Eating Disorders in Disguise: When healthy eating turns into an unhealthy obsession

This week marks the National Eating Disorder Awareness Week. It is an initiative run by the National Eating Disorder Association (NEDA) to shine a light on stories of people struggling with an unhealthy relationship to food and our bodies. Although very rarely discussed in the open, eating disorders affect over 9% of the population worldwide. 

When we think of eating disorders, we often think of anorexia or bulimia. However, there exists one more subtle category of eating disorder that tends to slip away from the radar called orthorexia. Dr Steven Bratman first coined the term orthorexia to explain why people would only pick ‘clean’, ‘pure’ or ‘healthy’ foods that ultimately significantly interferes with many aspects of a person’s life. 

After the holidays, the New Year, birthdays or other major celebrations, we tend to say things such as “I’m going to make an effort to eat healthier” “I’m going to stop eating so much” “I need to get back on track”. Although there is nothing wrong with enjoying a salad once in a while, we are currently living in a society that has praised excessively clean eating and dieting. As a consequence, many people have found themselves pursuing these unhealthy behaviors in the hopes of becoming ‘healthy’. An originally well-meant intention to care for oneself sadly turns into a worrying fixation on calories, nutritional labels, tracking food and daily weigh-ins. Whilst being more conscious of our food and our intake can result in being more mindful of our nutrition it can often come at the expense of our own mental health. 

When someone says no to a dessert or chooses a salad as a main meal, friends will quickly praise such behavior and label us as “the healthy one”. However, this does not always reflect on the relationship with food which may turn out to be actually unhealthy. Orthorexia is present when people tend to create food rules where one can only consume healthy and pure foods. They will tend to cut out certain food groups or ‘bad’ food as a result and experience extreme guilt or anxiety when eating an ‘unhealthy’ food. In this case, the focus is more on the quality and type of food rather than the quantity like in anorexia or bulimia. 

These are signs to look out for if experiencing symptoms of orthorexia:

  • Checking nutrition labels and ingredients of food
  • Spending a lot of time reading, researching and planning what you are going to eat (e.g. looking at the restaurant’s menu to ‘prepare’ what you are going to have)
  • Tracking food
  • Cutting out food groups and focusing on macronutrients
  • Exercising daily and feeling anxious when you cannot exercise
  • Separating “good” foods and “bad foods” and avoiding foods that are ‘bad’
  • Isolating yourself from social gatherings which include food for fear of not knowing what you will eat and not being able to control your intake
  • Feeling guilty or ashamed when eating things that are ‘bad’ or ‘off-limits’
  • Feeling anxious when there is uncertainty around foods
  • Not being able to have spontaneous meals or snacks as they are not part of your ‘meal plan’
  • Having a meal plan that is rigid and does not allow for flexibility

Although these signs seem subtle, it is clear that if you notice your relationship with food is impacting your day-to-day life or affecting your wellbeing by hurting your relationships, social life or career, then it is important to address it. Focusing on the quality of a food intake will only be healthy if the relationship with food is healthy at the same time. A nutritious diet can be rich in vegetables, salads and beetroot juice or whichever latest health fad is trending, however, food choices that are coming from a place of fear, deprivation and self-imposed stress can hurt more than help. 

Whether or not you are experiencing these symptoms, Eating Disorder Awareness week can help you reflect on your current relationship with food and your body. Here are some tips to help start build a healthy relationship:

  • Pay attention to your body’s rhythm. If you are not immediately hungry, it is best to not eat right away. Learn how to feel full and stop as soon as you notice this.
  • Eat mindfully. Mindful eating can help you identify when you feel full and when you feel hungry. Become more aware of your food’s textures and tastes. It is best to avoid eating while watching TV or working to be fully present and aware when you are eating.
  • Be careful of tracking technology. Although Apple watches are great to motivate us to move, regular use of them can intensify obsessive behaviors. It is best to not fixate on these numbers unless advised to do so.
  • Don’t ignore cravings (within reason). If you have had dinner, you can always allow yourself a snack or a dessert if you still feel hungry afterwards if your body is craving something in particular. 

This is only the beginning as our relationship with food and our bodies continue to evolve as we grow older and enter different stages in our life. It is important to share your own experience with someone you trust that can help recognize some of these behaviors and help support you. 

If you notice you are struggling with any of these symptoms and would like to build a better, stronger relationship with food and your body, seek advice from a health professional who can guide you through this. 

If you are interested in scheduling a session with Aurélie Comes or have further queries, please contact us today.

About The Author

Dr. Aurelie Comes

Aurélie is an experienced Cognitive Behavioral Therapist (CBT) who trained and worked in the UK’s National Health Service. In addition to her CBT specialty, she also qualified as an Eye-Movement Desensitization Reprocessing (EMDR) Practitioner.Aurélie has worked extensively in the private and public sector with clients experiencing mild to severe difficulties (e.g. depression, anger management, substance misuse, sleep problems, life adjustments, individual relationship difficulties). Her areas of special interest include trauma and eating disorders.Aurélie also provides therapy with adolescents to help with adjusting to a third-culture kid lifestyle, school issues, bullying and transitioning to university.