“I often feel like I have little control over anything in my life and what happens to me.”

Most therapists come across this statement from almost every client who is struggling with an eating disorder. Whether the individual is struggling with anorexia nervosa, binge eating disorder, bulimia nervosa or orthorexia nervosa, there is always some form of underlying control that the individual is struggling with. Individuals with eating disorders use food and weight as a way to control what happens to them when other aspects of their lives are out of control. The fear of losing control is the main factor that continuously perpetuates the cycle of an eating disorder. For individuals who are struggling with anorexia nervosa, exerting control over their eating disorder is falsely perceived as a success in a world where they viewed themselves as a failure in many other areas of their life.

Defining Orthorexia Nervosa

Orthorexia nervosa (ON) is an eating disorder characterized by having an unhealthy obsession with healthy food. This obsession with healthy dieting and consuming only pure foods becomes deeply rooted in the individual’s way of thinking to the point it interferes with their daily life. Examples of severe eating disturbances seen in orthorexia nervosa include eating only fruits and vegetables or just consuming organic food. Unhealthy and obsessive thoughts, emotions and behaviors about eating “clean” or “healthy” food can drive individuals to isolate themselves from their friends and family, causing a strain on their social life and personal relationships. The need to eat clean and to only consume healthy foods is a way for individuals to exert control over their bodies and diet. When this cycle of control is broken, leading to cyclic episodes of “straying” or “cheating,” these individuals will feel as if they have failed. They think they have failed their diet and have failed themselves.

Common Fears Associated with Control and Orthorexia Nervosa

Losing control over one’s body: “If I put on weight, I will have failed in the one area I thought I could control.” Keep in mind that orthorexia is not centered on weight; however, these weight centered thoughts are more commonly perceived in individuals who are struggling with anorexia nervosa.

  • What if I start to enjoy food?
  • What if I relax and then can’t stop putting on weight?
  • What if I have to buy bigger clothes?

Losing control of one’s identity: “This will change how other people see me.”

  • What if others comment on my weight? (Whether good or bad, I will lose their support, and they will change the way they look at me.)
  • Who will I be without my eating disorder? (It will be difficult facing the world with my new identity as a recovered person.)
  • How will I be able to face the world? (I will be left defenseless with nothing to hide behind.)

Losing control of one’s emotions: “I will lose my safety net.”

  • How else will I feel special?
  • How else will I cope with my feelings?
  • How else will I punish myself?

In orthorexia nervosa, the individual is allowing food and their restrictive eating patterns to take control whereas in recovery the individual learns over time how to take control of their thoughts and emotions without using food as a crutch.