Adopting a "clean eating" plan has become a popular way to lose weight and improve overall health. But while being more mindful of eating minimally processed, whole foods can be a good thing, the drive to eat healthy can sometimes veer into problematic territory.
Unfortunately, it's not always easy to tell when your 'healthy diet' has crossed the line into something you should worry about. To help you assess whether your approach to eating has become a health risk, Lonnie Sarnell, PsyD, a clinical and sport psychologist in New Jersey, encourages you to ask yourself the following questions:
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- Do you spend hours each day thinking about your diet?
- Do you feel anxious or guilty when you eat foods you deem "unhealthy?"
- Do you avoid social events because you won't have control over the food you eat?
If you answered yes to these questions, you might have a condition called orthorexia.
What Is Orthorexia?
According to the National Eating Disorders Association (NEDA), orthorexia is "an obsession with proper or 'healthful' eating."
"We're seeing this disorder come up a lot more, in part because we're experiencing a shift in our culture where the body ideal has moved from being as thin as possible to being as fit and healthy as possible," says Alexis Conason, PsyD, a New York-based clinical psychologist and creator of The Anti-Diet Plan.
But with all the focus on achieving picture-perfect health, this "new moral standard of wellness" can inadvertently endorse and normalize the quest for dietary perfection, which may lead to disordered eating. Consequently, there's often a blurred line between a truly healthy diet plan and orthorexia, Conason says.
To help you differentiate, read on for red flags that indicate you may be struggling with this condition.
1. You Think About Food Constantly
We all know meal planning each week can be time-consuming. But when thoughts of food dominate your headspace 24/7, that could be a warning sign, says Lisa Moskovitz, RDN, founder and CEO of The NY Nutrition Group.
If fixating on every bite you eat takes up hours of your day, you might need to examine your relationship with food.
2. You Fixate on the Quality of Food
Are you preoccupied with checking ingredient lists and nutritional labels? This is another indicator of orthorexia, Moskovitz says. It may also present as excessive worry and fear about eating sugar, additives and other chemicals that the person deems toxic, Conason adds.
What's more, some individuals will only consume narrow groups of food that they consider "safe," she says. For example, you'll only eat bone broth made from grass-fed cows in Australia because you're afraid other kinds are unhealthy. This rigid way of eating can quickly become limiting and restrictive.
3. You Follow Rigid Rules Around Eating
Lack of flexibility is another red flag of orthorexia, Conason says, explaining that problematic eaters often find it extremely difficult to depart from their strict diet plans.
Consider this scenario: You practice intermittent fasting, but your bestie's dinner party starts at 8 p.m. tonight, which is usually during the time you fast. Do you think, I typically don't eat after 8 p.m., but this party is an exception and I want to spend time with my friends? Or does the idea of disrupting your eating routine cause so much anxiety that you make an excuse to skip the festivities?
If you find yourself confined by your own rigid rules and often missing out on social activities because of it, you may have an unhealthy relationship with food.
4. You Feel Major Distress About Veering From Your Diet
When "safe" foods are not available, people with orthorexia will often exhibit high levels of anxiety, Moskovitz says. And this stress can take a major toll on your mental health.
Feelings of shame, depression and guilt may consume you if you break your "food rules," adds Sarnell, who explains that punishing yourself for deviating from your diet is a trademark of orthorexia.
The anxiety you feel about your diet may even cause you to avoid social situations where you may not have control over food choices, Moskovitz says. It's common for people with orthorexia to isolate themselves, agrees Conason, who adds that your relationships with friends and family may take a hit as a result.
"Food is about a lot more than eating," she says. "It's a way to mark a celebration, a way of connecting with people, and there should be flexibility in that, otherwise you miss out on special occasions."
6. You Eliminate Food Groups
This is pretty common among those struggling with orthorexia. People typically cut out foods perceived as "unhealthy" like carbs, animal products or dairy, Moskovitz says.
But with so many popular diet plans centered around restrictive eating — like keto or the paleo diet — spotting orthorexia can be difficult.
With that said, whether you're dealing with an issue of problematic eating or not, eliminating entire food groups without the supervision of a doctor or dietitian might be damaging to your health, as you may risk depriving your body of essential nutrients and vitamins.
"The consequences of orthorexia, like any eating disorder, can include nutrient deficiencies and resultant malnutrition," Moskovitz says.
7. You Equate Food With Purity
With orthorexia, there's often a connection between eating and morality. In other words, some find virtue in being able to abstain and restrict themselves from certain foods, says Conason, who adds that this sense of superiority is typical of eating disorders.
Eating in a way that's perceived as "clean" or "pure" is seen as "right," whereas straying from your diet plan is "wrong" and "impure." To that point, you may even find yourself judging what others put on their plates.
Comparison is yet another hallmark of many eating disorders, Conason says. So, if you're always sizing up other people's food choices — and you feel like you deserve the moral high ground for what's on your dish — you may be exhibiting symptoms of orthorexia.
What to Do if You're Showing Signs of Orthorexia
Talk to a licensed therapist who specializes in eating disorders, Conason recommends. Don't know where to find a provider? NEDA is a great resource that can help you locate a therapist in your area. Just make sure they're a weight-inclusive practitioner.
Sarnell agrees consulting with an expert in disordered eating is key. "It's incredibly challenging to change your relationship with food, and it's important to have support in this process," she says.
You may also want to visit your medical doctor and enlist the help of a registered dietitian for a comprehensive approach to treatment, adds Moskovitz.
And while you work to develop a healthier relationship with eating, consider doing a social media cleanse, suggests Conason, who explains it's a good idea to delete or unfollow any accounts that make you feel bad about yourself or compel you to make unhealthy comparisons.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.