When Does Eating “Healthy” Become Harmful?
Anytime you hop online, there are more and more videos about eating clean, reducing our toxin intake, and how even buying vegetables from certain stores isn’t actually healthy for us. Many people have felt moved by the uprising of the healthy conscious living trend, and people are more determined than ever to take care of their health. First, it starts by cutting down on sugar, then only eating organic, and then removing anything else from their diet that’s processed or has more than five ingredients.
Creating a new healthy eating lifestyle started as an innocent way to help people feel better and take care of themselves, but now, for some people, every meal feels like a test of how to be healthier than the day before. Grocery shopping becomes exhausting (since so few ingredients meet this high standard), and there isn’t any wiggle room for foods off of the ‘okay’ list before the guilt takes over.
Sound familiar?
In today’s wellness-promoting world, it can be hard to tell when our efforts to eat healthy actually become harmful. Because of this rising trend, here at Soultality Psychotherapy in Cambridge, MA, we’re noticing how people’s desires to eat rigidly healthy are actually bringing out an eating disorder called orthorexia.
Today, we want to talk about orthorexia, how it differs from other eating disorders, and how we help our patients find relief from this lesser-known condition.
What is Orthorexia?
Orthorexia is an obsession with eating foods only deemed as pure, clean, or healthy. Oftentimes, it starts with great intentions of wanting to be a healthier person. The problem with orthorexia is that it goes much further than picking up organic vegetables at Whole Foods.
Unlike typical eating disorders that are focused on body size, orthorexia is more about the morality of food. The fear rooted in orthorexia isn’t necessarily about weight gain; it’s about contamination, being “good” or doing things “right.”
People struggling with orthorexia may experience symptoms like:
Not wanting to eat, due to fear about the food not being healthy enough
Constantly checking food labels to see if they’re clean enough
No longer attending social situations that involve food or eating
Refusing to eat anything that they didn’t personally prepare
Feeling immense guilt anytime they eat something that isn’t “healthy”
Only shopping from specific grocery stores, as others are considered bad
Skipping meals rather than eating something imperfect
Avoiding anything that could have pesticides, isn’t organic, or is processed
Obsessing over food rules based on the latest online health trends
From the outside, this could look like they’re incredibly disciplined and dedicated to their health. But on the inside, it’s exhausting, isolating, and very scary. People struggling with orthorexia often don’t realize just how intense their obsession with healthy food has become, as it’s normally a pretty gradual progression that starts with seemingly good eating habits.
Does Orthorexia Overlap with OCD?
Yes, orthorexia does have an overlap with OCD. But before talking about how the disorders play off of each other, we want to make sure you understand exactly what OCD is.
Obsessive Compulsive Disorder (OCD) is commonly thought to be a disorder of cleanliness or organization, but at its core, OCD is a mental health condition driven by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) done to reduce stress or prevent a feared outcome.
It can latch onto lots of things: germs, relationships…food. And specifically when OCD and an eating disorder like orthorexia overlap, it can cause extreme thoughts and behaviors that many people socially praise, like “Look at you being so disciplined!” or “Wow, you eat SO healthy, congrats!” which actually allows the behaviors and compulsions to thrive.
And suddenly, the person isn’t choosing food for pleasure or nourishment; it’s chosen (or disregarded) out of fear.
How We Treat Orthorexia at Soultality
At Soultality in Cambridge, MA, we use a specialized evidence-based treatment for OCD and orthorexia called Exposure and Response Prevention (ERP). ERP is currently considered the gold standard for OCD treatment.
What ERP allows us to do is help our patients gradually face their feared foods or situations in a controlled environment. By doing this with patients gradually, it helps them work through fears with a professional guiding them, and it also teaches them how to work through feared foods without performing rituals, like restriction or “making up for it” with exercise.
Here’s What ERP for Orthorexia May Look Like:
Starting with a feared food list
Eating non-organic yogurt without compensating behaviors
Eating carbs with dinner without rearranging the rest of the day to “make room”
Sitting with discomfort and learning that it doesn’t last forever
During ERP treatment, we also work on increasing flexibility, which is the opposite of the rigidity that OCD causes people to feel. We help our clients explore what they actually enjoy eating (not just what they feel they “should” be eating), helping them find what feels emotionally and physically nourishing, and what life looks like without some of the food rules they’ve been following.
We also help our patients create plans that they can take home for more improvement between sessions. The goal is that we address a feared food or situation during the ERP sessions, and if we feel the patient is ready, we ask that they continue this progression at home. That could be eating non-organic food, eating something they enjoy but is on their feared food list, or asking them to skip exercise after dinner. The goal is to make gentle improvements between sessions so our patients experience mental relief faster.
And most importantly, we work closely with our patients to help them develop self-compassion. Going through treatments and orthorexia is hard, and we want to make sure that our patients are giving themselves grace and acceptance during the treatment process.
Orthorexia FAQ’s
“Can you treat orthorexia and not OCD?”
Since orthorexia shares common aspects of OCD, we’ve found that treating orthorexia with common treatments for OCD, like exposure and response therapy, shows higher levels of success and relief for our patients.
“Is orthorexia named in the DSM-5?”
Currently, orthorexia is not named in the DSM-5, mainly due to an ongoing debate on its distinction. Since it shares significant overlap with other conditions like OCD but isn’t listed as a direct subtype of OCD, there currently isn’t a clear distinction that would allow it to be listed in the DSM-5. There is ongoing research that will hopefully allow orthorexia to be listed in the DSM-5 soon!
“What triggers orthorexia?”
Orthorexia can be triggered in several different ways, the most common being certain personality traits like leaning towards perfectionism, a history of dieting, having a health scare or fear of potential health problems, and constant exposure to media promoting healthy and clean eating.
We Believe People Deserve a Life Bigger Than Food Restrictions
Orthorexia and OCD can take away so much joy and connection from lives. But with the right support, we can help people find freedom to nourish their bodies (and souls!) without needing to ‘earn’ it anymore.
At Soutality, we see people with good intentions get stuck in the loop of orthorexia, and we want people to know that help exists. We specialize in treating OCD, eating disorders, and helping people find relief, right here in Cambridge, MA.
If this blog made you feel seen, we’d be honored to support you because you deserve a life that’s beyond obsessing over food and trying to be the best at being healthy. Life feels more aligned when you have balance, and that’s exactly what we help people find. Please schedule a complimentary therapy consultation so we can learn how to help create a healthy lifestyle that supports YOU.