Tag Archives: orthorexia nervosa

What is Orthorexia Nervosa and what can I do?

Orthorexia Nervosa is the newest eating disorder phrase on the block. It was devised by Steven Bratman in 1996, after he noticed a trend in his patients. Ortho means rich or correct.

Orthorexia = an unhealthy obsession with healthy eating. It can have elements of anxiety disorders and OCD with it.

Orthorexia Nervosa

Whilst there is an overlap here with anorexia nervosa and people with orthorexia may end up developing anorexia, there is also a big difference. Orthorexia is taking healthy eating to the extreme, it has an aspirational, wellness culture ideal associated with it. This means it is less about weight and more about purity and an ideal lifestyle. Social media has certainly heightened this and fuelled it. With role models who life perfect pure lifestyles of food, exercise and spirituality, it can seem as if that ideal is achievable and realistic. Striving to achieve it leads to feelings of failure and guilt.

The Bratman Orthorexia Self-Test

This is a test devised by Steven Bratman to help identify if you are at risk of orthorexia. If you answer YES to ANY of these questions you may be at risk.  I think it is useful test to read through and think to how much you identify with the statements.

(1) I spend so much of my life thinking about, choosing and preparing healthy food that it interferes with other dimensions of my life, such as love, creativity, family, friendship, work and school.

(2) When I eat any food I regard to be unhealthy, I feel anxious, guilty, impure, unclean and/or defiled; even to be near such foods disturbs me, and I feel judgmental of others who eat such foods.

(3) My personal sense of peace, happiness, joy, safety and self-esteem is excessively dependent on the purity and rightness of what I eat.

(4) Sometimes I would like to relax my self-imposed “good food” rules for a special occasion, such as a wedding or a meal with family or friends, but I find that I cannot. (Note: If you have a medical condition in which it is unsafe for you to make ANY exception to your diet, then this item does not apply.)

(5) Over time, I have steadily eliminated more foods and expanded my list of food rules in an attempt to maintain or enhance health benefits; sometimes, I may take an existing food theory and add to it with beliefs of my own.

(6) Following my theory of healthy eating has caused me to lose more weight than most people would say is good for me, or has caused other signs of malnutrition such as hair loss, loss of menstruation or skin problems.

If you identify with anything in this post then I highly recommend that you reach out to your medical team, GP, a friend, a parent, a dietitian who works in this field like myself. You can also contact B-Eat.

Top tips for Orthorexia:

Here are some steps you can take to help combat Orthorexia, I suggest these are done with the support of a therapist and dietitian.

  1. Unfollow anyone on social media who fuels the thoughts of having to eat a pure diet/lifestyle. Or try a social media detox for a week.
  2. Focus on eating a variety diet. There are no wrong or right foods it is all about the balance and variety that you eat. Nothing is off limits. Nothing is wrong to eat. 
  3. Work with someone qualified in this area to redefine healthy for you. This may include food, movement, quiet space, social time, family time.
  4. Develop alternative coping skills. Can you see how food helps you feel in control and also makes you anxious? Using distraction after a meal and journalling your thoughts can be a good initial step.
  5. Write out a list of your food rules/beliefs. These need to be challenged.
  6. Only allow yourself to get your nutrition knowledge from someone with a minimum of a degree in nutrition    a registered nutritionist or dietitian.
  7. Stop tracking your nutrition. This may take time to do so start with doing it at one meal at a time. 

Orthorexia: when healthy eating is not healthy.

If you read my blog regularly you will know that healthy eating is definitely something that I promote. Sometimes, there can be point where healthy eating goes a step, or several steps too far. Can we be too healthy with our eating? 

The rise of healthy eating blogs, clean eating movements and instagram gurus has led to there being almost too much access to information, recipe and tips. As well as the not always qualified voicing their nutritional opinions. This can lead to confusion and information overload.

Dietitian UK: Orthorexia

What is Orthorexia?

Orthorexia Nervosa is a relatively new term meaning a “fixation of righteous eating”.  It was first used in 1996 by Steven Bratman, MD. It is not yet recognised as a fully fledged eating disorder in the diagnostic criteria, but is definitely something that is on the increase. 

People with orthorexia may not notice they have an issue with their eating, in face they may think the opposite. They can start out trying to eat a healthier diet but get drawn into the spiral of trying to eat a healthier and healthier meal plan. They become consumed with food, trying to eat right, being strict with their food intake and restricting the foods they are allowed to have. Purity, eating the healthiest foods they can and guilt if they stray off the plan are hallmarks. This can lead to an obsession with weight, shape and calories. Weighing food and adding in specific “health” foods can also creep in.

There are usually underlying issues that precipitate Orthorexia. This could be a need to escape, feeling out of control and needing to control an area of life, feeling a loss of identity. Suddenly finding an outlet in the form of control via eating can help fill that void. It starts out seeming like a healthy way to deal with your feelings, but then spirals out of control.

Why is it a problem?

Although on the surface a diet may sound healthy, when you dig down it is usual to find nutritional deficits in the diet. A lack of calcium for example, that can affect bone health. A lack of essential fatty acids, affecting brain function, skin and blood flow.

More noticeable is often the weight loss that ensues and the affects on socialisation. Physical side effects of weight loss can include: poor circulation, feeling cold, hair loss, poor concentration, memory and reactions times, low mood and mood swings, being unable to eat out, wanting to isolate yourself, fatigue and a general lack of lustre. People can feel consumed with the need to know what they are eating each day, needing to prepare it all themselves, planning meals and recipes far in advance and this becoming all-consuming. There can be a loss of hunger and fullness signals, with increased anxiety around meals. 

Dr. Bratman, who recovered from orthorexia, states “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong. The poetry of my life was disappearing. My ability to carry on normal conversations was hindered by intrusive thoughts of food. The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach. I was lonely and obsessed…I found it terribly difficult to free myself. 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.” (Source: www.orthorexia.com)

So a healthy diet is bad for me?

Well it can be, if it takes over your life, your thinking, your time and leaves you with feelings of anxiety, guilt and self-loathing. If you are not able to relax and eat cake now and again then that is not normal eating.

How to get help?

  1. Recognise the problem. This is a huge step.
  2. Talk to your GP and ask for advice. They may be able to refer you to a local eating disorders team.
  3. Look for an eating disorders specialist who can work through your food beliefs and give you the confidence to make changes.