How Healthy Eating Differs from Orthorexia

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Center for Hope of the Sierras provides tips for spotting the difference between eating healthy versus an obsession taken too far

In the face of the public obsession with health, and the claims that no one is doing it right, it can feel confusing to hear that healthy eating can be problematic.

Orthorexia, a term used to describe a pattern of disordered eating involving pursuit of dietary purity and perfection in the name of health, is on the rise both in number and in publicity. Dr. Lorraine Platka-Bird, a registered dietician for more than 30 years and nutrition therapist provides tips on how to spot the difference between eating healthy and orthorexia during the warm summer months when many people seek the “perfect” beach body.

The surge in media attention may be due to the surprise many feel when they hear that healthy eating can be dangerous. There are already many mixed messages about what to eat and what to avoid. Eat more vegetables, drink less sodas and look at calories on restaurant menus. In the face of the public obsession with health, and the claims that no one is doing it right, it can feel confusing to hear that healthy eating can be problematic.

There are a few key questions to ask when differentiating orthorexia from a general interest in nutrition and healthy eating:

1.    Have the food rules and list of permitted foods become increasingly restrictive over time?
2.    Does the individual experience guilt, shame or anxiety when “forbidden” foods are consumed?
3.    Do the individual’s food behaviors and beliefs prevent him/her from eating at social events?
4.    Has the person decreased their participation in interests and hobbies not related to food, health and nutrition?
5.    Is the individual able to eat freely at social events and share food with others, or do they tend to bring and eat only their own food?
6.    Does the person demonstrate traits of perfectionism in other areas of his/her life?
7.    Does the person allow for different ideas about how to achieve health, or is he/she fixated on his/her approach being the only way to achieve ideal health?
8.    Does the person’s ideas about food and health interrupt normal functioning at work/school, in relationships, etc?
9.    Are they able to choose foods based on pleasure or convenience, even when those options don’t fit their definition of healthy?
10.    Is the individual’s approach to exercise and fitness compulsive/obsessive?

Eating a wide range of enjoyable foods is important for both physical and mental health. However, nutrition as it has been portrayed by the media can be problematic, as these sources often communicate a very narrow—and usually misguided—definition of which foods are okay to eat and which are not, and the lists vary greatly depending on the source.

There are dozens of different ideas about what healthy eating looks like. For each of them, it is easy to find adherents who are adamant about the healthiest way to eat. Following food guidelines may not be inherently problematic, except that they all risk distancing followers from their innate hunger and satiety cues, not to mention natural taste preferences.

A problem arises when an individual integrates these guidelines in an increasingly rigid manner and begins to attach morality and a sense of self-esteem to the ability to follow the rules. What may have begun as a choice to explore different foods becomes an obsession with dietary perfection. Once orthorexia is established, an insidious process the individual may not be fully aware of, eating behaviors are compulsive and the individual is no longer psychologically able to practice flexibility in eating habits. This compulsive need to continue the dietary guidelines is a very clear marker that an eating disorder is present.

A few different factors make orthorexia particularly difficult to identify. The first is that many behaviors involved in this type of eating disorder are held up culturally as the gold standard of responsible eating. People who are very controlled with diets and vocal about the pursuit of health are often complimented for self-control, and others may idolize what is seen as a virtuous approach to eating. Further, many people who struggle with orthorexia continue to eat regular portions at regular intervals and many do not see a change in weight because nutritional “perfection” resulting in “perfect” health, disease prevention and physical purity are the goals, not necessarily weight loss. Often, orthorexia becomes so restrictive that the individual starts to exhibit symptoms similar to those in anorexia, but these symptoms needn’t be present before deciding there is a problem.

“Because orthorexia is not an official diagnosis, there is not an established set of criteria to clearly identify whether somebody might be struggling with this disorder,” said Dr. Platka-Bird. “Rather than serve to diagnose, the list above is intended to help identify those who might benefit from further exploration with a treatment professional who is experienced in treating eating disorders.”

For more information on Center for Hope of the Sierras please visit http://www.CenterForHopeoftheSierras.Com or call 866-690-7242.

About Center for Hope of the Sierras
Nestled in the foothills of the Sierra Nevada Mountains, Center for Hope of the Sierras provides an intimate setting ideal for healing and recovery for individuals suffering from anorexia nervosa, bulimia nervosa, binge eating disorder, and related disorders. Center for Hope offers residential (RTC), partial hospitalization (PHP), and intensive outpatient (IOP) treatment to women and adolescents, ages 16 and up (ages 14 and up for PHP/IOP program). Center for Hope also offers RTC, PHP and IOP treatment to men, ages 14 and up. Center for Hope is proud to offer one of the country's only specialized residential tracks for the complex treatment of co-occurring diabetes and eating disorders. For more information, visit:


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Stephanie Myers
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