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Last updated on June 27th, 2024 at 06:19 pm
Are you obsessed with eating clean? Do you feel obligated to shift your body to be just “a little fitter?” These seemingly “healthy” goals are also common orthorexia symptoms.
Orthorexia is the eating disorder that is often associated with:
- Healthy eating that went a little too far
- An obsession with zero or low-calorie foods
- Desiring changes in the body size or shape (but not always wanting to be thinner)
- Extreme dieting
- Obsession with clean, organic, or other food trends
While orthorexia is not an official eating disorder diagnosis according to the DSM-V, this does not make the condition any less disrupting to your life or downright dangerous.
In this article, we’ll explore the meaning of orthorexia, the symptoms of the condition, and the steps to recovery.
Orthorexia Meaning
Orthorexia is the obsession with achieving proper nutrition and optimal health to the extent that it reduces a person’s quality of life or becomes dangerous.
Orthorexia can lead to severe physical and mental restrictions of food.
The distinguisher between orthorexia and simply “healthy eating’ are that orthorexia:
- Impairs your quality of life
- Decreased mood with food restrictions
- Comes with an intrusive eating disorder voice or inner critic
- Comes with health risks
- Is ritualistic
At this point, there is no definitive way to measure orthorexia.
Orthorexia symptoms can be different from person to person, which makes it difficult to diagnose and get appropriate treatment for.
Orthorexia Vs. Anorexia
With both anorexia and orthorexia, there is a lot of “noise” in your head that keeps you doing other activities you enjoy.
Orthorexia and anorexia are similar in that:
- You can’t stop thinking about food
- You Have many food rules
- You feel guilty after eating something that’s not a safe food
- You may hate your body
- Intense fear of gaining weight
- You desire perfectionism
- You feel like it’s impossible for you to just eat normally
Differences between orthorexia and anorexia include:
- Orthorexia focuses on “healthy foods” whereas anorexia focuses on shrinking the body
- Anorexia is diagnosed according to the DSM-V using weight criteria
- Orthorexia has no weight criteria
- Orthorexia is not a formal diagnosis in the DSM-V
- Weight loss may or may not be a desire of someone with orthorexia
- Orthorexia may not result in weight changes
- Anorexia is characterized by weight loss
Orthorexia does not always come with weight loss or even a desire to lose weight. It is a myth that eating disorders always mean weight loss.
Food restriction in orthorexia can look different than what is seen in other eating disorders, as the hallmark of orthorexia is being “healthy” rather than changing appearance.
I think it’s important to note here that while the official diagnosis for anorexia nervosa involves weight loss, this is not always the case for atypical anorexia (an eating disorder that meets all the DSM V criteria for anorexia other than the weight criteria).
While BMI is commonly used to diagnose eating disorders, BMI is a flawed screening tool. Using this tool alone will cause us to miss eating disorders.
What Are Some Orthorexia Symptoms
Symptoms of orthorexia vary highly from person to person. However, some common symptoms include:
Behavioral Symptoms of orthorexia
- Cutting out food groups
- Obsessions with clean eating
- Cutting out gluten, dairy, or other food types
- Only eating organic foods
- Vegetarianism or Veganism
- Being preoccupied with protein-rich foods
- Excessive weighing
- Ritualistic food preparation routines
- Cutting out fats
- Excessive exercise
- Desire to “bulk up”
- Isolation
- Diet pill use
- Preoccupation with avoiding chronic diseases
- Use of cleanses or fasting
- Feeling hungry after eating
- Frequent body checking
- Abusing insulin (for type 1 diabetics)
Physical Symptoms of Orthorexia
- Gastroparesis (slowed digestion)
- Hair loss
- Low bone mineral density
- Low heart rate
- low blood pressure
- Weight loss
- Low blood sugars from food restriction
- Abnormal lab values
- Starvation syndrome
Vegan Orthorexia
Vegetarianism and veganism are common ways that orthorexia can show up.
If someone reports they are vegan, they should always be assessed for an eating disorder. The high level of rigidity and restriction of the vegan diet is attractive to a person obsessed with orthorexia.
Some reasons that extreme eating patterns such as veganism are attractive to someone with orthorexia are that:
- They are socially acceptable
- They focus on fruits and vegetables which soothe the “healthy food” fixation
- There is a clear set of rules
- They offer communities that can reinforce the choice to be vegan
- They can be justified using environmental and animal rights components
- They often make it necessary to socially isolate (for example, no vegan restaurants available)
- Fewer questions are asked when foods are avoided
Vegan eating disorder recovery can be tricky. It is not appropriate for most people to follow a vegan meal plan in eating disorder recovery unless the reasons behind being vegan is tied to ethics in nature.
The vegan lifestyle should also predate the eating disorder by several years if this eating pattern is to be considered in recovery.
Orthorexia Recovery
The goals of orthorexia recovery will include:
- Normalizing meals and snacks
- Eliminating fear foods and food rules
- Weight restoration where necessary
- Working through body dysmorphia
- Normalizing the relationship with exercise
For most people in orthorexia recovery, a mechanical eating plan developed by an eating disorder dietitian will be critical. It can sometimes be necessary to achieve overshoot weight gain before we see digestion, metabolism, hormones, and organ function return to normal.
A healthcare team including a doctor, a therapist, and a dietitian is typically necessary.
Inpatient and outpatient treatment options are an option for orthorexia recovery, with those with high-risk behaviors typically needing a higher level of care.
Some difficulties with obtaining treatment for orthorexia include:
- Treatment may not always be covered by insurance as orthorexia is not a medical diagnosis
- People with orhorexia may not meet weight criteria for certain treatment centers, even though their medical condition is just as dangerous as anorexia or other eating disorders
- Symptoms of orthorexia often go unnoticed because they are disguised as healthy eating
Orthorexia Recovery Tips
These tips can help you stay motivated during your orthorexia recovery:
- Find someone you trust to tell about your eating disorder
- Practice body respect through food and outside of food
- Challenge your food rituals by creating a fear food hierarchy chart
- Do a social media purge of triggering accounts
- Keep a list of eating disorder recovery quotes that inspire you
- Practice joyful movement instead of exercise to bulk up or lose weight
- Journal using body positive journal prompts
- Practice honoring all types of hunger
- Seek appropriate meal support
- Check out appropriate eating disorder recovery books
It might be helpful to try food chaining for foods that cause high anxiety.
Recovery from orthorexia is sometimes a long road. The path is typically not linear. Eating disorder relapse can be a common part of the recovery journey.
These experiences do not mean that we are failing at recovery or that recovery isn’t worth it. It is simply important to give ourselves time and grace in the process.
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