balanced eating habits

Orthorexia: When Healthy Eating Goes Too Far

The celebrity news world lit up in February after David Beckham revealed in a podcast that his wife, Victoria Beckham, had eaten the same dinner for 25 years. That meal? Grilled fish with steamed veggies, a seemingly healthy choice for the former Spice Girl and longtime pescatarian. “Since I met Victoria, she only eats grilled fish, steamed vegetables,” David said in the River Cafe Table 4 podcast. “She will very rarely deviate away from that.” Victoria has spoken openly in the past about her meal choices. The fashion designer and performer discussed her history with eating disorders in her 2001 memoir, Learning to Fly, and in 2021 revealed in a podcast that her favorite comfort food is whole-grain toast sprinkled with a bit of salt. She also admitted to being a “very fussy eater,” preferring her food cooked without any fat or sauces, even when eating out at a restaurant. While there’s nothing wrong with her meal choices, what may ring an alarm bell is the extreme nature of the choices, and how such extreme healthy eating is becoming more commonplace since the pandemic (and not without its hidden burdens). Behaviors such as this sometimes falls into the realm of an eating disorder called orthorexia. If you’re wondering what orthorexia is, and whether someone in your life may be taking their healthy eating too far, read on. Below, we delve into the definitions of orthorexia, signs of the eating disorder and what to do if you think someone has orthorexia. What is Orthorexia? Orthorexia is when people take healthy eating to an extreme, to the degree where their behaviors paradoxically become unhealthy. Some behavioral examples of active orthorexia include: Being unwilling to eat a meal prepared by someone else Limiting social activities, such as skipping a loved one’s party, in order to maintain a stricter eating regimen Spending exorbitant amounts of time planning meals. There are other signs and symptoms, too, which we’ll discuss further in a moment. The term orthorexia nervosa was first coined by Dr. Steven Bratman in the late 1990s. Similar to anorexia nervosa, which describes a different eating disorder, this new appellation comes from the Greek ortho, meaning correct, and orexi, meaning appetite. While anorexia nervosa, bulimia nervosa and other specified feeding and eating disorders are recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), orthorexia does not have a specific category. But the disorder is captured under the Avoidant/Restrictive Food Intake Disorder (ARFID), which is a broad diagnostic category of eating and feeding disturbances. The difference with orthorexia is that it does not include “a negative evaluation of one’s body influenced by weight, shape or fear of gaining weight,” writes Dr. Susan L. Bennett, PhD, CEDS, a clinical advisor at the Gaudiani Clinic, which focuses on medical care for eating disorders. “In other words, in the case of orthorexia, the individual is losing weight due to food choices, but not due to a drive to be thin.” What Are the Signs of Orthorexia? To gain further insight into orthorexia, Nutritious Life interviewed Victoria Kupiec, RD, LDN, CEDS, the Director of Nutrition and Eating Disorders Services at Timberline Knolls, a residential treatment center for women and girls in the Chicago suburbs. Orthorexia can be a tricky condition to contend with, in part because it’s not yet recognized by all medical professionals as a clinical diagnosis. Moreover, “orthorexia can fly under the radar, because a lot of the symptoms are validated by diet culture,” Kupiec explains. “Symptoms are often minimized by both the individual and their peers. They classify (orthorexia behavior) as a quest for health rather than a disorder.” But for individuals whose commitment to healthy eating becomes extreme, individual choices and behaviors that once signified a positive change in life descend into obsession. In addition to the indications listed above, Kupiec shares a detailed list of further signs that a person might have developed orthorexia, which include: Cutting out specific foods or entire food groups, followed by significant weight loss and/or nutritional deficiencies as a result of that change in diet; Attaching morality to food, which leads to feeling guilty after eating “bad” foods, or a sense of pride after eating “good” or “clean” foods; Judging other people’s eating habits, or attempting to get others to eat the way they do; Struggling to concentrate or handle daily activities, because being a perfect meal planner and eater consumes most of their time and mental energy. What To Do If You Think Someone Has Orthorexia Don’t make assumptions To begin with, don’t make any assumptions about who might struggle with eating in a healthy way, based on their age, sex or race. While research on various kinds of eating disorders has historically focused on women, it appears that teenage boys and men increasingly face these challenges too, driven partly by social media pressures to look a certain way. (It’s also worth noting that among the myriad shock waves unleashed by the COVID-19 pandemic, eating disorders have increased since early 2020.) When it comes to orthorexia specifically, “We need more research to determine any trends in demographics,” Kupiec says. “But it’s important to distinguish that body image is typically not an underlying cause in the development of orthorexia, (compared to) an emphasis on purity to achieve ‘ideal health.’ Given that healthy eating is heavily emphasized and valued in our culture, I am sure we will continue to see an increase in incidence in various demographics.” Lead with compassion Because of the cultural stigma that accompanies eating disorders, if you have concerns about someone’s relationship with food, it’s important to discuss your questions and observations with compassion, not judgment. A gentle approach—thereby “decreasing some of that guilt and shame they carry around struggling with eating disorder behaviors,” as Kupiec says—can be a critical first step for someone to seek professional help. Aim for early intervention when possible Early intervention can be helpful in reducing the severity of the illness, too. “Many variables influence what

How I Broke Up With Food Guilt and Started Loving My Body

Like most people born in the ’80s, I was a member of the clean plate club. I’d ask questions like “how many more bites?” and was always told to finish what was on my plate. My mother made sure that we had balanced meals consisting of protein and greens. I kept up my plate-cleaning practices as I got older, but as a young adult, that quickly meant lots of takeout, fast food, and microwave dinners—all things that have a place in a healthy non-restrictive diet, by the way. But those things became my diet. My eating habits didn’t change until I started working out in my late twenties. I was beginning to hear nutrition buzz words around the gym, like macros and BCAAs. Being too embarrassed to ask, I’d Google these new-to-me terms to figure out what they were. Slowly, I started thinking more about the food I was putting into my body. I lost around 40 pounds over the course of eight months by eating better and working out regularly. This interest in health eventually led me to a new career a few years later. As I transitioned out of working in mental health, I pursued further education in nutrition and health coaching. I’m now a holistic health coach with a practice focusing on women and families. (I’m Nutritious Life Certified, too!) Even still, I was constantly living in fear that I would fall back into my old habits. After living a mostly sedentary life, I was terrified I would lose my motivation and enjoyment of eating well and exercising regularly. I constantly looked at myself in the mirror. I scrutinized the roundness of my hips, measured various parts of my body, and chastised myself because the inches weren’t coming off. Then I got pregnant… I exercised throughout my pregnancy, but I really leaned into my carb-y cravings. I had gained weight in places I wasn’t expecting, and the weight didn’t fall off as easily as I had hoped. After I had my baby, I recorded my measurements on my bathroom mirror and took pictures of myself every single week. I’d cry and become angry when I didn’t hit my weight-loss goals, and I had a constant inner dialogue of self-harm and hate. Rationally, I knew that obsessing didn’t matter. I knew that the doughnut I had for breakfast wouldn’t cause me to spiral out of control. But I would still beat myself up about it afterward. Worse, it seemed that the more I learned about food and nutrition, the more extreme I became. I realized things were getting out of hand when I was about 24 weeks pregnant with my second son. I told myself that I was going to have a healthier pregnancy. Eat more vegetables but indulge consciously. And I was doing a really good job! I was indulging in extra calories, exercising, and enjoying a fair amount of fruits and vegetables. But I still had a full meltdown when I realized I was gaining more weight than I had anticipated. I was devastated. My turning point… I knew that my reaction was abnormal, so I reached out to a friend, who met my downward spiral with love and support. She gave me some amazing advice: don’t look at the scale. She reminded me of what I was carrying (my son!) and why I needed the weight. I already knew this, but I needed to hear it from someone else. After my pregnancy, I fell back into some of the same habits. But at some point, I just let it go. Diving further into my own wellness journey and seeing the cycle of body dysmorphia and obsessive control over my eating habits and size made me feel a bit ill. Seeking help from my friends, my doctor, and my therapist best friend helped me break the vicious cycle. I’d ask myself what I needed in the moment: water, food, rest? And if the answer was food, what kind of food? Of course, I still have times when I look in the mirror and chastise myself for not having the perfect body, but I don’t let it consume me. I share my feelings with someone, or just say them out loud and move forward. Every day, I work to focus on what I’m grateful for, how my body feels, and what my body and my heart need. And during pizza night, I focus more on the laughter and time I’m spending with my family than feelings of food guilt. I know everyone’s journey is different, and trust me, I’m still a work in progress, but self-acceptance is well worth the effort. (Photo: Shutterstock)