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Do you or someone you know have a strong focus on eating extremely healthy food? Here we explain what orthorexia is and how you can get help.
What is orthorexia?
Orthorexia is an unhealthy focus on eating extremely healthy food. People with orthorexia obsess over foods that they consider “clean” or extremely healthy. They may avoid large groups of foods that they perceive as unhealthy or “unclean.” This obsession can lead to significant nutritional deficiencies, social isolation and a severely reduced quality of life.
Is orthorexia a diagnosis?
Orthorexia first came to attention as a condition in the 1990s by Dr. Steven Bratman. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not currently recognize orthorexia as a unique diagnosis. However, many specialists and healthcare providers recognize orthorexia as an eating disorder. Additionally, orthorexia symptoms may fit the criteria for an unspecified feeding and eating disorder in the DSM-5.
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What causes orthorexia?
The causes of orthorexia are complex and can include genetic, psychological and environmental factors. Personal experiences related to food and diet and biological factors such as genetic predisposition may also play a role.
Orthorexia is a complex condition that affects both physical and emotional health. Therefore, treatment should address the underlying causes, often through psychotherapy and nutritional counselling.
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What are the symptoms of orthorexia?
People with orthorexia exhibit an obsession with food quality. They may spend an inordinate amount of time thinking about and preparing food that they consider healthy. People with orthorexia may limit their diet to a very small group of “allowed” foods. Additionally, they may avoid foods considered unhealthy or “unclean.” This can lead to social isolation as they avoid social situations involving food. Feelings of anxiety, guilt or stress arise if they deviate from their strict diet. Physical problems such as nutritional deficiencies may occur due to the restricted diet.
The obsession with healthy food can cause people with orthorexia to neglect other interests and activities, reducing quality of life. People with orthorexia may strongly defend their dietary choices and have difficulty accepting other points of view or scientific evidence that contradicts their beliefs. This extremely health-conscious attitude can result in ill health when it leads to restrictive eating habits. It can also result in emotional distress and social isolation, making it important to seek professional help if these symptoms affect you or someone you know.
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Treatment of orthorexia
Treatment for orthorexia aims to restore a healthy relationship with food and to address the psychological aspects behind the condition. Psychotherapy, such as cognitive behavioural therapy (CBT), helps individuals identify and change the thought patterns that contribute to unhealthy behaviours. Additionally, acceptance and commitment therapy (ACT) and compassion-focused therapy (CFT) focus on accepting thoughts and feelings and promoting self-compassion.
Nutritional counselling is central to developing a balanced diet plan that covers all nutritional needs without being restrictive. For people whose orthorexia has led to nutritional deficiencies or other medical problems, medical supervision may be necessary. Support groups and possibly family therapy can also offer valuable support and guidance during the recovery process. The treatment process is often long-term and requires an individualized plan that addresses both nutrition and psychological needs to promote a healthy relationship with food and body image.
12 common questions and answers about orthorexia
What is orthorexia?
Orthorexia is a term used to describe an unhealthy focus on eating extremely healthy foods.
Is orthorexia a diagnosis?
Orthorexia is not officially recognized as a separate diagnosis in the major diagnostic manuals such as DSM-5, but awareness and discussion of the condition is ongoing.
What causes orthorexia?
Orthorexia is due to a combination of factors including perfectionism and the need for control, social and cultural influences, personal experiences related to food and diet, and environmental factors. Biological factors such as genetic predisposition may also play a role.
What are the symptoms of orthorexia?
Individuals with orthorexia show an obsession with eating only foods they consider healthy, leading to strict dietary restrictions and social isolation. This fixation causes nutritional deficiencies, anxiety about dietary deviations and a significant negative impact on quality of life.
How can orthorexia be treated?
Orthorexia can be treated with different methods such as cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT) and compassion focused therapy (CFT). Nutritional counselling is key and depending on the severity of symptoms, medical supervision may be required.
What is CBT?
Cognitive behavioural therapy (CBT) is an evidence-based form of psychotherapy that aims to change negative thought patterns, emotions and behaviours that contribute to mental illness.
Is orthorexia an eating disorder?
Orthorexia is not a formal diagnosis but depending on presentation, people with orthorexia behaviours may be diagnosed with a unspecified feeding and eating disorder as detailed in the DSM-5.
Are you addicted to exercise when you have orthorexia?
No, you don’t have to be addicted to exercise, the problem is mainly focused on food and its content.
I have a strong need to check that my food is healthy and it is affecting my life, what should I do?
If you feel that you have a behaviour that is becoming a problem, help is available. Go to your family doctor, local walk-in clinic, or in emergencies, your nearest emergency room.
My partner has a strong obsession with healthy food, what can I do?
If someone close to you has a problem that you think may be related to orthorexia, you can bring it up with them. If they aren’t receptive, you can try encouraging them to speak with a healthcare provider for more support.
Can you get therapy online?
It is possible to get treatment online. At Lavendla all our psychologists and therapists work digitally.
Where can I seek help?
If you want to seek therapy, we recommend that you contact a licensed psychologist or therapist, or ask for a referral for one through your family doctor. You can book a first appointment with one of our therapists here at Lavendla. We make the hard things easier.
Treatment with cognitive behavioural therapy
Treatment approaches can differ between different schools of therapy. This is what a treatment can look like with cognitive behavioural therapy (CBT), which can be helpful for eating disorders:
1. Understanding and assessment
The first step is to understand the problem and that it is okay to seek help for it. A licensed psychologist can help you assess your situation. You can also fill in assessment forms.
2. Psychoeducation and objectives
You will learn about the problem and how it affects you both physically and mentally. It is important to understand what is happening in your body, thoughts and feelings. It also involves setting goals for treatment.
3. Tools to change behaviours and patterns
This works on identifying and changing patterns of thinking that relate your eating disorder. This will help you develop a more nuanced understanding and increase your ability to manage emotions, thoughts and change behaviours. Together with your therapist, you will explore situations and learn how to deal with them. You will also receive homework to practice between sessions.
4. Follow up and evaluate progress
You will have support from your psychologist throughout the process. At the end of the treatment, you will also receive a plan to continue practicing to help maintain your progress over time. Feel free to book a first session with one of our licensed psychologists or therapists to see how we can help you.
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