It starts almost imperceptibly. You do a cleanse and want to make it a lifestyle thing, or you decide to cut out gluten. Then dairy. Then sugar. Soon enough, what can you eat is a much smaller list than what you can’t. And without even realizing it’s a problem—how can eating a healthy diet be a problem?—you are deep in the orthorexia minefield, just waiting for some high fructose corn syrup to put you in a tailspin. As Steven Bratman, the doctor who coined the term has said regarding his own bout with the disease, “I had been seduced by righteous eating. The problem of my life’s meaning had been transferred inexorably to food, and I could not reclaim it.”
Just as restrictive notions of quantity drive anorexia, says Thomas Dunn, associate professor of psychology at the University of Northern Colorado and co-author of a recent paper in Psychosomatics that outlines diagnostic criteria for the disorder, restrictive notions of quality drive orthorexia. The determination of what is deemed healthy to eat becomes narrower and narrower, as the rituals that pertain to foods preparation and purity become lengthier and lengthier.
So how do you know when your penchant for healthy eating is not so healthy?
The No. 1 cause for concern is when you start to present symptoms of malnourishment, says Dunn. If you are limiting what you to eat to the point of not getting enough nutrients, you have definitely crossed over into the realm of disorder. However, if you feel like you are on the cusp of obsessive, here are some questions (courtesy of the National Eating Disorders Association) that can help clarify how deep you are in—and thus help you determine how you might start digging yourself out. A lot of yes answers means something’s gotten out of balance.
- Do you occasionally wish that you could just eat and not worry about food quality?
- Do you ever wish you could spend less time on food and more time living and loving?
- Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
- Are you constantly looking for ways foods are unhealthy for you?
- Do love, joy, play and creativity take a back seat to following the perfect diet?
- Do you feel guilt or self-loathing when you stray from your diet?
- Do you feel in control when you stick to the “correct” diet?
- Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?
Basically, how deep you are in depends on how much the fixation interferes with your quality of life, and your ability to be social and function. If it has become a rigid position instead of a preference—if you really can’t roll with a smidge of fat or a dusting of conventional produce—you might want to consider loosening up a bit.
Of course, our society’s growing attraction to organic and healthy foods, which has made some people fearful of ingredients like fat, sodium, and sugar, helps normalize the fixation on health. As an article on orthorexia in Popular Science points out, “in a climate that now includes $70-a-day juice cleanses, four gluten-free lifestyle magazines, and a “superfoods” industry set to hit $130 billion in 2015, we’re also a culture fascinated with achieving some perceived pinnacle of well-being.”
While orthorexia appears to be nobly motivated by health, there are underlying motivations, which can include immunity from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity. As Dunn says, “All eating disorders have overlap with obsessive compulsive disorders and impulse control disorders.”
Orthorexia symptoms don’t appear overnight, but as Dunn says, are the result of a series of small decisions over a long period of time, the solution is to slowly reverse those decisions.
Here are some more tips to finding a better relationship to food:
- Seek middle ground. Even if you’re stuck at a place where you think there is nothing to eat (for you), get creative. Even McDonald’s has apple slices and raw crudités.
- Stop polarizing foods as “good” or “bad” and work with a nutritionist to sort through the food judgments you have adopted.
- See a therapist to deal with the emotional subtext of eating disorders, such as an intense need to feel in control.