Preventing Orthorexia

We all know that nutrition is important for our wellbeing. It is nearly impossible to escape the messaging, particularly in the developed West. There are articles, social media posts, news segments, wellness experts, and healthcare professionals all claiming to know what foods you should eat and what foods to avoid. The barrage of information is near constant and often contradictory and confusing.

For those of us who are very conscious of our health and want to improve/maintain our wellbeing, we pay close attention to these messages. There is value in nutritional information, in knowing what foods are shown to improve our health and increase our longevity. However, there is a subset of vulnerable people who take nutrition information – particularly information delivered in black and white or even life and death terms – and develop an unhealth obsession with eating healthy or “clean.”

An obsession with healthy or “clean” eating could be signs of a disorder called Orthorexia Nervosa. Orthorexia is characterized by the following symptoms [1,2,3]:

• Eating healthy or ”clean” is considered the most important thing in life
• Spending the majority of the day thinking about food
• Being obsessive about reading labels and only eating “clean”
• Only being willing to eat a limited number of food groups
• Fixating on what others are eating and judging them for it
• Considering eating choices as an indication of moral superiority
• Becoming highly distressed when only provided foods that do not fit approved criteria

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While not considered an official eating disorder (it is instead classified as an unspecified eating and feeding disorder [2]), by the Diagnostic and Statistical Manual of Mental Disorders - V (DSM-V) those who express the characteristics described above often experience damage to their health and wellbeing including malnutrition and psychological impairment. These negative consequences to physical and mental health are also experienced by those suffering from the DSM-V recognized eating disorders of Anorexia Nervosa and Bulima Nervosa, and has resulted in many mental health professions treating Orthorexia Nervosa as an eating disorder [1].

At this point you may be thinking, but wait, I thought eating certain foods and avoiding others was extremely important to our health? I thought nutrition was one of the main ways we improve/maintain our physical and mental health? Shouldn’t eating healthy be a priority?

You are correct. Nutrition is very important. However, there are three things to keep in mind:

1. When healthy eating becomes an obsession, it becomes another stressor in your life. Chronic stress has been shown to be extremely detrimental to our physical and mental health [4].
2. When you have extreme anxiety about being in a situation where you do not have access to the only foods you allow yourself to eat, and/or you are constantly analyzing and judging what others eat, socializing will become difficult. Social connection is crucial to our physical and mental wellbeing [5].
3. Our bodies and minds are the healthiest when we eat a large variety of foods. Cutting out entire food groups can lead to malnutrition [1,2,3].

In essence, eating healthy foods should not result in chronic stress or social isolation, as they will counteract any benefits provided by the nutritional value of the food.

A Different Approach to Nutrition

So, now we know that fixating on nutrition to the point where it becomes an obsession has negative impacts on our health, but nutrition is still important. How do we honor it in a healthy way?

In their book, Intuitive Eating, Evelyn Tribole, MS, RDN, CEDRD-S and Elyse Resch, MS, RDN, CEDRD-S, FAND, explore “Gentle Nutrition,” the approach to healthy eating without the obsession that can lead to chronic stress, social isolation, restriction, and even disorders such as Orthorexia Nervosa.

The following tenets of Gentle Nutrition are powerful whether you are someone looking to eat healthy or a wellness professional looking to help your clients [6]:

1. What you eat for one meal, or even for one day, is not going to make you healthy or unhealthy. What matters most is the average of what you eat over time.
2. Taste and pleasure still matter when eating healthy foods. If you don’t like it, don’t eat it. There is a huge variety of healthy foods out there and numerous ways to prepare them. Experiment until you find what you actually enjoy.
3. Junk food, or what Intuitive Eating refers to as “play food,” is still an important part of your food intake. When we restrict a food, the more we crave it, and the more we lose control when we finally give in and allow ourselves to eat it.
4. Nutrition science is constantly evolving. Use your common sense and your intuition. Pay attention to how the food you are eating makes you feel.
5. You have the right to set boundaries with others in regards to your food choices. Only you know what foods provide you with the right balance of energy, satiety, pleasure, and overall wellbeing.
6. Your weight should not be the primary indicator of your health. There is much more to your health than the number on the scale.

As someone with a history of an eating disorder, I often find the nutrition information provided by the media and in the wellness space to be scary and overwhelming. Keeping these tenets in mind helps to decrease my anxiety about my food choices, and I am able to eat a variety of healthy foods that I enjoy along with my play foods, without guilt.

If you are someone who is working on eating in a way to support your health and wellbeing or are a wellness professional guiding clients on their nutrition journey, I strongly encourage you to keep in mind the dangers of obsessing about nutrition, and to use Gentle Nutrition as guide to healthy eating. Wellness is not about setting strict parameters. It is about being kind to ourselves, being open to all the possibilities for healing, and intuiting what works for our unique body, mind, and spirit.

Here's to your wellbeing.

Resources

1. Scarff, Jonathan R. MD. “Orthorexia Nervosa: An Obsession With Healthy Eating.” Federal Practitioner, 2017, v. 34(6), p. 36-39, PubMed Central, March 12th 2024. www.ncbi.nlm.nih.gov/pmc/articles/PMC6370446/
2. “Orthorexia.” The Body Project, Bradly University, 2021, Marth 12th 2024. www.bradley.edu/sites/bodyproject/disorders/orthorexia/
3. Dennis, Amy Baker, PHD, FAED. “Orthorexia.” National Eating Disorders Association, March 12th 2024. www.nationaleatingdisorders.org/orthorexia/
4. “How stress affects your health.” American Psychological Association, 2022, March 12th 2024. www.apa.org/topics/stress/health
5. Martino, Jessica, Jennifer Pegg, and Elizabeth Pegg Frates, MD. “The Connection Prescription: Using the Power of Social Interactions and the Deep Desire for Connectedness to Empower Health and Wellness.” American Journal of Lifestyle Medicine, 2017, v. 11(6), p. 466-475, PubMed Central, March 12th 2024. www.ncbi.nlm.nih.gov/pmc/articles/PMC6125010/
6. Tribole, Evelyn, MS, RDN, CEDRD-S and Elyse Resch, MS, RDN, CEDRD-S, FAND. Intuitive Eating: A Revolutionary Anti-Diet Approach. v. 4, St. Martin’s Publishing Group, 2020, p. 229-251

Meagan Harold is currently enrolled in the Nickerson Institute’s Integrative Mental Health Coaching Program. She graduated from the University of Minnesota in 2014 with a degree in Geology, but after a couple of years working in the industry, found her passions lay elsewhere. After working as an Administrative Assistant for a few years, Meagan was inspired by her own mental and physical healing journey, as well as the encouragement of others who know her compassionate spirit, to help others on their journeys. Meagan has worked within her current Administrative Assistant position to provide a safe space for mental health healing for those in her organization, and she is very excited to continue to help others in her coaching practice.

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