When Does Nutrition Become an Obsession?

With roughly 45 million Americans dieting each year, healthy eating is a hot topic—not only at New Year's, but through all seasons. But at what point does eating nutritious foods become an unhealthy obsession?
When most people think of eating disorders, anorexia or bulimia usually spring to mind. However, there is a less obvious food-related condition that can be just as dangerous.
The term "orthorexia nervosa" was first coined in 1997, when Dr. Steven Bratman defined it as a "fixation on righteous eating." While it's great to strive for eating balanced, wholesome meals, someone with orthorexia becomes so focused on nutrition that it can become all-consuming and can ultimately jeopardize his or her health. Sufferers may eventually become extremely thin, malnourished or even at risk of starvation.
Although orthorexia hasn't yet been added to the Diagnostic and Statistical Manual of Mental Disorders as an official diagnosis, many nutritionists and medical professionals have reported a growing number of patients experiencing its negative effects.
Why the Increase in Orthorexia?
Dina Zeckhausen, PhD, founder of The Eating Disorders Information Network, believes the trend toward healthy eating is culturally driven. "More food companies are touting the health benefits of juice fasts and cleanses, and people are looking for a quick fix to their weight problems," she says. "Social media adds fuel to the fire, with people bonding around pictures of their food and linking up with others online who share their obsessions. This all helps to normalize the disorder. Plus, we praise people who exhibit tremendous control around food, so there is lots of reinforcement for extreme behaviors."
Becky Hand, Registered Dietitian Nutritionist (RDN) with SparkPeople, understands how the obsession to eat healthy can easily spiral out of control. "Consumers are bombarded daily by food messages from all sources of media—(the) Internet, television, radio, magazines, books, blogs, posts and tweets," she says. "Food is labeled as good or bad, healthy or dangerous. Forbidden food lists are designed and trophy foods are highlighted."
How do you know if you or someone you care about suffers from orthorexia? The first step is recognizing the signs. When working with her personal clients, Hand listens carefully for early signs of obsessive eating behavior. "When providing nutrition coaching, it's important to pay close attention," she says. "I want to assist in restoring a sense of balance to one's eating plan, and help the client build a healthy relationship with all foods.”
Below are some signs that the line between healthy and dangerous has become blurred:  
Sign #1: Excluding a large number of foods
In an effort to eat an entirely "pure" diet, people with orthorexia are likely to exclude certain foods—or even entire food groups—from their plates. For example, someone may choose to eliminate all sugars, fats, animal products, carbs or preservatives, or to only eat raw, vegan or organic dishes. These food limitations can lead to malnourishment.
Sign #2: Spending a large portion of the day thinking about food
This can include researching and planning meals, shopping for ingredients, cooking and talking about food (in person or online). If these activities consume three or more hours of the day, it's a sign of being overly absorbed with food.
"Sometimes the wake-up call comes when they find themselves standing in a grocery store aisle for 30 minutes trying to decide between two kinds of quinoa," Zeckhausen says. "It can be paralyzing and debilitating."
Sign #3: Getting more pleasure from the health and purity of food than from the taste
People with orthorexia tend to prepare foods not because they enjoy eating them, but because they appreciate the idea of eating them.
Sign #4: Gradually adding more diet restrictions
Orthorexics may start with mild restrictions and then gradually increase them. For instance, a plan to decrease fat intake could eventually lead to a complete elimination of fats, which can be dangerous.
Sign #5: An interference with career or social activities
To maintain total control over what they consume, those suffering from this disorder may avoid eating at restaurants, parties or friends' houses, or may bring their own foods to social events. This obsession with extremely healthy eating can negatively impact relationships, friendships, careers and all aspects of life.
Hand has seen this topic discussed on Spark's message boards. "One member said they no longer spent time with family or friends for fear of eating the 'unhealthy forbidden foods,’" she says.
Sign #6: Getting a self-esteem boost for sticking to a strict diet
A defining feature of orthorexia is extreme rigidity. Everyone slips up or splurges now and then—but for orthorexics, any deviation from their diet causes guilt and distress. They rely on their strict meal plans as a source of comfort.
Sign #7: Extending strict eating habits to children and/or other family members
Hand points out that in many cases, children are exposed to their orthorexic parent's food rules, start to mimic the behavior and then get caught up in the obsession to eat purely healthy foods and avoid the "taboo" foods.
Finding the Healthy Balance Between Moderation & Deprivation
Although it's good to be conscious and concerned about what goes on our plates, Zeckhausen points out that mental health is just as crucial as physical health. "Like other eating disorders, those suffering from orthorexia are often channeling anxiety or masking depression with food—whether they're thinking about it, eating it, restricting it or burning it off," she says.
If you or a loved one is experiencing symptoms of orthorexia, consider contacting a registered dietician or eating disorders specialist for an assessment. A psychotherapist may also help to address any underlying issues that triggered the condition.
To find help in your area, visit www.nationaleatingdisorders.org.
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Member Comments

The key word is "balance" Report
I like all kinds of foods. I can't imagine not eating something. Except for liver. Liver isn't a food, as far as I am concerned. Report
Great article! Report
Thank you Report
Great article! Report
Interesting Report
This is my mom. After years of dealing with her behavior, it is such a relief to know that there is a word for this. Report
Thank you Report
I'm concerned based on this article, that someone might think that I have orthorexia. In our home we have discovered multiple food allergies, which means some food groups are eliminated; these life styles are projected on to my children (food allergies are inherited); and yes social events and restaurants are uncomfortable places to be, because food gets cross contaminated. So I bring my own food to be safe, and not burden others with having to accommodate me. It's very hard living with very real food allergies. Report
thanks Report
Thank you for the article. I am a mental health professional who works with process addictions. They aren't all in the DSM, but they are real and cause distress to individuals and families. One of the things I've noticed in my own experience with diets is that there are those who get an all or nothing compulsion with dieting. Especially with certain diets. When dieting becomes a compulsion and you can't adapt it to real life, then you have to rethink your diet. If someone is out there policing how you are doing the diet, its not healthy. Now, if it helps you make healthy choices in the midst of your real life that's one thing. But if you have a panic attack because someone gave you or your child a cookie, something is wrong. Life is not about doing things perfectly all the time, life is about adapting and learning as we go. Report
One of the advantages of the old American Diabetic Association's exchange plan is that if you eat from the lists, all the nutritional stuff is taken care of without having to count it all. Report
Last year, I went to Cognitive Behavioral Therapy to overcome rigid thinking around food (ex: feeling the urge to cut out foods completely), which seemed to be of major benefit for me. I learned that it is best to eat everything in moderation (through portion size control and meal size control) rather than to cut out any foods or drinks entirely. I learned that stressful events of the present and/or traumatic events of the past can cause people to display warning signs of orthorexic behavior. Report
Thank you for the insight! Report
I used to read the labels when i was younger. I never heard of the word 'vegan" until a few years ago Report


About The Author

Melissa Rudy
Melissa Rudy
A lifelong Cincinnatian, Melissa earned a Bachelor of Arts in English Literature from University of Cincinnati before breaking into online writing in 2000. As a Digital Journalist for SparkPeople, she enjoys helping others meet their wellness goals by writing about all aspects of healthy living. An avid runner and group fitness addict, Melissa lives in Loveland with her guitarist husband and three feisty daughters.