Lucy's* eating disorder started out innocently enough, wanting to eat a little healthier, feel better, have more energy, maybe lose a few pounds. So she started eating more fruits and vegetables, fewer desserts, and cut out soda. People gave her compliments like, "You have so much self control!" and "You're such a healthy eater; I wish I had that much willpower." The accolades felt good, and she was convinced she felt better physically too.
Lucy decided to learn more about nutrition and living a healthy lifestyle, so she started researching it online and following fitness bloggers. It wasn't long until she learned about something called "clean eating" which fit well with the changes she had already made to her diet. The more she read the more convinced she became that processed foods were bad and needed to be eliminated from her eating. She became obsessed with eating "clean."
Friends started to notice a change in Lucy. She wasn't the same silly, spontaneous girl that they loved. Lucy was spending countless hours at the gym and refused to go out to bars or restaurants with her friends because the food there was deemed unhealthy, and of course alcohol, a "toxin" in her mind, was totally off limits. Lucy became progressively more withdrawn and isolated.
Lucy had a problem. Lucy was suffering from orthorexia.
Orthorexia, while not officially recognized in the DSM-V as it's own type of eating disorder, does fall into the category of eating disorders. Don't confuse this as me saying that it's not as severe as anorexia, bulimia or binge eating disorder – that's not the case at all. There's just not a name for it in the manual, although it is a widely recognized disorder among professionals.
Symptoms of orthorexia may include:
- Obsessing over a healthy diet
- Avoiding certain foods or food groups deemed unhealthy (e.g. grains, dairy, fat, non-organic food, preservatives, etc.)
- Believing (without medical testing) that foods are making their body unwell or that they are allergic/sensitive to foods
- Taking lots of vitamin, mineral and/or herbal supplements
- Compulsively exercising
- Avoiding foods they did not prepare themselves (e.g. social gatherings, restaurants, etc.) out of fear of ingredients or preparation methods
- Intense feelings of guilt if something "unhealthy" is consumed
- Depression, isolation, irritability
- **Weight loss may or may not occur. This is NOT one of the diagnostic criteria. A person can have orthorexia at any weight or size.
Lucy's family was able to help her find a therapist to talk to about her underlying emotional issues, including low self-esteem. The therapist recommended she also meet with a dietitian who could help her redefine healthy eating, which included ALL food groups and types of food, even (especially) those Lucy was most afraid of. Lucy was eventually able to see that all foods are safe and healthy and that there is no such thing as a "good or bad" food (or a "clean" food for that matter).
*"Lucy" is not a real person. She is a generalized example of orthorexia based on my clinical experience. Any similarities to actual clients I've worked with are purely coincidental, and nobody's privacy has been compromised. I take that part of my job very seriously.