Orthorexia: what happens when you become obsessed with 'clean eating'?

woman peeling orange to represent 'clean' eating
8 subtle signs you may have orthorexiaAndrew Olifirenko - Getty Images

The warmer months may mean we might naturally want to eater fresher and lighter meals, whether we're trying out healthy new recipes in the evenings or putting a picnic spread together for friends on the weekend (there's also nothing wrong with having your winter favourites all-year-round too).

But while incorporating new healthy habits into your day-to-day is no bad thing, especially when it can boost your nutrition and help you to feel on top of things, what about when it goes too far and actually hinders more than helps? While it may sound extreme, sadly for an increasing number of people, eating habits can feel all-consuming, controlling their every thought and move.

Take Rhiannon, who is in her twenties, from London. "I first noticed it creep into everyday life in my second year of uni - I became obsessed with the term ‘clean eating'," she shares.

"I cut out entire food groups. Oils, cheese, and butter were a big no-no. So were carbs - pizza, pasta, and bread were all off the cards. Rice cakes became my toast, cauliflower became my rice and I spent ridiculous amounts of money on pastas that had zero carbs and calories (and also zero flavour)," she explains.

A healthy diet consists of eating fruit and veg, potatoes, bread, rice, pasta and other starchy carbohydrates, beans, pulses, fish, eggs, meat and other proteins, dairy and alternatives, and oils and spreads, according to the NHS Eatwell Guide.

So, what is orthorexia?

While it's not yet an 'official' eating disorder, 'Orthorexia' is the term used to explain an obsession with healthy eating, according to leading sports dietician and eating disorder specialist Renee McGregor. "It's often the search for purity, with individuals going to any extent to eat what they perceive as pure or clean," she explains. "Sometimes, this is at the expense of getting key nutrients, means spending huge amounts of money on particular ingredients, and can make you avoid social situations for fear of certain foods."

That's exactly how Rhiannon felt. What started out as a way of increasing the number of healthy foods in her diet soon took over, controlling social events, holidays and ultimately, her life.

"I felt like putting anything into my body that wasn’t ‘healthy’ or ‘nutritious’ was like poisoning myself," she adds. "Gradually, the food I was eating left me with no energy, miserable and depressed. My relationships with friends and family became strained. People around me had normal relationships with food - food was a part of their life, but not all-consuming. Food was my whole life. It dictated my every thought."

Sadly, Rhiannon's far from alone. There's nowhere near enough research on the condition yet (and eating disorder charity Beat have confirmed that orthorexia is yet to be officially recognised as its own disorder), but the few studies that have been done predict that orthorexia affects between 1% and 7% of the general public. Some studies have also shown there's a link between orthorexia and OCD, too.

Chartered psychologist and eating disorder therapist Rachel Evans explains that the focus on maximising your health by eating the 'perfect' diet often involves cutting out whole food groups and previously enjoyed foods. "What can start as making healthier choices can turn into black-and-white thinking about 'good' and 'bad' foods, with overwhelming guilt and shame when a food rule is broken," she explains.

avoid eating with friends
drazen_zigic - Getty Images

What are the signs of orthorexia?

According to registered associate nutritionist Isa Robinson, noticing the signs of orthorexia isn't straightforward – eating disorders present in complex and confusing ways and differ from individual to individual.

However, there are a few stand-out warning signs to be aware of if you think you, or someone you know, may be suffering.

1. Obsession with eating healthy food

Someone with what is generally described as orthorexia will likely fixate or obsess over only eating food that they deem healthy, Evans explains.

"There is stereotypically a sense of judgement or criticism about others who don't follow such a strict diet as them, which can damage close relationships. Often the sufferer will prioritise clean eating, exercise and healthy living over their former hobbies or interests, and can be quite unaware or even defensive about their changes in behaviour," she shares.

2. Focus on only eating pure products

While food 'rules' will vary from person to person, many affected by orthorexia tendencies will only eat pure or organic products, shares Robinson.

3. Severely restricting

Often, those suffering from orthorexia will opt for cutting out entire food groups. "They'll sometimes continue to cut things out until their diet is severely restricted and only includes the 'healthiest' foods," she adds.

4. Strict eating rules

A big red flag for orthorexia? Having set rigid eating patterns that dictate your day-to-day life. "People with orthorexia will do pretty much anything to avoid eating any foods they don't consider to be healthy," Robinson emphasises.

Rhiannon gives the example of making up an excuse not to eat with her friends when they said they were going to a restaurant she deemed as unhealthy.

5. Anxiety around breaking their food rules

If you've ever felt guilt, stress or anxiety about breaking a food 'rule', you could be affected.

"Remember that orthorexia is all about rule-following, so if any rule is broken, the sense of guilt in the sufferer can be overwhelming," McGregor shares. Sometimes, the person will then try to right their 'wrongs' (obviously they've done nothing wrong or bad at all, but it can feel this way), by over-exercising or restricting.

clean eating obsession
Hispanolistic - Getty Images

6. Avoiding eating out

Tying in with the above, eating out or enjoying social situations can be extremely difficult for people affected.

"You'll normally face difficulties eating in restaurants or having a meal prepared by someone else," Robinson shares. Why? Because you'll feel a need to control the food, and perhaps the food preparation, too.

"Those who suffer from eating disorders will avoid at all costs social situations that might involve the need to eat outside of their rules," McGregor adds.

7. Low mood and health complications

Naturally, if you're limiting what you eat, you're bound to experience low energy, mood swings, anxiety and physical health complications, shares Rachel. "This can include a weakened immune system and hair loss as a result of eating a restrictive and often unbalanced diet," she explains.

8. Creating (or assuming) undiagnosed food allergies

Whether it's gluten-intolerance or dairy-free, regularly omitting certain food groups by creating or assuming undiagnosed food allergies is a big red flag, explains McGregor.

"Individuals struggling not just with orthorexia but with any eating disorder may use this as an excuse to limit or control what they eat," she shares.

Why does orthorexia manifest itself?

As with any mental health disorder, it's different for everyone, and to truly get to the bottom of why you might be experiencing certain signs, you'll need to visit your GP or a qualified eating disorder specialist.

However, McGregor makes an interesting point about any eating disorder being a means to control your life and current situation. "That need for control is a key trigger for any eating disorder. It can manifest in food choices or set rules about food preparation, ingredients, or portions."

In short, the routine of your disorder can evoke a sense of control and calm. However, deviation from these 'rules' can create extreme anxiety and stress. "These routines create a false sense of security. They're a fundamental method of denying your more difficult and uncomfortable emotions that you don't want – or know how – to cope with."

What should you do if you think you have orthorexia?

The most important thing is to speak to someone, say all three professionals. Reach out to someone you can trust, who can help guide you to the right helplines and resources. Beat has an eating disorder hotline that's open every day, and the National Centre for Eating Disorders and the National Eating Disorders association both have guides with lots of handy pointers. While eating disorders are serious, it is possible to make a full recovery.

And do know this: you are not alone.

What should you do if you think someone you know has orthorexia?

Again, this can be tricky as with any mental health condition, but one thing that works really well is careful questioning, shares McGregor.

She recommends asking the following:

  • "I have noticed that you never come to coffee with us anymore, is everything ok?"

  • "You don’t seem yourself, it feels like you are withdrawing a little, I miss your laughter and fun. Is there anything you want to talk about?"

Note: When contacted, eating disorder charity Beat was quick to point out that orthorexia is yet to be officially recognised as its own disorder. "While orthorexia can be serious and those affected should seek help, it isn't currently recognised as a separate eating disorder," the experts emphasised.

"Someone who visits a doctor with the symptoms wouldn't be officially diagnosed with 'orthorexia', although the term may be brought up when discussing their illness. Depending on their precise symptoms, they may be diagnosed with anorexia or OSFED [other specified feeding or eating disorder]."

Beat is the UK's leading charity dedicated to helping people with eating disorders. If you or someone you know is struggling and want to seek help, call their helpline on 0808 801 0677 or visit their website for more details.

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

You Might Also Like