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

Intuitive Eating: How Tuning Your Relationship with Food Can Change Your Life Forever

Excerpted from Burning Bright: Rituals, Reiki + Self-Care to Heal Burnout, Anxiety and Stress by Kelsey J. Patel, reprinted with author’s permission. Copyright © 2020 by Kelsey J. Patel. I’m someone who loves to eat. I will regularly have a pizza with my kids or a dinner out with friends with wine and dessert, but I also know when my body is craving clean, natural food or I need a break from overindulging. Sometimes I can tell I just need to keep things simpler. I’ve learned to do this through intuitive eating. Here’s how you can try this natural way of tuning your relationship with food.   Every time you are ready to eat, sit quietly for a moment before eating even one bite. Remind yourself there is no rush. Close your eyes. Focus on your breath. Get to a calm space, then gently ask your body: What is the best meal for my body right now? RELATED: Mealtime Meditation: 15 Minutes for Mindful Eating Wait for the answer. You might also ask: Will this food nourish me right now? Wait for the answer. Remind yourself that there is no rush. When you have an answer, open your eyes and, maintaining a feeling of inner peace and calm, prepare your meal. If the answer is that you don’t need food right now, ask your body: What do I really need or want right now? You may feel that your mind wants a distraction from something you’ve been procrastinating about or don’t want to do, you’re seeking some sort of reward, or you are trying to avoid facing or admitting to a feeling. Notice what it feels like beneath that false hunger. If you determine that the cause is something other than real hunger, stay in this place of focus and self-care. Let yourself take time to find an answer. Do you need to feel a feeling instead of pushing it down? RELATED: The Step-by-Step Guide to Mindful Eating This is something to work on over time. It might feel difficult at first, but know that whenever you give in to the urge to eat when you aren’t really hungry—but just don’t want to feel your feelings—you will reinforce the message that food is an emotional crutch, rather than the beautiful, vibrant source of physical energy it really is. Instead of eating when you aren’t hungry, turn to any of the practices in this or the next two chapters (or any of the rituals in part 3). Excerpted from Burning Bright: Rituals, Reiki + Self-Care to Heal Burnout, Anxiety and Stress by Kelsey J. Patel, reprinted with author’s permission. Copyright © 2020 by Kelsey J. Patel.   Kelsey Patel is one of LA’s leading wellness and reiki experts, and an expert in burnout. A spiritual coach, Reiki master, and wellness expert, Kelsey has helped thousands struggling with burnout and anxiety. Kelsey worked on Capitol Hill in the U.S. Senate for 4.5 years and as Director of crisis PR for a Fortune 500 company for several years prior to discovering Reiki as a last resort for her stress-induced back pain. Kelsey’s own journey has led her to help many others find balance and burn bright instead of burning out.  Her teachings and practices, along with private client work to some of Hollywood’s biggest names, have been highlighted in various publications such as The New York Times, Reader’s Digest, US Weekly, SELF Magazine, Bustle, Well + Good, Marie Claire, GOOP, the Chalkboard Magazine and more. Her public workshops, corporate seminars and private coaching are all aimed at helping people bring joy, balance, fulfillment and purpose to their daily lives and work.  She is previously the owner of Pure Barre Beverly Hills, where she learned first hand the intricacies of owning and operating a business. She is now the owner of the Magik Vibes product line, and host of the podcast of the same name. She is also the co-host of the podcast Breakup With Your Bullshit, alongside Ryan Weiss. Her first book, Burning Bright: Rituals, Reiki + Self-Care to Heal Burnout, Anxiety and Stress, released on April 28, 2020 and is available now.