What Is Orthorexia? When Eating Healthy Isn't Healthy Anymore

It’s easy — at first — to envy a girl who declines a slice of cake without hesitation. At times, we’ve all aspired to do the “eat clean thing.” Still, most of us know that it takes a strange kind of discipline to omit anything with salt, chemicals, sugar, meat, carbs, etc. — a discipline that is so controlled, one might say it’s disordered, and in fact, can be. Because you can go too far with healthy.

Celebrities who hail additive-free diets, like Gwyneth Paltrow and her GOOP diet plan, or other celebrities who denounce sugar (and say what you will, chocolate does beat kale sometimes, and a green juice is not a glass of wine), make claims advocating a "clean" lifestyle. Regarding her cleanse, Paltrow said, "I feel pure and happy and much lighter (I dropped the extra pounds that I had gained during a majorly fun and delicious ‘relax and enjoy’ life phase about a month ago)… This thing is amazing. And don’t forget to ask your doctor if a cleanse is right for you."

The claims endorse a kind of ideology that can sway women into thinking if it’s not all natural, if it’s not perfect, it’s bad, and moreover..."majorly fun and delicious" is bad for you! It needs to be perfect. It needs to be right. Anything not natural will harm my body.

In fact, when I was 16 years old, I cried when my mother pulled out a can of soup. Canned soup has so much sodium! It’s terrible for me!

“It’s soup,” she said. “You can have it with something else.”

“Right, but I’m supposed to only eat healthy things.

I didn't know it at the time, but I had orthorexia.

The Obsession With "Getting It Right"

The term “orthorexia” comes from the Greek word orthos which means “straight” or “proper.” (Think: an orthodontist makes your teeth straight.) Orexia means appetite. It’s an unhealthy obsession with maintaining a clean or "proper" diet.

Orthorexia is similar to obsessive compulsive disorder. It's a condition in which women and men are fixated on eating what’s healthy and what’s right — and begin to deeply fear eating anything that may not be completely natural or that falls within their restrictions, and, as a result, sacrifice so many other parts of their daily lives. It's technically not a part of the DSM-IV, and some specialists dislike referring to it as an eating disorder at all, since that term isolates the individual suffering with eating healthily in an obsessive fashion.

Dana James MS, CNS, CDN of Food Coach NYC says that the battle that obsessively healthy eaters struggle with is primarily rooted in fear. They exist in a day-to-day environment with the thought of, "If I put something in my body that is unhealthy, then my body will be psychologically sick." These individuals do not trust their bodies to process food that they don't perceive is healthy, when, in fact, according to James, the body is designed to process toxins — just not all the time or on a regular basis.

Often, these individuals, according to James, start out overweight, eating a "standard American diet" (ie: a whole lot of fat) or suffer from a digestive issue and find that restricting one thing works for them. From there, they end up taking it too far, creating unjustified rules as to why everything must be restricted. What these individuals fail to recognize, then, is that the body is far more intelligent than they give it credit for. The body is designed to work in a balanced fashion.

In fact, being obsessed with something — like a set of rules, for example — can send an individual spiraling even further. Emily Shapiro, who is a holistic health coach and the founder of Love and Kale in NYC, says that finds that obsessive clients actually have a harder time processing food. (Think: if you're constipated, you're holding a lot in... a lot of feelings, a lot of anger, a lot of something.) She says that, "Our bodies don't process foods well when we're obsessed.... about anything. If it's food or it's this diet obsession — or this negative attitude about food, I can't eat this, I can't do this — it's the same thing. Your body is feeling that intense energy. It won't process food as opposed to [when one is] happy and healthy."

The Scary Part

Orthorexia is scary because unless someone is debilitatingly thin, it can be hard to catch; these are the people who are eating a ton of veggies that are filling up their plates. They try the paleo diet. They exercise. They appear to have met the Hollywood-level ideal of “healthy and thin.” Some orthorexics possess enough muscle mass from eating the right combination of proteins and carbs that they even look ripped. Having such toned and even enviable bodies can make it so easy for them to get away with the havoc they are wreaking on themselves emotionally.

What's even scarier about orthorexia is that it can disguise itself as healthy eating. Someone who's orthorexic may pose as the no-sugar, no-Splenda girl.

That's what happened to me. In fact, in high school, I was weirdly heroic — emphasis on the word "weird." I had straight A's, and I was certainly a perfectionist, but beyond the educational realm. At birthday parties I politely turned down pizza for salads. I was always running around the track. It was a strange badge of pride: I was so freaking healthy, what could be wrong?

Sure, it was isolating; when my friends went out for lunch, I'd exercise or eat my pre-packed apple and hummus, but I also wasn't going out with people.

Orthorexics start out by appearing to be models of discipline. They eliminate commonly denounced items artificial sweeteners or meat, for example, and it later stems to nearly everything. Eating out at restaurants is out of the question; orthorexics often isolate themselves and suffer socially. Not only that, they often ostracize themselves by speaking pedantically towards others about foods. You're eating sugar? I'm a vegan! (Shapiro is a practicing vegan, but mentions "it works for her," and that it doesn't work for everybody, and that pushing a nutritional agenda on others is a sign of discomfort with a diet regimen.) So much of eating is social, and even the strictest of dieters let go every now and then. But this discipline is a completely different kind — it's that obsessive kind.

Not As Cool As It Looks

Incidentally, my obsession with eating healthy arose from attempting to treat the fact that I was worrisomely thin. I was addicted to exercise, and I began a diet plan to re-nourish myself. I went from diet products to plain tuna on lettuce with pears. I need to be healthy! I would cry out. My body needs nutrients! I took the "replenishing" too far, and, as a result, ending up spending years battling what I imagined was "healthy eating," even though it was frighteningly isolating.

Other women suffer from this descent, too. About four years ago, ABC reported that a young woman, Kristie Wurtzel, nearly died from being too healthy, which was an eye-opening moment for a public who knew nothing about orthorexia. Wurtzel, who was in her mid-20s, started out as vegetarian, and then became vegan, and soon adopted a raw diet. She said that it wasn’t about losing weight — it was about not wanting to put any contaminants in her body.

But who are the people struggling? This obsessiveness with healthy eating is often found in groups of people fixated on their health and well-being. It shows incidence in medical professionals, fitness professionals, and those in the performing arts most frequently. Think about it: these are people who need to appear to models of all things healthful. Actors may claim that they can't do a show if they don't eat clean, that it will mar their performances. These people often are highly achieving, which can, at times, make this disease even more difficult to detect. When I was in college, even though I was painfully thin at the time (I cringe when I look at pictures), some people just touted me as petite and as a healthy eater. Not to mention, I was a theater major and was cast as little kids all the time, which only fueled the fire.

Not The Cool Thing To Do

You’ve tried juicing? Oh God, you have so much strength!

What’s scary about orthorexia is that healthful eating is ubiquitous; eating clean is so trendy today. I've tried a cleanse, just to see what it's like (and, to be frank, before I was about to go on vacation and drink and eat a ton), and though my skin certainly glowed for a day, I was miserable. No wine with the ladies, that was for sure. Moreover, I didn't want to do anything other than sleep, and I was a moody bitch. Still, I received praise as I walked around with my bags of juice; how bold I was to go forth and cleanse! I had to make an effort to remind myself that this was no way to live, and that I was really doing it for the margaritas that were around the corner.

But some people can get sucked into the praise. Women, who at once were at risk for social isolation with orthorexia, can be put on a pedestal by peers, and oddly encourage one another to participate in dangerous behaviors. Women can scarily unite in their quest for so-called health. With the Internet serving as a vast resource for any diet — healthy or not — it’s even scarier to watch someone close to you suffer. Or, moreover, it’s scary to realize that what once seemed healthy has gone beyond the threshold.

James and Shapiro are in agreement that juices are both delicious and filled with nutrition, but strictly juicing and not chewing and digesting food is not only not a sustainable way of living. Instead, it causes you to neglect your body of nutrients that you need.

"Most people do it to prove to themselves [they can]," James says. That's what I did! (Fun fact: I could not.)

A Balancing Act

Counseling is often integral to recovering from orthorexia, since it is so based in the desire to control, much like obsessive compulsive disorder. James says that those with obsessively healthy eating tendencies need to begin with re-education about how the body processes food. Not on food itself. These individuals know the nutrients in products almost to a fault, so it's about reminding them, again, that the body is far more capable than they give it credit for. For example, clients who eliminate tuna due to mercury, she says, "Rather than saying, I'm never going to eat tuna," it's important to say, "I trust my body will detoxify this." It's about recognizing, If I eat a healthy diet, then I can control a health diet. A healthy diet, in fact, is all about balance.

Shapiro, in fact, teaches her clients to operate on a basis of balance. She says that food is actually just a tiny component of your health — your overall health is beyond what goes into your body; it's your relationships, how you feel about yourself, your living situation, and beyond. It's about living a healthy lifestyle that one can sustain.

Shapiro says she will tell clients,

Of course, Shapiro also tells her clients to eat more greens, and to eat what works for themnot what society or friends are telling to eat. But it's about being able to have kale, and then the ice cream, and not worry about it, and be confident in your dietary choices to the point where your diet and health regimen — no matter what they are — do not interfere in your everyday life (as they did with mine).

Kale And Fries

As for me, the 16-year-old who nearly cried over a can of soup is no longer here. (I mean, she's here, typing this, but she eats a damn can of soup.) Though she tries to eat well, and does eat mostly vegetables, and occasionally bemoans the drunken fries she had last night, she gets up, and moves on. Are there days when I wish I ate more than peanut butter out of the jar? Absolutely. But it’s better to eat peanut butter out of the jar than to fear it. I trust that my body can process it. My skin looks better (except when I forget to take off of my make up at night — whoops), I have more energy for fulfilling workouts, I go out when I want to, and make decisions based on how I feel.

In fact, I silently chastise myself when I say out loud, today is the day I will start eating healthy. My twisted relationship with food has taught me that while what I suppose I aspire to do is to eat healthy (because, much to my disappointment, a diet of sweet potato fries and whiskey will not give my brain the nutrients it needs to write — though the whiskey will certainly inspire me!), what I really aim for is what both Shapiro and James tell their clients: a sustainable lifestyle of balance. I say yes to fries, and I feel pretty damn healthy. When I think about it, fries — and the company that comes with it — are what my body needed all along.

For more about Dana James and her practice, MS, CNS, CDN, please visit Food Coach NYC. For more about Emily Shapiro and her practice (and to find out where and when she teaches yoga!), please visit Love And Kale.