The pervasive and dangerous message to “eat clean” can be a slippery slope. What can start as trying to eat for wellness can evolve into obsessively thinking about food, threatening your mental and physical health.
While it is not officially classified in the Diagnostic and Statistical Manual 5-TR (DSM-5-TR), orthorexia is a growing concern in today’s society. Part of what makes it so dangerous is how it is rooted in diet culture and society. Diet culture labels restriction and disordered behaviors as “clean-eating.” This pervasive and dangerous message to “eat clean” can be a slippery slope. What can start as trying to eat for wellness can evolve into obsessively thinking about food, threatening your mental and physical health.
Orthorexia has been described as “a condition characterized by an exaggerated, obsessive, pathological fixation on healthy food, eating healthy,” says Rebecca Rialon Berry, Ph.D., clinical associate professor at NYU Langone Health.
Simply put, those that struggle with orthorexia are heavily concerned with attaining what is believed to be “health-conscious or clean eating.” In reality, these choices can mask disordered eating. Over time, rigid restriction can lead to malnutrition and other physical health problems, along with anxiety, guilt, and social isolation around food.
Medically Necessary Diets Are Different
Many people need to avoid certain foods for real medical reasons: celiac disease, food allergies, diabetes, kidney disease, or a diet prescribed for POTS, migraine, or a gastrointestinal condition. Following your medical team’s advice is not orthorexia. Researchers’ proposed criteria for orthorexia make the same distinction: concern arises when restriction goes beyond what is medically recommended, is driven by fear, guilt, or rigid rules about “purity,” and starts to harm your health, relationships, or daily life.
For people living with chronic illness, the line can blur. A necessary diet can sometimes grow into fear of foods that were never restricted. If that sounds familiar, it can help to work with a therapist alongside a dietitian and your medical providers, so you can follow the guidance you truly need without the extra fear.
How to Recognize Signs of Obsessive Healthy Eating
So what does this actually look like on a day-to-day basis? Orthorexia can manifest in many different ways. Here are some signs to look out for:
- You find yourself obsessing over the food options at restaurants and struggling to pick anything on the menu because it's not “healthy” enough.
- You obsess over meal prepping and experience extreme guilt when you are unable to adhere to what you view as a “healthy” diet.
- You struggle with food variety because you have the mindset that you are only allowed to eat a narrow group of “good” food.
- You find yourself concerned or fixated on what others are eating and compare their eating patterns to yours.
- You find yourself spending more time in the grocery store, reading every nutrition label and checking everything you put into your cart.
Social Media Perpetuates and Masks Orthorexia as “Healthy Eating”
With unregulated platforms like TikTok and Instagram, fake news and biased information are everywhere! As therapists in the Bay Area, we have seen or heard about several influencers on these platforms who market themselves as “holistic health coaches” when in reality they advertise and give nutrition advice that is often disordered. Their marketing messages convey that if you eat only clean foods, you will achieve some level of ultimate wellness or happiness.
It's important to be wary of accounts that promote juice cleanses, extreme fasting, and “what I eat in a day” videos. There are several things problematic with these videos that can be detrimental to mental health. First, unless you have a medical reason to avoid certain foods, our bodies generally do best with balance and variety. If we become so focused on only drinking lemon water and eating rice cakes in the morning, we risk denying our bodies what we may actually need at that moment. Instead, tuning into our cues can help us get in touch with what food our body may actually be craving. Lastly, food is not “good” or “bad” — food is just food! Every food serves a purpose, including providing energy, tasting good, satisfying a craving, or being part of a social activity.
We want you to know that struggling with orthorexia is so valid and real. Even if you are not underweight or you’ve never skipped a meal, you deserve to abandon this detrimental relationship with food. All eating disorders are harmful, and just because social and diet cultures advertise “clean eating” does not mean it is genuinely healthy for you.
We understand that being labeled by your friends as the “healthy one” can become a part of your identity. Therefore eating foods outside of diet culture norms, such as foods that bring you joy, can feel like you are losing a part of yourself. This is a very important part of recovery. While it can feel difficult to navigate and come to terms with losing this part of your identity, recovering from orthorexia and healing your relationship with food is the healthiest thing you can do for yourself.
The licensed psychologists in the collective are here to traverse this recovery journey with you and help you with the bumps along the road. Healing your relationship with food is possible.
If you’re interested in healing your relationship with food with the help of a therapist, eating disorder therapists at Telegraph Psychology Collective (formerly North Berkeley Counseling Collective) are here to support you. Therapists in the collective offer in-person therapy in Berkeley and Kensington, as well as eating disorder therapy online in California, Florida, Virginia, and Hawaii. Book your first session today!