Orthorexia - When Desire for a Healthy Lifestyle Becomes an Unhealthy Obsession

You may have heard the term “orthorexia” as it relates to eating disorder.  While not a formal diagnosis, it’s a way to differentiate one restrictive/avoidance type of eating disorder from another.  For example, one may be diagnosed with Anorexia Nervosa and has behaviors around caloric restriction while another may fall under the diagnosis of Anorexia Nervosa as well, but have behaviors around strong food avoidance such as cutting out whole categories of foods (dairy, meat, sugar, etc) but eat frequently throughout the day.  We want to help tease this out because we are currently living in a culture that elevates a healthy lifestyle sometimes to the point of this becoming an unhealthy obsession.


Healthy Lifestyle


So a couple of disclaimers to start.  1) I have nothing against a healthy lifestyle and 2) I’m not a dietitian or exercise physiologist so I’m very limited in my scope of talking about nutrition and exercise!


Okay, now that I have that out of the way, let me say this.  Having a well balanced lifestyle of eating a variety of foods (apart from food allergies) including fruits, vegetables, lean proteins, whole grains, etc is great.  Also, we know that exercising regularly (with some rest days of course) is very good for the heart, sleep, stress levels, etc.  


As a therapist, I like to expand healthy lifestyle to also include healthy sleep habits, balance with technology and social media, healthy social connections, regular self care and finding meaning and purpose in life through spirituality, faith, religion, nature, etc.   A healthy lifestyle also includes things like psychological flexibility, self awareness, and often some sort of mindful practice (yoga, meditation, prayer, etc). Healthy communication patterns including assertiveness, boundaries, using a sense of humor and giving the benefit of the doubt when needed can also be a part of a healthy lifestyle.  


If you’re reading that entire list (and that doesn’t even cover all the possibilities!) thinking “wow, I’ve got a ways to go” you’re in the right place!  This is such a work in progress for all of us and I’ll emphasize the psychological flexibility piece that sometimes the healthiest thing to do is not take life so seriously at times and just be happy if you didn’t sleep through your alarm that morning and got to school or work on time.  


So what about this unhealthy obsession orthorexia part…


Unhealthy Obsession


The conversation I have the most with my clients when I’m trying to assess “is this client just genuinely finding enjoyment in a healthy lifestyle or is this healthy lifestyle getting in the way of this client’s enjoyment of life?”  Here are just a few signs someone may be engaging in such obsession about a healthy lifestyle that they are not enjoying life so much anymore:


  • Rigidity (schedule, food, exercise, sense of humor, “to do” list, etc)
  • Critical of Self and Others
  • Loss of Social Connection (turning down invitations, making excuses, outright lying when really just need to stick to an eating or exercise schedule)
  • Health Concerns (loss of menstrual cycle, low bone density, overuse injuries, vitamin or mineral deficiencies, etc)


I often hear a sense of loneliness in a client’s life.  They may not use that exact word, but it’s something to the effect of “I’m just feeling disconnected from my spouse/friends right now and I don’t know how to fix it” or “Other people seem to not worry so much about these things but for me it’s always on my mind” or even “I see people who don’t weight themselves and who don’t exercise everyday and sometimes I think that sounds very freeing, but I’m freaked out about gaining weight or people thinking I’ve just let myself go.  I have this reputation for being super healthy and I feel pressure to maintain it.”


Okay so what do I do about this…


Well it takes some time, but learning how to pull back the reins a bit and still live a healthy lifestyle without the obsessions is possible!  In therapy, I begin working with a client on the areas that are most distressing to them and we start working on one or two goals related to expanding a definition of a healthy lifestyle and/or creating more flexibility in life.  If the behaviors around food and exercise are especially problematic that healthy is impact, I always refer to a Registered Dietitian who knows eating disorders! This is crucial since we all play different roles on the treatment team.


Even though it can be a tough process, each time I see clients engage in more and more flexibility and finding that helpful balance in living an enjoyable healthy lifestyle, I see freedom occur.  Freedom from obsession, loneliness, health concerns, discontent…you get the idea.


If you’re interested in processing some of these concerns in the form of individual therapy and you live in Texas or Virginia, you can reach us here and we’ll get you scheduled as soon as possible!


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