a medical condition in which the sufferer systematically avoids specific foods in the belief that they are harmful.
(source)
Over the past few years, orthorexia has become a better-known term. It is thought to be one of the most common eating disorders, however, because it is not recognized in the Diagnostic and Statistical Manual (DSM), exact medical research is scarce. Orthorexia is thought to be recognized under the Otherwise Specified Feeding and Eating Disorder (OSFED) category, but research on OSFED alone encompasses so many vast behaviors and thought patterns, and cannot reflect orthorexia alone.
So, what is orthorexia?
The National Eating Disorders Association states the symptoms of orthorexia as:
- 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’
- Unusual interest in the health of what others are eating
- Spending 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
- Body image concerns may or may not be present
It is rare to find treatment specifically for orthorexia. However, treatment from general OSFED, anorexia, bulimia, and binge eating is more easily accessible than orthorexia or other specific disorders that fall under the OSFED category. When you're in the beginning of recovery, especially in a treatment program/facility, you're in a tiny bubble of safety. However, sneaky diet culture can slip it's way in and if it doesn't, it will once you're back in the "real world". For those of us diagnosed with an eating disorder, we may be prone to not just relapse but a "switching"of diagnostics. There is no exact statistics, but sources such as Healthy Place, Science of EDs, and Orchid Recovery have stated that switching symptoms is very common. Because of this likelihood being mixed with orthorexia on the rise, not only could people with EDs (especially restrictive ones) slip into orthorexia, but it could be ignored or invisible.
As orthorexia weaves it's way into a sufferer, it is seen to present intentions of health, wellness, and prosperity. The goal of eating disorder recovery is to gain back heath and liveliness, but with a world full of short-term (if any "term" at all) solutions that seem so promising, it can be easy for your eating disorder to seek a new obsession in attempt to not be eradicated. Perhaps it's something commercial such as Atkins, Weight Watchers, or a well known gym. Maybe it's paleo, raw food, or high carb-low fat. Or perhaps it's an exaggerated adaptation of things you always associated with health. When it boils down to it, it doesn't matter what you are or aren't eating that determines "how orthorexic" you are, it's the mindset you have.
For the next bit of text, I'm going to be talking about my experience with anorexia nervosa and orthorexic tendencies. If you have concerns that it may be triggering, scroll until you see bright blue text like this.
I was around 8 years old when I unknowingly developed anorexia symptoms. I would avoid eating before school weigh ins, only eat a reasonable quantity of food before or after gymnastics, and force myself to look in the mirror during routines for "motivation". I didn't know anything was wrong but after my usual picky eating became less and less, my parents and one coach started to worry. After learning what anorexia was, I was determined not to upset anyone by "getting it". Still, I couldn't bare to let go of what controlled eating gave me. I convinced myself I didn't have anorexia- I couldn't. Even the doctor implied I couldn't possibly at my age. In order to be my healthiest and still not become lazy, or fat, or whatever I dreaded, I used basic elementary nutrition knowledge to build off of that. I wasn't limiting my intake- in fact I could eat lots of food...if it was safe. I went vegetarian (a decision I am now happy about but was probably unhealthy at the time), followed fitness blogs, learned to count macros, exercised relentlessly, uploaded workout pictures, and of course tracked my food. I would freak out about being offered "unhealthy" food and make sure everyone knew I wasn't blind to "how bad I was". But deep inside, I couldn't keep up the healthy front. It wasn't what my eating disorder wanted anymore. I was still anorexic, but developed so many orthorexia symptoms that would not go away, at least not easily. Fitspo lead me to thinspo then to bonespo and so on. I swapped health blogs for pro-ana communities. My ED was thrilled to finally be "free to starve". Fast forward to discharge from the first inpatient. I was more aware of diet culture than ever before. Health was no longer something I wanted, but everyone wanted it for me. If health truly was cleanses, fasts, and macros then why couldn't/shouldn't I participate? My parents always were the wiser, but it was easy to use modern day health claims to keep my eating disorder while portraying I was recovering. But, it got trickier when I was convinced I really was recovering. I was physically recovering but found myself tensing at the thought of not replacing every ingredient with a "superfood" version. It doesn't last long for me before my anorexia decides to say "screw it" and accept my unhealthy intentions, but I always get conflicted between what's real recovery and what's my illness trying to stick around. Still, I speak from a place of privilege, considering I have never dealt with full blown orthorexia.
So, what can we do to be sure were not trading out one eating disorder for a more socially acceptable one?
-eat traditionally "unhealthy" foods when you either have support or feel it necessary.
-if you can afford to, find an intuitive eating/health at every size dietitian, therapist, physician, or other clinician
-again, if you can afford to, seek treatment at a place that treats orthorexia in addition to your diagnosis (One I've heard of, Timberline Knolls, treats orthorexia)
-build up a supportive network
-discard any photographs, accounts, blogs, etc regarding health and nutrition
-rely on you care provider(s) to make nutritional decisions for you until they can allow your involvement
-challenge your thoughts through journaling or other thought-stimulating activities
-be vulnerable and reach out to a hotline, chatline, or website supporting eating disorders
-open up to a loved one and/or care professional
-don't blame yourself. it's okay to struggle and recover
Because orthorexic behaviors are so normalized, it can be hard to differentiate true health and disordered behaviors. You are not alone or invisible if you're silently struggling with orthorexia.
For more information visit nationaleatingdisorders.org or mirror-mirror.org/orthorexia-nervosa
