The Dark Side Of Wellness: Orthorexia Nervosa

What happens when health becomes an unhealthy obsession? Welcome to the world of orthorexia nervosa. We investigate the hidden dangers of this easy-to-overlook eating disorder. 

The rules of etiquette say that you should never discuss sex, religion or politics at the dinner table. In the noughties, though, you can add diet to that list. So personal are people’s food preferences that commenting on someone’s eating habits is akin to asking them how much money they earn or how they voted in the same-sex marriage plebiscite. Unless you’re in the circle of trust, it’s easier to avoid bringing it up for fear of offending, upsetting or – perhaps worse – embarrassing your companion. Even at the best of times, talking to a friend or family member about their eating habits can be difficult. So we ignore them, try to be supportive and, even when that fussiness becomes a full-on food fixation, we turn a blind eye. But at what point does having a healthy diet and lifestyle go from being admirable to insidious? Thanks to social media and the cult of #cleaneating, it is easier than ever to get pulled into the obsessive compulsive vortex of wellness propaganda. Though well meaning, the rise of wellness influencers and health bloggers – who document, diarise, critique and condemn every dietary move – has seen increasing numbers of women suffering from a new kind of eating disorder: orthorexia. 

WHAT IS ORTHOREXIA?

You’ve stopped getting those mid-week Uber Eats deliveries, you’re cutting back on wine and you’ve successfully completed the first 30 days of a sugar-free eating plan. Your skin is a little brighter, your clothes feel a little looser and you wake up feeling refreshed and energised. You start to wonder how much better you might feel if you just made a few more simple lifestyle changes. Gluten-free seems like an easy place to start, so you cut out bread. While you’re at it, you may as well give up starches, too. Then you cut out dairy. And all those waify, long-limbed wellness bloggers you follow on Instagram seem to thrive off a plant-based diet — so you decide to give veganism a go. Before long, though, things start becoming increasingly hard. You’re sluggish, your brain is foggy and all you can think about is what you are going to eat. You start avoiding eating in public and even turn down catch ups with friends because the idea of eating in front of people makes you nervous. You haven’t prepared the food yourself so who knows how many high-calorie nasties might be lurking within it. Welcome to the world of orthorexia. Originally coined by Dr Steve Bratman, orthorexia is a condition where someone is compelled to adopt a diet or eating pattern because they see it as being more clean or ‘pure’. It is categorised as a pathological fixation with healthy eating, often involving strict, compulsive or inflexible food-related behaviours. Like all well-meaning endeavours, orthorexia often starts out as an intention to eat a healthier diet and, over time, develops into an obsession with eating as clean as possible. This can mean cutting out all ‘unclean’ food groups (sugar, carbs, processed foods, dairy, meat and gluten are generally the first to go), refusing to eat anything they haven’t prepared themselves, only eating within certain time frames, or only eating foods they deem as ‘good’. If they cannot maintain these rules for any particular reason – in a social setting, for example – they experience psychological distress, anxiety and even depression.

Before long, though, things start becoming increasingly hard. You’re sluggish, your brain is foggy and all you can think about is what you are going to eat. You start avoiding eating in public and even turn down catch ups with friends because the idea of eating in front of people makes you nervous.

WARNING SIGNS

While it isn’t yet clinically diagnosed, orthorexia is closely related to anorexia and, due to its restrictive nature, can cause lasting health problems, both physiologically and psychologically. Maintaining a balanced diet is the cornerstone of overall health, but when that balance is defined as rigid restriction of foods, inflexible eating habits and an almost phobia-like avoidance of anything deemed unhealthy or ‘bad’, it begs the question: how far is too far? “ Orthorexia is a condition where someone is compelled to adopt a diet or eating pattern because they see it as being more clean or ‘pure.’ ” The most difficult aspect of orthorexia is that it can be passed off as just a conscientious or mindful approach to health. And being able to mask a disorder as such not only makes it easier for sufferers to hide, but also much harder for doctors or specialists to identify and diagnose. A person with orthorexia may suffer from nutritional deficiencies due to eating a limited range of foods. This can also lead to low energy, fatigue or irritability.

CONSCIOUS OR IMPULSIVE 

Many people eat healthily or follow certain diets; it doesn’t mean every health nut has neurotic or orthorexic tendencies. The Bratman test for orthorexia is a six-question test developed by Dr Steve Bratman. It is designed to help you determine whether you have come close to, or already crossed, the line of health-aware versus obsessive. If you answer ‘yes’ to any of these questions, you may benefit from seeking support.

(1) I spend so much of my life thinking about, choosing and preparing healthy food that it interferes with other dimensions of my life.

(2) When I eat any food I regard to be unhealthy, I feel anxious, guilty, impure, unclean and/or defiled.

(3) My personal sense of peace, happiness, joy, safety and self-esteem is excessively dependent on the purity and rightness of what I eat.

(4) Sometimes I would like to relax my self-imposed “good food” rules for a special occasion, but I find that I cannot.

(5) Over time, I have steadily eliminated more foods and expanded my list of food rules in an attempt to maintain or enhance health benefits.

(6) Following my theory of healthy eating has caused me to lose more weight than most people would say is good for me, or has caused other signs of malnutrition such as hair loss, loss of menstruation or skin problems.

If you or anyone you know is experiencing or showing signs of orthorexia, seek advice from a health professional. For more info, visit butterflyfoundation.org.au