how to recover from orthorexia
  • May 16, 2024

How To Recover From Orthorexia

A balanced, varied and nourishing diet is a great goal for all. It can help your physical, mental and emotional […]

A balanced, varied and nourishing diet is a great goal for all. It can help your physical, mental and emotional health, and can promote an overall state of wellbeing.

For some, this can spiral, turning into something incredibly unhealthy. The goal to eat ‘healthy’ can quickly end up consuming every aspect of your life – and can restrict your ability to eat socially, and to enough to meet your needs.

This disordered pattern of behaviour can lead to a lesser known eating disorder – orthorexia nervosa.

Although not officially recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) orthorexia is a debilitating eating disorder, which may greatly impact your quality of life. 

You can recover from orthorexia. This article will explore some practical strategies to get you started on your journey, and provide some pathways for seeking support.

 

What is orthorexia? 

Orthorexia nervosa is an eating disorder characterised by an obsession and fixation of eating only healthy foods, focused on quality rather than quantity (1). The word ‘orthorexia’ was coined in 1997, by a Dr Steven Bratman, meaning ‘fixation on righteous eating’ (2).

However innocently this may start, the nature of the disorder can spiral into entirely consuming your life. You may start by reducing certain foods, then eliminating foods, even entire food groups. 

This is often coupled with the fixation to eat a ‘clean’ and ‘healthy’ diet. 

The irony in this is that on the path to eating ‘healthy’, you end up with an extremely unhealthy relationship with yourself, body and food. This can cause isolation, loneliness, insecurity, and severe detriments to your physical health. 

As a relatively new diagnosis, there is limited information and statistics about how it impacts the Australian population. 

In a study on Australian university students, a prevalence rate of 6.5% was found (3). Again, this is limited and further research is needed for healthcare professionals to understand the disorder.

For us to better understand how to manage and understand how to recover from orthorexia, it is important to understand the common symptoms to guide you on your path to recovery. 

 

 

What are the signs and symptoms? 

Orthorexia varies from person to person, but common symptoms and indicators include:

 

Cutting out entire food groups

It can start with something you may think is simple. 

The goal to cut out white bread can quickly spiral into avoidance of all carbohydrates. Cutting out a type of oil can lead to avoidance of all fats. But, these nutrients are crucial to our bodies!

This can quickly lead you to being at a high risk of vitamin and nutrient deficiencies. All food groups are essential for us to live healthy and balanced lives.

This is usually due to black and white, all or nothing categorisation of ‘healthy’ and ‘unhealthy’ foods, or ‘good’ and ‘bad’ foods. 

Reducing foods to these distinct categories just perpetuates these thoughts and behaviours. 

All foods fit in a balanced and varied diet. 

 

Withdrawal from social eating 

You may avoid socialising when food is involved, out of anxiety over food preparation and the food options available. 

Worrying about how food is prepared, how it is cooked, and what you can order that is ‘safe’ can lead you to a state of complete isolation and loneliness.

Social eating is a core component of the human experience. It is how we celebrate birthdays, anniversaries, and achievements. 

This fixation on health can result in complete withdrawal from connection, and ultimately an incredibly unhealthy relationship with food, body and self. 

You may experience preoccupation with what you will eat when you are out, rather than the company you are with, or the event you are going to.

Food shouldn’t be the central narrative to your life. 

Events and socialising should not be revolving around what you can eat that is ‘healthy’. You should be able to enjoy the company of others, spending time catching up or celebrating with your loved ones. This is important – rather than the preoccupation of what you will eat when you are out with them.

 

Constant planning and rumination over food 

Spending time researching and planning your next meal is a core indicator that your relationship with food is unhealthy. 

If you have eliminated many foods from your diet, it is going to be difficult to find foods you actually can eat. 

Your days may revolve around what you will eat, where you will buy food from, how you will prepare it, and how much you will eat. 

Spending time working around this, planning out meals that are safe, can result in not having much room in your mind to think about anything else. 

This can cause problems in your work, studying and social life. 

You lose the ability to think about anything other than your next meal, and how you can avoid situations where you may have to break down your food rules. 

 

 

Feeling guilt and shame after eating foods you consider ‘unhealthy’

Part of being human is to eat foods that may be considered ‘unhealthy’. Not every meal is going to be perfectly balanced, and that is more than okay!

In a social event or situation where you are not in ‘control’, you may experience emotional distress when there are no ‘healthy’ foods available. This can lead to complete avoidance, or eating these foods and dealing with the negative emotions after it. 

In a healthy relationship with food, there should be no overwhelming distress associated with eating these foods. We should live with flexibility, not dictated by how we fuel our bodies and nourish our lives. 

 

Constant research about nutritional information, and seeking nutrient information from others

Finding yourself spending time researching and reading nutrient panels of food can again cause a disconnect from life. 

Walking the grocery store isles constantly turning the packaging over to read the nutritional information, ensuring you are making choices that are aligned with your perception of ‘health’.

This can also look like following influencers/accounts on social media that promote these ‘healthy’ (and disordered) lifestyles, and constant comparison to this. 

These figures often promote macro-breakdowns, nutrient misinformation and dietary advice – and you may be seeking advice that can serve as justification for your behaviours. 

You should be able to eat foods without concern over the nutrient profiles in each food you eat.

 

Focusing on other people’s eating habits 

It is common to compare your eating with what your family and friends are eating, alongside a fixation to eat ‘healthier’ than they are. 

Investment in their dietary habits, and attempting to educate them surrounding healthy/clean eating is a sign that you may be struggling with your relationship with food.

Unless you are a licensed healthcare professional – you don’t need to comment on the eating patterns of others, ever. 

 

Viewing food objectively as a source of health

Sure, we need food to live. We need food to thrive, to function, to go about our daily activities. It is our fuel, our way to nourish our bodies and maintain our wellbeing.

But food exists beyond just ‘fuel’. 

Food is enjoyment, it is pleasure, it is self-soothing, it is central to socialising. Food is more than nutrients and vitamins. Food exists beyond what it delivers to your physical health. 

 

woman eating a simple garden salad with a fork and smiling

 

Ultimately, these symptoms and behaviours can lead to physical implications

Sustaining an eating disorder has severe impacts on your physical, mental and emotional health. Physical symptoms may look like:

  • Malnutrition 
  • Nutrient + vitamin deficiencies
  • Weight loss 
  • Bloating
  • Constipation 
  • Low body temperature  
  • Difficulty falling and staying asleep
  • Bone mass/density reduction
  • Slow heart rate (4). 

 

Orthorexia vs Anorexia 

Orthorexia and anorexia share some common symptoms and behaviours, but with different driving forces behind them. 

They also commonly coexist as comorbid conditions, meaning that you may be experiencing symptoms of both illnesses at the same time.

Anorexia is an eating disorder characterised by fixation over weight and shape. 

The individual may use restriction and compensatory behaviours to maintain weight loss, driven by their anxiety over the idea of gaining weight. 

The distinguishing factor is that in orthorexia, the focus driving the disorder is not rooted in body image and weight concern. It centres around the preoccupation with eating a healthy diet, without emphasis on the way this changes your body. 

 

Some common patterns of behaviour may be present: 

  • Behaviours and rituals surrounding the preparation of meals 
  • Intrusive food thoughts and fixation on next meals
  • Avoiding social eating 
  • Researching nutrient profiles 
  • Isolation
  • Malnutrition (5).  

 

BOOK IN A FREE DISCOVERY CALL WITH OUR DIETITIANS
 

 

 

What causes orthorexia?

Every person with an eating disorder is uniquely individual. No two humans are the same in thoughts, patterns and behaviours.

There are some common triggers of orthorexia, including:

 

Desire for control

The need for control is a central theme in many eating disorders. In a world that feels overwhelming and scary, controlling your diet can provide that sense of control.

However the more power you give the thoughts, the less and less control you truly have.

 

Fear of illness/chronic disease

Everyday there is some new news special/article about how certain foods can impact your health.

From claiming foods to be inflammatory, cancer or diabetes causing – diet culture has it’s grips firmly around us. 

Beginning a path to eat ‘healthier’ and ‘cleaner’ and avoiding these foods can slowly turn into a full blown eating disorder. 

 

Veganism 

Plant-based eating can definitely bring balance, nourishment and variety to your diet. Everyone should aim to include lots of plants in their diet!

However, many vegan influencers have made an immense impact on the vegan diet space, and have created a whole new form of disordered eating. 

There is nothing healthy about ‘raw till 4’. There is nothing healthy about living off a diet of fruit and vegetables.

This is commonly paired with a strict avoidance of seed oils/fats.

Veganism CAN be done well. But listening to these figures is incredibly dangerous and can put your body at extreme risk.

 

Building an identity 

Everybody wants to find themselves. For some, following a ‘clean’ and ‘healthy’ diet can slowly become a personality trait – when what we eat should really only be a very small part of our lives, rather than consuming our identity. 

Having others perceive you as this ‘healthy’ eater can provide that sense of selfhood you may be missing. This can fuel orthorexia, as you don’t know who you are outside of these rules.  

 

How on earth do I recover from orthorexia?

Finding treatment might be overwhelming and scary, but there is help available. 

Recognising that your relationship with food is holding you back from living your life is confronting. But, identifying these thoughts, challenging these behaviours and having external support is crucial in guiding your path to recover from orthorexia.

 

Seek support 

Working with a multidisciplinary team can help you be supported in your path to recover from orthorexia. This may look like an accredited practising dietitian (APD), general practitioner (GP) and psychologist. These professionals can work together in guiding you on the path to freedom from the thoughts.

Challenge the rules 

Write down a list of the rules your eating disorder has created. Speak them aloud – with a friend, a treatment provider, family. 

Talking the thoughts through with others who don’t share the same disordered mindset can help you identify that the thoughts have no real basis.

This will include eating the foods you may think are ‘bad’ and unsafe. Recovery is all about mending your relationship with food and yourself. Learning that these foods are safe, more than just nutrients and numbers. 

These rules need to be challenged to be truly overcome. 

Categorising foods as ‘good’ and ‘bad’ will keep you trapped in your disordered mindset. 

As mentioned, food is far more than just fuel. Food is more than just nutrients for your body. Food is pleasure, enjoyment, connection. 

Challenge the rules and learn to teach yourself that these distinct, black and white categories are not based in truth or sustainable recovery.

 

Nutritional counselling 

Working with a dietitian can help you learn about food in a way that does not fuel your eating disorder. 

Together, you can challenge the rules through real, evidence-based science. You can learn to trust a healthcare professional more than the thoughts that have consumed your life. 

A dietitian can provide a meal plan to meet your nutrient requirements and challenge your comfort zone. While this may be confronting, to recover from orthorexia, you need to eat any and all foods than cause distress or may be categorised as ‘bad’.

A meal plan often looks like 3 meals and 3 snacks. You can write a list with your dietitian of your main ‘fear foods’, the foods that you have eliminated from your diet. Slowly making your way through this list, you will learn that these foods are not bad – they will not hurt you. What will hurt you, is the thoughts. 

Working with a psychologist alongside your dietitian can strengthen your support system. Exposure therapy and cognitive behavioural therapy both have proven benefits in treating eating disorders.  

 

Unfollow diet/nutrition ‘influencers’ 

The influencers, with zero nutrition qualifications, should not be who you are taking your nutrition advice from. 

Unfollow anyone who promotes an unhealthy relationship with food, with exercise, with self. 

Keep your social media feed a safe space, full of positive support. It may even be helpful to take yourself off social media in the initial recovery period, to give yourself the best possible chance to recover from orthorexia sustainably. 

 

up close picture of a phone with instagram food posts

 

 

Take back the control of your life

Finding yourself beyond these strict rules may take time, but it is completely possible. You are destined for a life beyond food rules and behaviours. You can recover from orthorexia. 

Finding new coping mechanisms, healing your relationship with food – this is confronting. 

Be kind to yourself, open up to loved ones, and never give up on yourself, on your recovery.

The team at Imbodi Health can provide nutritional counselling, support you in your journey and help you challenge these strict rules and behaviours. 

 

Reach out for a free discovery call, and begin your journey to recover from orthorexia. 

 

 

Written by: Student dietitian Tara Finn

Reviewed by: Imbodi Health Dietitian Jade Wrigley

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