What Is Orthorexia Nervosa?
When you think of an eating disorder, anorexia or bulimia are probably what comes to mind. Yet, there is one that’s becoming very common as we become more health conscious as a society – Orthorexia nervosa, or the unhealthy obsession with eating healthy.
You might be thinking, “isn’t eating healthy a good thing, though?” Of course it is! Your body needs essential vitamins and minerals to function optimally, and we get those essential vitamins and minerals from the food we eat. However, for people that battle orthorexia nervosa, the obsession with eating healthy has less to do with eating healthy and more to do with the purity of the food.
I am going to talk about the signs of orthorexia nervosa, the risks to your health caused by orthorexia nervosa, and to choose a diet that works for your health and your lifestyle. So, what is orthorexia nervosa?
Orthorexia Nervosa Defined
Dr. Steven Bratman, a functional medicine doctor from California, coined the term orthorexia n in 1997.1
The prefix “ortho” means “straight” or “right.” Think of an orthodontist, who straightens your teeth. “Rexia” means “appetite.” So the word orthorexia means right appetite, or righteous eating.
There’s very little research about what causes orthorexia nervosa, however many studies on eating disorders indicate they are caused by obsessive-compulsive tendencies.2” Other risk factors include tendencies toward perfectionism, high anxiety, or need for control.
Several studies have also discovered that your career may play a factor in your risk of developing orthorexia nervosa. Examples include healthcare workers, dancers, and athletes.3
Unlike those who have anorexia nervosa, where you are obsessed about your weight, those that struggle with orthorexia nervosa may not be obsessed with weight, yet instead fixate on eating healthy. Eating healthy is fine. However, an obsession with eating healthy is not and could have severe risks to your health. Let’s discuss those.
Health Risks of Orthorexia Nervosa
Orthorexia comes with several risks to your overall health. These include brain fog, not getting enough nutrients, kidney problems, isolation, or a weak immune system. Let’s talk more in depth about the common health risks of orthorexia nervosa.
Orthorexia nervosa tends to begin with a person cutting down on certain food groups, such as red meat or processed foods to make their diet “more healthy.” I recommend everyone remove processed foods from their diet, however meat is a fantastic source of protein as well as many essential vitamins and minerals, including vitamin B12 and iron. However, choosing grass-fed beef is essential to ensure you’re getting the highest quality of nutrients in your meat.
It’s not just cutting out meat. If you have orthorexia nervosa yo u may cut out fats or other foods because you believe they are not “healthy.” The problem is that when you cut out entire food groups without replacing them with food that has a similar nutritional profile, nutritional deficiencies can happen. Fats, for example, are often mistakenly considered unhealthy. While some fats, such as trans fats or saturated fats are not good for you, healthy fats such as olive oil or avocado oil contain essential fatty acids your body needs to support your immune system.
Have you ever frantically looked for your glasses to only find out they were on your head the entire time? That’s a sign of brain fog. Brain fog is not a medical condition or a diagnosis. It’s simply a term to describe the inability to focus, remember things, use logic, or solve problems. Brain fog feels like it takes hours to complete a 10-minute task or that you’re struggling to listen and comprehend what is being said in a meeting.4
Orthorexia nervosa can cause brain fog because you likely aren’t getting enough of the nutrients you need to support brain health or your nervous system, such as vitamin B12, iron, or magnesium. That’s especially true if you are obsessed with not eating meat.
Weakened Immune System
The food you eat plays a big role in the support of your immune system. As I just mentioned, food is your primary source of the nutrients needed to achieve optimal health. Unfortunately, when you are overly restrictive with your eating, these nutrient deficiencies have a domino effect on your overall health.
Working with thousands of patients, I was able to point to nutrient deficiencies as one of the main underlying causes of autoimmune disease and its progression. If you are on the autoimmune spectrum, you’re more likely to be deficient in nutrients such as vitamin D and B12, both of which are essential for a healthy immune system.
Orthorexia nervosa has a lot in common with anorexia nervosa, and the health of your kidneys is one of those areas. If you have orthorexia nervosa you may cut out all foods with salt because many people consider salt to be unhealthy. It’s true that too much salt can lead to high blood pressure, which can lead to heart disease. However, salt is actually an important nutrient for your body because it contains sodium.
Sodium, along with chloride and potassium, are essential minerals known as electrolytes, which are important nutrients especially for your kidneys. Electrolytes regulate fluid in your body and help eliminate waste. People with eating disorders tend to use diuretics (water pills) to help them lose weight or detox faster after eating something they believe to be unhealthy, even those with orthorexia nervosa. The problem with that is that diuretics remove electrolytes as well, and cause your kidneys to work harder. Over time, this can cause your kidneys to become tired and stop functioning properly.
If you are fixated on eating healthy, you may avoid social situations such as going out to eat with friends or family, going to dinner parties, or other social events because of the fear of not having anything to eat that’s healthy or pure.
If you have orthorexia nervosa, you could also be overly critical of friends and loved ones who do not eat the same as you. This can put a big strain on your relationships whether its intentional or not. Constantly worrying about what foods might be at these events can cause excessive amounts of stress, and could cause you to avoid them altogether and make you feel isolated. Don’t worry! I’m here to tell you that you can eat a range of different kinds of food and still live healthy! I will tell you how to do that later. First, let’s talk about the signs of orthorexia nervosa.
Orthorexia Nervosa Signs
As I mentioned earlier, studies show that orthorexia nervosa is tied to obsessive compulsive behavior. While there are no tests to diagnose orthorexia nervosa, there are common signs of orthorexia nervosa.5 Here are the common signs Bartman proposed to determine if you have orthorexia nervosa:
- Spending more than 3 hours a day researching, buying, and preparing specific types of foods (not for a job).
- Avoiding restaurants or social gatherings because of the food they offer
- Being judgemental of others who don’t eat “clean” foods
- Experiencing feelings of guilt after eating restricted foods.
- Feeling that sticking with your food restrictions determines your self worth
- Your thoughts about food interfere with daily activities
- Using frequent cleanses or fasts to “detox” your body
- Experiencing malnutrition or weight loss
Remember, eating healthy is a good practice to maintain optimal health and as I always say, food is medicine. However, too much of a good thing isn’t always a good thing. Now that we’ve talked about orthorexia nervosa, let’s talk about how to eat healthy and not obsess over it.
How to Stop Obsessing Over Eating Healthy
There are so many diets and information available. It can get overwhelming. Simply put, the best diet is the one that gives your body the nutrients and minerals it needs while minimizing any side effects such as inflammation and digestion issues.
As a functional medicine doctor, I know that diets aren’t a one-size-fits-all. In general, the food you eat should be fuel for your body, full of nutrients. However if you eat that sweet dessert one time it’s not the end of the world.
If you feel like you have become obsessed with healthy eating, or your diet and weight loss, it’s time to change your focus to overall wellness and how you feel instead of weight loss and the food itself. Everyone is different! Your age, gender, and genes all play a role, and remember there’s not one “ideal weight” for everyone.The goal should be to feel your best and achieve optimal health. The best way to do that is The Myers Way®.
The Myers Way®
The Myers Way® is not so much a diet as it is a way of life. The protocol is a Paleo-autoimmune diet where you eat lean, grass-fed animal protein, along with plenty of leafy-greens, vegetables, and healthy fats.
My first recommendation for anyone struggling to lose weight or want to eat healthier is to complete an elimination diet to remove all toxic and inflammatory foods, and identify any personal food sensitivities. An elimination cuts out all of the processed foods and removes inflammatory foods such as gluten, dairy, corn, soy, sugar, and eggs.
Then, after your body has had a break from the constant inflammation, and has begun digesting foods the way it was designed to, you can add foods back in one at a time, to figure out which ones you do well with (and can continue eating), and which ones you have a sensitivity to. Everyone should permanently eliminate gluten and dairy from their diet. Both of these foods are highly inflammatory and cause problems for most people.
Unlike short-term, cookie cutter weight loss diets, this process will help you discover the perfect life-long diet for your unique needs. You won’t be restricting food based on arbitrary guidelines. You’ll be eating the foods that make you feel best. That’s where your focus should lie. Your body was designed to eat and digest real food – meats, vegetables, and fruits – not packaged foods, even those labeled gluten-free. When you feed your body processed foods that are calorie dense, nutrient poor, and full of toxic chemicals, it doesn’t function properly.
Don’t let social gatherings, holiday dinners, or going out to eat with friends or family make you feel stressed about maintaining The Myers Way®. Preparation is key to making this way of life work for you!
Doing your research can go a long way. I always look at the menus at restaurants I’m planning to go eat at to make sure I have options. With healthier options for food, it’s becoming easier to find healthier options at restaurants.
If you’re going to a party at a friend’s house or a family member and worried about food, it’s perfectly acceptable to bring your own food. Plenty of healthy foods don’t require refrigeration and are completely portable. Some of my favorites are unsweetened organic applesauce, Epic bison bars, kale chips, roasted seaweed snacks, and organic dark chocolate.
Finally, don’t forget your supplements. I recommend taking a digestive enzyme anytime you eat out. Restaurant food is often richer than the food you would eat at home, and digestive enzymes help you break down and more fully digest your meal. Plus, enzymes that contain dipeptidyl peptidase (DPP-IV) minimize the symptoms of being “glutened” because they help your body break down the gluten faster.
Focusing on eating healthy is a great way to achieve optimal health. However, obsessing about food to a point where it affects your overall wellbeing and keeps you from enjoying social gatherings is not healthy. I recommend eating nutrient-rich foods, grass-fed meats, leafy greens, and organic fruits and vegetables. Remember, it’s not the end of the world if you have that occasional sweet treat.
- On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Thomas M Dunn and Steven Bratman. Eating Behaviors vol. 21. 2016.
- Orthorexia nervosa and adaptation of ORTO-11 into Turkish. Gülcan Arusoğlu. Turkish Journal of Psychiatry vol. 19. 2008.
- Prevalence of Orthorexia Nervosa among Turkish Performance Artists. E. Aksoydan. Eating and Weight Disorders vol. 14. 2009.
- 6 Possible Causes of Brain Fog. Valencia Higuera. Healthline. 2018.
- Orthorexia. National Eating Disorders Association. 2021.
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