Orthorexia: Anxiety about Health and Fitness

What is it?

Orthorexia is an unhealthy fixation on healthy eating. Although not officially recognised on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), it is similar to other eating disorders where individuals obsess about specific types of food and overall intake. Orthorexia typically starts out as an innocent attempt to eat more healthily. However, individuals with orthorexia become unhealthily fixated on food quality and purity, and start to obsess over what, how and when, to eat, including in what way they will deal with “slip-ups” (typically via stricter eating or more exercise).

What are the signs and symptoms?

Because society has been pushing us to be more aware of our foods and to be healthier, it can be easy to miss some of the signs of orthorexia. At times, we may hide behind the idea that we are simply eating well. Following a healthy diet does not make you orthorexic. However, there are some key characteristics that can be indicative of orthorexia. These include:

  • Excessive concern about food quality
  • Spending excessive amounts of time and attention on food (e.g., reading about, preparing)
  • Eliminating or avoiding foods deemed “unhealthy”
  • Difficulties eating a meal prepared by someone else without attempting to control what is served
  • Looking for ways that food is unhealthy for you
  • Feelings of guilt or self-loathing in the event of a “slip-up”
  • Intrusive thoughts about food
  • Spending time discussing food and attempting to convince others of the “correct” diet
  • Becoming separated or lonely as a result of the need to eat healthily

How do we treat Orthorexia?

Evidence-based treatment strategies used in the treatment of other eating disorders and Obsessive Compulsive Disorder (OCD) has been found to be effective in treating orthorexia. Both Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) can be highly effective treatment approaches. CBT can help individuals learn more about nutrition and strategies to challenge their thoughts and beliefs underlying their orthorexia. Exposure is also incorporated into treatment, to enable the gradual reintroduction of foods into your diet, returning to social interactions with others involving food, and limiting the amount of time researching foods. Individuals with orthorexia also learn to accept uncomfortable thoughts and sensations in relation to food and their body. The goal for treatment is on identifying what the underlying cause of the obsession behind healthy eating is and for individuals to become more comfortable with their bodies and health to change their relationship with a variety of foods. Ultimately, treatment will help individuals learn to have a more balanced perspective on food and to be able to enjoy eating.

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