What is Orthorexia Nervosa?

Orthorexia is a lesser known eating disorder that involves fixation or obsession about eating “healthy,” and can be all-consuming. This intense drive to eat and live perfectly (like “clean eating,” or extreme discipline in lifestyle) typically occupies your mind space, interferes in your relationships, gets priority over work or school, and generally causes a lot of anxiety and distress.

Exercise can also be wrapped up in Orthorexia, and can be excessive or extreme. If this is the case for you, it can be extremely anxiety provoking to miss a workout, and can ruin your day, fueling the need to “make up for it” later with more exercise or restricted eating.

People with Orthorexia may become so preoccupied with eating "clean" or "pure" foods that they restrict their diets to the point of malnutrition. They may also experience anxiety, guilt, or shame when they eat foods they consider "unhealthy."

If you or someone you know is struggling with orthorexia, it's essential to seek professional help.

Eating disorders are known to require specialized treatment for lasting recovery, and without it, they tend to come back, especially during times of high stress.

The ACED clinicians are fully specialized and trained to help people of all ages who are struggling with Orthorexia. Please reach out to us for confidential support - we are here for you! We offer both in-person sessions (Austin, TX) and virtual sessions (for Texas residents) with compassionate therapists and dietitians who know exactly how to help you.

The way that Orthorexia shows up for each person is unique, but there are common characteristics.

Orthorexia: 5 Signs to Get Help

1. Obsessive focus on “healthy” eating and/or exercise

You may spend hours each day thinking about what you should and shouldn't eat. You obsess over food labels, ingredient lists, and nutritional information, to the point where it becomes a significant source of stress in your daily life.

This obsessive focus on “healthy” eating can lead to restrictive eating patterns and the elimination of entire food groups, and avoidance of eating in social situations.

Lots of info below about compulsive exercise.

2. Preoccupation with food purity and/or “lifestyle”

You may have a rigid set of rules around what you consider to be "clean" or "pure" foods. Perhaps you refuse to eat anything that isn't organic, free-range, or locally sourced, and may become anxious or upset if you can't find foods that meet your standards.

This preoccupation with food purity can make it challenging to eat in an intuitive, varied, and flexible way, which can lead to undernourishment, and other health problems.

Furthermore, you may be hyper-focused on living a certain lifestyle, which often includes exercise. If your exercise routines get in the way of your life, keep reading.

3. Emotional distress related to food choices

You have intense feelings of guilt, shame, or anxiety when you eat foods you consider to be "unhealthy." You often beat yourself up for imperfect eating, and these distressing emotions spiral into a cycle of self-loathing and self-punishment, and more restrictive eating and/or exercise.

The emotional distress related to food choices deeply affects mental health and quality of life, often leading to depression, anxiety, or other mood disorders.

4. Physical symptoms related to disordered eating

Orthorexia can lead to lack of proper nourishment, which can cause a range of physical symptoms, including:

• Fatigue

• Weakness

• Dizziness

• Hair loss

• Dry skin

• Irregular or missing periods

• Digestive problems

• Difficulty concentrating

If you or someone you know is experiencing these symptoms, it's essential to seek professional and specialized support immediately.

5. Social isolation

You have become so preoccupied with food rules that you avoid social situations where you might be offered food that doesn't meet your standards. This social isolation is lonely, depressing, and anxiety provoking, which can further exacerbate Orthorexia symptoms.

Compulsive Exercise and Orthorexia

Compulsive exercise is a common behavior that often co-occurs with Orthorexia Nervosa. Compulsive exercise involves preoccupation with exercise that can become obsessive and interfere with daily life activities. It is characterized by:

• an intense fear of missing a workout,

• excessive exercise even when injured or ill,

• and feeling anxious or guilty when a workout is missed.

While exercise can be helpful for physical and mental health, overexercise can have catastrophic consequences and lead to physical injuries, exhaustion, and extreme emotional distress.

Compulsive exercise often goes hand-in-hand with Orthorexia because individuals with Orthorexia may feel a need to "burn off" any calories they perceive as unhealthy or to "earn" the right to eat certain foods. This can lead to excessive exercise that may be detrimental to physical, psychological, and emotional health.

If you're struggling with compulsive exercise in addition to Orthorexia, it's essential to seek specialized support from a qualified therapist and a registered dietitian.

5 Warning Signs for Compulsive Exercise

1. You feel anxious or guilty when you miss a workout.

2. You schedule events around your workout schedule.

3. You exercise even when you're injured or sick. If you can’t miss your workout even when you feel awful or are sleep deprived, it may be a sign that your exercise has become disordered. This can lead to further injuries and can also compromise your immune system, making it harder for your body to fight off illness.

4. You prioritize exercise over other important activities. You consistently choose exercise over spending time with friends and family, or fulfilling work and school responsibilities. This can lead to social isolation and can impact your ability to function in other areas of your life.

5. You feel a need to exercise to compensate for eating "unhealthy" foods. You feel like you need to exercise to burn off calories from foods you perceive as unhealthy. Your approach to exercise and eating is restrictive and rigid.

6. You feel like you can't stop your obsessive exercise behaviors. This includes your thoughts about exercise, planning and structuring your workouts, scheduling, tracking, reviewing, and even secrecy and/or deception to “protect” your exercise.

If you're experiencing any of these warning signs, it's important to seek specialized support from a qualified therapist and registered dietitian trained in eating disorders and compulsive exercise from a HAES® perspective. A specialized team can help you develop a more balanced and flexible approach to exercise that prioritizes physical and emotional health rather than rigid rules and restrictions that shrink your life. If you live in Texas, please reach out to us for support. We are here for you.

6 Tips to Jumpstart Your Compulsive Exercise Recovery

• Take rest days and allow your body to recover.

• Engage in a variety of non-exercise related activities that you enjoy.

• Avoiding overexertion during your workouts - pay attention to your body sensations and level of fatigue.

• Challenge critical thoughts and beliefs about your body shape. Remember everything your body can do.

• Practice self-care activities such as meditation, journaling, and spending quality time with your loved ones.

It's important to note that recovery from Orthorexia and Compulsive Exercise may not be a linear process. It will involve setbacks, challenges, and times when it feels difficult or impossible. However, with the right support and resources, you will make progress towards a more balanced and fulfilling life. It takes time, but we know that it is worth it, and moreover, you are worth it.

Reach Out for Support

If you or someone you know is struggling with Orthorexia, it's essential to seek professional help. A specialized team (therapist and dietitian who collaborate in service of your care, along with medical support) can help you heal your relationship with food, body, and/or exercise so you can get back to living your life.

You deserve to live a live beyond what you eat and how you exercise, one that is fun and free, deeply meaningful, and liberated from the prison of your eating disorder.

Get Specialized Support

The ACED team is an inclusive group of specialized therapists and dietitians who can help you to heal so you can get back to living your life.

We’re here to help. Schedule your complimentary 15-20 minute phone consultation to find out if the ACED team could be a good fit for you. If you’re ready, we’ll match you with your dream team.

References:

Bratman, S., & Knight, D. (2000). Health food junkies: Orthorexia nervosa: Overcoming the obsession with healthful eating. Broadway Books.

Dunn, T. M., Gibbs, J., & Whitney, N. (2019). Starving for perfection: A meta-analysis of the prevalence of orthorexia nervosa. Eating and Weight Disorders, 24(5).

Legal disclaimer: The ACED team is comprised of mental health professionals licensed to practice in the state of Texas. Reading our blog does not create a therapist-client relationship between us. Our blog is designed for informational purposes only, and is not intended as a substitute for professional care. The contents of this blog should not be used to diagnose or treat illness of any kind, and before you rely on any information presented here you should consult with a trusted healthcare professional. If you are currently experiencing a mental health emergency please call 911 or the National Suicide Prevention Hotline at 1-800-273-8255.