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Understanding and Managing Orthorexia Nervosa: When Healthy Eating Goes Too Far

Over the past few years, particularly after the pandemic, health has become an increasingly important priority for many Singaporeans. From the many run clubs that are growing popularity to the ubiquity of asking for siu dai (‘less sweet’) when ordering your coffee or tea, exercising regularly and having a balanced diet have become integral parts of a healthy lifestyle.

However, can being health conscious go too far, and end up harming your health instead?

While we typically think of eating disorders as an individual eating too little (or not at all) or eating too much, a less commonly understood eating disorder is orthorexia nervosa, which is an over-fixation on healthy eating. Because an individual living with orthorexia nervosa focuses on the health aspect of what they’re eating, they may simply come across as a person who’s overly concerned with their health. 

Yet, this over-fixation can have huge negative repercussions. This article explores what orthorexia nervosa is, the signs of this eating disorder, and how it can be treated.

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What is Orthorexia Nervosa?

Orthorexia nervosa is a lesser known eating disorder, where an individual is overly fixated on eating ‘healthy food’ and overly obsessed and fixated on leading a ‘healthy lifestyle’.

While it’s not formally recognised in the Diagnostic and Statistical Manual of Mental Disorders, which is the main guide used by mental health professionals, awareness around this eating disorder has been growing. The term was coined by Steven Bratman, MD, a doctor in California, and it refers to a “fixation on righteous eating.”

The key difference between ‘healthy eating’ and ‘orthorexia nervosa’ is the extremity of behaviours. While we may be mindful of the nutritional value of the foods we eat, a balanced lifestyle is accepting of a mix of foods – both healthier and unhealthier. Individuals with orthorexia nervosa reject any types of foods that they deem unhealthy, to the point where it may end up hurting their health, typically because of malnutrition.

Signs of Orthorexia Nervosa

It can be hard to identify if an individual is struggling with orthorexia nervosa at first, because of how innocuous an interest in healthy eating is. However, there are a few key behaviours that you can look out for. 

Signs of orthorexia nervosa include:

  • Compulsively checking the nutritional labels and value of the foods and ingredients one may consume
  • Cutting out entire food groups without any discrimination, such as ‘all carbs’, ‘all fats’, ‘all sugars’
  • Refusing to eat anything outside of their own definition of ‘healthy’
  • Being distressed when they have nothing in their ‘healthy’ food group to eat, and turning down any other alternatives offered
  • Having an extreme increased interest in what others are eating; and sometimes, showing their judgement of what those around are eating
  • Developing an obsession with food research
  • Going on frequent food cleanses if they find that they have been eating ‘unhealthily’

If left untreated, orthorexia nervosa can have a profound impact on an individual’s mental and physical health. Because a person restricts themselves from eating a variety of food, they will tend to lose weight, and may eventually suffer from malnutrition. 

The disorder can negatively harm one’s relationships. It can be difficult to agree to outings involving food (due to worries about having nothing ‘healthy’ to eat). The strict restrictions one places on themselves can also be a huge source of stress, compounded by the pressure to be perfect to adhere to one’s diet.

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Treating Orthorexia Nervosa: How to Manage an Eating Disorder

The goal of treatment would be to reframe how one thinks about food, and to (re)cultivate a healthier relationship with food again. 

Depending on the severity of the condition, you could work on recovery on your own; however, it would be good to get the help of a trained therapist to help you work through what you’re facing.

Addressing our mental health habits

Eating disorders can be linked with poorer mental health; being overly restrictive of the food we eat can be a way of compensating for feeling out of control in our own lives. 

Learning how to better manage our mental health can help to reduce these feelings of helplessness or stress, as well as help us have a more compassionate understanding of ourselves.

This can include:

  • Starting to practice mindfulness in our lives, ensuring we have more awareness around our feelings and emotions; and how this may lead to more destructive behaviours (such as food restriction)
  • Finding ways to cope with our stress (such as taking five deep, long breaths whenever we feel anxious; incorporating a daily walk in our routine to help us unwind) so that we don’t need to turn to food as a coping mechanism

Going for Therapy

According to studies, behavioural therapy is one of the most effective ways of treating an eating disorder.

Behavioural therapy focuses on changing your learned behaviours, to improve your overall health. In the case of orthorexia nervosa treatment, your therapist will help you with unlearning the rigid beliefs you may hold about certain foods, and how to reframe the way you view various groups of food and the act eating.

One of the most common types of behavioural therapy is ‘Cognitive Behavioural Therapy’ (CBT); where you will learn how to address the negative thoughts around food and your disorder, and how to redirect these emotions in a healthier, more constructive way.

Therapy can be emotionally difficult at the start, particularly when your therapist begins to challenge you on your food rules. Recovery does take time, so remember to be patient with yourself throughout this process.

There are mental health professionals who specialise in working with individuals managing eating disorders; such as the therapists and counsellors we have at A Space Between. You can take a look through our therapist directory, and reach out to our team to make an appointment for support.

References

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Written by Em Tang

An experienced health & wellness writer, I am a story-teller at heart. For me, writing is a way of weaving together the little details that make our existence meaningful and significant into a beautiful, larger story.

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