's blog The Blonde Vegan became The Balanced Blonde, regularly documenting her attempts to maintain balance and ensure she doesn't go to the same extremes as she discovered in that juice bar last year, Katie has to stay mindful of balance. As she puts it: 'There will always be little dust bunnies in my head from the way things used to be, ones that like to sneak out and play after I’ve eaten something I used to shun, or when I wake up bloated - but I remind myself that my body changes by the day, by the minute, even. I’ve been sick, I’ve been healthy, my appearance has shifted time and again. But you know what? By listening to my body, I now know what it actually needs.'

If you're worried that you might have a fixation on healthy eating, then you would be forgiven for not wanting to go to your GP considering it's not a recognised problem - but Cognitive Behavioural Therapy (that works to change thought processes and perspectives) can really help, and there are loads of exercises on Katie's website, Women Against Negative Talk, that are tried-and-tested that can aid recovery.

She also believes in being imperfect on purpose, to try and rewire an Orthorexic's obsession with control and only eating the cleanest, healthiest things possible. 'By this, I don’t mean planning for a “cheat” meal or a decadent dessert – I mean consciously making a spur of the moment, unplanned, conscious decision to have something you might deem less-than-virtuous,' she explains. 'Something you’d actually really like the taste of and would eat if it were not for its “bad” nutritional value. At the coffee shop and a touch of cream sounds good? Go for it! There’s cake at work that looks ridiculously delicious? Steal a bite or two. It’s like exercising a new muscle: un-perfecting yourself makes it a whole lot easier to be forgiving of yourself any time you “slip”, which means your body will automatically relax and realize it doesn’t need to live in the defensive.'

Does my friend have it?

According to the National Centre For Eating Disorders, the symptoms of Orthorexia include the following:

Fingers crossed that all this renewed interest in Orthorexia will see it medically recognised, so those who have no idea they have a problem can acknowledge it and get help. Check out the Beat website for more information on disordered eating.

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Follow Stevie on Twitter: @5tevieM

Picture: Maggy Van Eijk

This article originally appeared on The Debrief.