Orthorexia: The extreme quest for a healthy diet

By | September 12, 2018

The pursuit for the healthiest diet continues. Just as I was finishing writing this blog post, a new study came out suggesting that both low-carb and high-carb diets may shorten lifespan. In the 1980s and ‘90s, we were following the low-fat trend. These days, the ketogenic diet and the very-low-carb diet are all the rage. And if you think there is controversy about the right amount of carbohydrates, fats, and proteins you should eat, the conversation can get downright ugly if we start talking about specific items like gluten. Research continues to look for insight into the best diet for humans. But the relentless focus on diet and health may lead some people to obsessively seek a perfect “utopian” diet, a condition called orthorexia.

The difference between healthy eating and orthorexia

Orthorexia, although not yet recognized as a disease, is the obsessive fixation on healthy food and healthy eating. People with orthorexia are often on a stringent diet and may have anxiety about how much they eat, how certain foods are prepared, and where those foods came from. This behavior has hints of obsessive-compulsive disorder and anorexia nervosa. Some people feel very guilty if they do not follow the rigid plans they originally designed to have a healthy diet. Their lives are too focused on healthy eating, and they hardly ever have dinner with friends. They prefer starvation to eating “impure” foods. The result is social isolation and hours spent preoccupied and anxious about what to eat. It is important to note that people who choose to eat a specific diet for religious or environmental reasons, or to protect animal welfare and agricultural sustainability, are not considered to have orthorexia.

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Cultural shifts about healthy eating

Growing up in the ‘80s, I hardly knew anyone who had dietary restrictions. Today it is very common to know people who strictly avoid certain foods. There are several theories to explain this new phenomenon: exposure to more toxins and chemical products in our foods; the advent of genetically modified organisms; the modern, more hygienic way of living (which is also blamed for the rise of allergies, asthma, and autoimmune diseases). But others think it may be partially related to the increased recognition and awareness of healthier habits and the significant influence of social media, blogs, health magazines, and clinicians who pontificate ideas of what is right and wrong in the nutritional world. All these factors, added to the avalanche of contradictory studies published almost daily about what we should eat, create the perfect storm for those who may have anxiety about health and avoiding illness.

When the quest for a healthy diet leans toward orthorexia

For those who have documented medical reasons to do so (for example, food allergies or celiac disease), a restricted diet is essential and sometimes lifesaving. But if you do not have much reason to support a restricted diet, and a rigid eating pattern negatively impacts your life and relationships with friends and family, consider looking for medical help, ideally a mental health clinician with whom you can talk about your concerns and underlying fears. Relaxation training, behavior modification strategies, and medications may also help with obsessive and compulsive thoughts. Try to avoid reading blogs and books from people who have radical opinions regarding specific food items. The information era has brought great advancement in publicizing tips about a healthy lifestyle, but the broadcast of extreme views may not be so healthy. Of course, eating a lot of sugar, flour, and red meat every day, all day, will not help you live a long and healthy life, but it doesn’t mean you can never touch them.

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Most of the population will never need to avoid specific foods. If you suspect you might have a problem with a specific food item, before you make a final decision about eliminating it, first consult with your doctor. The aspiration to eat a healthy diet is not a problem in itself, but when these thoughts are excessive it may undermine the original goal. Food is one of the great pleasures in life; it is connection, it is culture, it is something to cherish. We should avoid going overboard toward notoriously unhealthy items, but we should be able to eat the most comprehensive diet possible. For most of us, eating nutritionally dense whole foods, mostly vegetarian and non-processed, rarely causes problems.

Harvard Health Blog