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When Does Nutrition Become an Obsession?

7 Signs of Orthorexia, a Lesser-known Eating Disorder

With roughly 45 million Americans dieting each year, healthy eating is a hot topic—not only at New Year's, but through all seasons. But at what point does eating nutritious foods become an unhealthy obsession?
When most people think of eating disorders, anorexia or bulimia usually spring to mind. However, there is a less obvious food-related condition that can be just as dangerous.
The term "orthorexia nervosa" was first coined in 1997, when Dr. Steven Bratman defined it as a "fixation on righteous eating." While it's great to strive for eating balanced, wholesome meals, someone with orthorexia becomes so focused on nutrition that it can become all-consuming and can ultimately jeopardize his or her health. Sufferers may eventually become extremely thin, malnourished or even at risk of starvation.
Although orthorexia hasn't yet been added to the Diagnostic and Statistical Manual of Mental Disorders as an official diagnosis, many nutritionists and medical professionals have reported a growing number of patients experiencing its negative effects.
Why the Increase in Orthorexia?
Dina Zeckhausen, PhD, founder of The Eating Disorders Information Network, believes the trend toward healthy eating is culturally driven. "More food companies are touting the health benefits of juice fasts and cleanses, and people are looking for a quick fix to their weight problems," she says. "Social media adds fuel to the fire, with people bonding around pictures of their food and linking up with others online who share their obsessions. This all helps to normalize the disorder. Plus, we praise people who exhibit tremendous control around food, so there is lots of reinforcement for extreme behaviors."
Becky Hand, Registered Dietitian Nutritionist (RDN) with SparkPeople, understands how the obsession to eat healthy can easily spiral out of control. "Consumers are bombarded daily by food messages from all sources of media—(the) Internet, television, radio, magazines, books, blogs, posts and tweets," she says. "Food is labeled as good or bad, healthy or dangerous. Forbidden food lists are designed and trophy foods are highlighted."
How do you know if you or someone you care about suffers from orthorexia? The first step is recognizing the signs. When working with her personal clients, Hand listens carefully for early signs of obsessive eating behavior. "When providing nutrition coaching, it's important to pay close attention," she says. "I want to assist in restoring a sense of balance to one's eating plan, and help the client build a healthy relationship with all foods.”
Below are some signs that the line between healthy and dangerous has become blurred:  
Sign #1: Excluding a large number of foods
In an effort to eat an entirely "pure" diet, people with orthorexia are likely to exclude certain foods—or even entire food groups—from their plates. For example, someone may choose to eliminate all sugars, fats, animal products, carbs or preservatives, or to only eat raw, vegan or organic dishes. These food limitations can lead to malnourishment.
Sign #2: Spending a large portion of the day thinking about food
This can include researching and planning meals, shopping for ingredients, cooking and talking about food (in person or online). If these activities consume three or more hours of the day, it's a sign of being overly absorbed with food.
"Sometimes the wake-up call comes when they find themselves standing in a grocery store aisle for 30 minutes trying to decide between two kinds of quinoa," Zeckhausen says. "It can be paralyzing and debilitating."
Sign #3: Getting more pleasure from the health and purity of food than from the taste
People with orthorexia tend to prepare foods not because they enjoy eating them, but because they appreciate the idea of eating them.
Sign #4: Gradually adding more diet restrictions
Orthorexics may start with mild restrictions and then gradually increase them. For instance, a plan to decrease fat intake could eventually lead to a complete elimination of fats, which can be dangerous.
Sign #5: An interference with career or social activities
To maintain total control over what they consume, those suffering from this disorder may avoid eating at restaurants, parties or friends' houses, or may bring their own foods to social events. This obsession with extremely healthy eating can negatively impact relationships, friendships, careers and all aspects of life.
Hand has seen this topic discussed on Spark's message boards. "One member said they no longer spent time with family or friends for fear of eating the 'unhealthy forbidden foods,’" she says.
Sign #6: Getting a self-esteem boost for sticking to a strict diet
A defining feature of orthorexia is extreme rigidity. Everyone slips up or splurges now and then—but for orthorexics, any deviation from their diet causes guilt and distress. They rely on their strict meal plans as a source of comfort.
Sign #7: Extending strict eating habits to children and/or other family members
Hand points out that in many cases, children are exposed to their orthorexic parent's food rules, start to mimic the behavior and then get caught up in the obsession to eat purely healthy foods and avoid the "taboo" foods.
Finding the Healthy Balance Between Moderation & Deprivation
Although it's good to be conscious and concerned about what goes on our plates, Zeckhausen points out that mental health is just as crucial as physical health. "Like other eating disorders, those suffering from orthorexia are often channeling anxiety or masking depression with food—whether they're thinking about it, eating it, restricting it or burning it off," she says.
If you or a loved one is experiencing symptoms of orthorexia, consider contacting a registered dietician or eating disorders specialist for an assessment. A psychotherapist may also help to address any underlying issues that triggered the condition.
To find help in your area, visit www.nationaleatingdisorders.org.

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Member Comments

  • One of the advantages of the old American Diabetic Association's exchange plan is that if you eat from the lists, all the nutritional stuff is taken care of without having to count it all.
  • Last year, I went to Cognitive Behavioral Therapy to overcome rigid thinking around food (ex: feeling the urge to cut out foods completely), which seemed to be of major benefit for me. I learned that it is best to eat everything in moderation (through portion size control and meal size control) rather than to cut out any foods or drinks entirely. I learned that stressful events of the present and/or traumatic events of the past can cause people to display warning signs of orthorexic behavior.
  • Thank you for the insight!
  • I used to read the labels when i was younger. I never heard of the word 'vegan" until a few years ago
  • It's not whether you get knocked down, it's whether you get up.
    - Vince Lombardi
  • Thank you for this as it made me think
  • Interesting article. A lot of good points to consider.
  • Good article. I can relate to a few of these and can remember not wanting to go to an event because of the temptation and scared it would derail me. I don't think it is a bad thing to bring a plate to a gathering where there is going to be "unhealthy" food. I will bring a salad when I know pizza and wings are all they are going to have but I will have a little pizza along with my salad.
  • Well...it is nice to see thoughtful comments on an article. I found this article interesting. I think I will do some more research about this topic.

    I do believe Sparkpeople's feed feature encourages people with extreme food and exercise obsessions by providing a platform where they can post images and thoughts and receive feedback, sometimes from people who are just commenting to get points for themselves. I have noticed that some people just leave one or two word answers on 7 feed posts in a row to get their 21 points.
    My sister in law has this, she makes my brother go out to eat alone on his birthday, and doesn't like to go out to eat, and when she does, she carries a knife to cut up her and my brother's food to take home or toss. And if others are also sitting at the table she critiques what is on every ones plate! No one goes out to eat with them anymore, or to their house to eat! But she allows their cats to walk on kitchen counters.....
  • Wow. I can see right away that this could happen. Even to me. Glad I read it!
  • This is real its truly happening I have seen this with a co worker. I believe she's getting help now but to see it happen its really heart breaking.
  • All these so called symptoms still reeks of anorexia to me.....
  • Sounds like the people who are upset about this article are still in denial they have a problem. While it is perfectly fine to choose being organic or vegetarian or paleo or whatever you deem healthy and preplanning for the week is a time saver, the point you missed is balance. If how and what you eat is all you think about then you are an addict. Talk to an alcoholic or drug addict and maybe you will learn something like food is a like a drug. If it weren't we wouldn't be here on sparkpeople trying to overcome our problems. All you are doing is replacing a bad drug for a seemingly good drug much like a heroine user getting off heroine using methadone only to become addicted to methadone.
  • The point of this article is not to say there is anything wrong with wanting to eat healthy foods or nutritious foods. It doesn't criticize checking ingredient labels. The problem comes when it becomes an obsession and a compulsion.

    "Extreme rigidity", "any deviation causes guilt and distress", "paralyzing and debilitating", "maintain total control", FEAR of eating a forbidden or unhealthy food (even one small bite). When it reaches that point, it is a case of HAVING to, not WANTING to, not CHOOSING to.

    It is food perfectionism. If you don't choose the absolutely perfect, best possible option, you consider yourself a complete failure. I don't know that being this way and adhering to it brings comfort at all. But for people struggling with this, NOT eating the absolute best choice causes such anxiety and stress for them. It's the same with any other compulsions, whether exercise, cleanliness, order and organization, etc.

About The Author

Melissa Rudy Melissa Rudy
A lifelong Cincinnatian, Melissa earned a Bachelor of Arts in English Literature from University of Cincinnati before breaking into online writing in 2000. As a Digital Journalist for SparkPeople, she enjoys helping others meet their wellness goals by writing about all aspects of healthy living. An avid runner and group fitness addict, Melissa lives in Loveland with her guitarist husband and three feisty daughters.