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Understanding Orthorexia

“Ah, I can’t do lunch, but would you want to grab coffee later on?” This is something I would say often to my friends. My circle was growing smaller. I rarely saw friends or even family. My apartment was my temple. The holder of all things healthy.

I prepared all of my meals after returning from my trip to Whole Foods. It was Sunday, my meal prep day, where I would hover over a stove baking bland free-range chicken, grass-fed steaks, organic broccoli and sweet potatoes.

After cooking and carefully putting my food into plastic containers, I ate. I ate in solitude. Mealtime was very important to me. All I cared about was food, feeding myself, perfectly timing out when I would eat and what I would eat.

Upon finishing my meal, I reached for the medicine cabinet where I would throw back a variety of vitamins and minerals, which I believed, were healing a host of “problems” ranging from digestive issues to anxiety. “Success, I feel healthy,” I would say to myself.

I picked coconut sugar over Splenda, grass-fed butter over olive oil, grass-fed steaks over salads, and full-fat grass-fed yogurt over sugar-free yogurt. Calories were not my concern, health was. I didn’t get an inch close to sugar-free anything. I was terrified of anything processed or artificial. Terrified it would make me unhealthy. Healthy was all I cared for.

Food aside, I certainly was concerned with my body image as well. Sure, I would avoid extra calories but the main fear was ‘bad’ food. Food that would take away my perfect health and body. I was orthorexic.

Orthorexia is the term for a condition that includes symptoms of obsessive behavior in pursuit of a righteous and healthy diet. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders. A person with orthorexia will be obsessed with defining and maintaining the perfect diet, rather than a thin weight. He or she will fixate on eating foods that give them a feeling of being pure and healthy. Their health typically defines them.

An orthorexic may avoid numerous foods, including those made with artificial colors, flavors or preservatives; anything considered “processed,” fat, sugar or salt; animal, dairy, or gluten. There are many overlaps between orthorexia and other eating disorders; however, there are a few symptoms that are distinctive to orthorexia. According to Timberline Knolls, a residential eating disorder treatment center, the following are signs of someone who may be suffering from orthorexia:

  • Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies.
  • Increasing avoidance of foods because of food allergies, without medical advice.
  • Noticeable increase in consumption of supplements, herbal remedies or probiotics.
  • Drastic reduction in opinions of acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods.
  • Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils.

While orthorexia is less well known than other eating disorders, it is just as serious and potentially fatal. My spell under orthorexia ended me up in the hospital eight times for attempted suicide. I was experiencing OCD, anxiety, and depression as a result of my eating disorder.

After a number of therapists, psychiatrists, nutritionists, and medications, I hit my knees. Crying on the floor in my living room after having a panic attack for not being able to go to the gym at the time I wanted to go, it hit me like a ton of bricks: I had to beat this thing. Do I want to spend hours thinking about food? Planning my workouts? Doing rituals and compulsions around food and exercise? Lose more friends? Be miserable? No. I don’t.

So, I embraced recovery and I am still on that journey. I work closely with a professional body image/orthorexic coach who is helping me take the actions needed to move forward. I chose not to work with a therapist at this time. After years of therapy, I decided to take a different route. I also knew myself very well. I knew exactly what I needed to challenge. I learned that I am better with action-oriented behaviors versus talk therapy.

Challenging my eating disorder behaviors was my goal. I set out to eat one food off of my “feared foods” list each week. I also made myself tweak my workout schedule each week. For instance, instead of working out five days, I would work out four days. I also made a challenge list that included things I never let myself do because the eating disorder was holding me back. I can’t tell you how helpful this has been.

I am still in recovery and very fresh to the whole experience. I am still working on my challenge lists. But I can tell you this has been a very eye-opening experience. I am feeling small moments of freedom every day. No matter how hard or uncomfortable it is to challenge a negative or unhelpful thought, I do it. The more you entertain your negative thoughts, the more they will hover.

While I am not currently working with a therapist, I do recommend seeing one. I also recommend working with your doctor and having a complete workup done to rule out any underlying medical conditions. Psychiatrists are incredibly beneficial as well, if you are looking to identify whether medications are going to be helpful for you during your recovery.

Initially, I also worked with a nutritionist weekly. She helped me to integrate “fear” foods back slowly and in a way I didn’t find scary.

Lastly, please confide in someone. It doesn’t have to be a parent; it can be a boyfriend or girlfriend, relative, or friend. Just make sure it is someone you can trust and feel comfortable talking to.

You can recover. Don’t let yourself live in this misery any longer. Embrace freedom.

Diet food photo available from Shutterstock

Understanding Orthorexia

Marianne Riley, MA, NCC, LGPC

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APA Reference
Riley, M. (2018). Understanding Orthorexia. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 1 Aug 2015)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
Published on Psych All rights reserved.