A specific type of dysfunctional eating, known as Orthorexia Nervosa, begins as a desire to treat or prevent illness or break free of “bad” eating habits but manifests into an unhealthy obsession with eating “good, pure, or clean” foods. This eating disorder is not formally included in the DSM-5 however it is recognized by eating disorder treatment centers and therapists alike.

The development of orthorexia

Orthorexia Nervosa develops in two stages. The first stage involves adopting a theory of healthy eating. These fad dietary theories change every year and, currently, the most popular dietary theories associated with Orthorexia Nervosa are clean eating, paleo, vegan, raw foods, and elimination diets.

Some dietary theories are simply unsafe.

For example, it is not possible to live on fruit and kale smoothies without developing dangerous malnutrition due to vitamin and mineral deficiencies, but most of the more popular diets associated with orthorexia can be executed safely. The problem for many individuals is going down the path of a restrictive diet in search of healthy living can escalate into dietary perfectionism.

Over time, an increasing number of foods are eliminated. More and more time is spent thinking about food, preparing it and planning meals. Self-imposed eating rules become difficult to follow, leading to cyclic episodes of “straying” or “cheating,” followed by increasingly severe cleanses and detoxes. It becomes difficult to eat with friends or relatives, which leads to social isolation. So much emotion, time and thought are devoted to eating correctly that there is little space for other interests. The individual’s strive for perfectionism takes over, which is turns commonly, results in social isolation.

Orthorexia can breed perfectionism

Person lining pencils up.

The obsession with the desire to “eat clean” can be driven by perfectionism as individuals with Orthorexia Nervosa spend inordinate amounts of time planning, purchasing, preparing, and eating their meals, to the extent that it interferes with other aspects of their lives. Orthorexia Nervosa is often referred to as “righteous eating” because the individual will often self-praise their ability to eat “clean” and take pride in their ability to resist temptation and eat a “near-perfect” diet. Many therapists believe that these feelings of superiority provide individuals with a way to overcome their low self-esteem and vulnerable ego, a trait that many struggling with an eating disorder share. The strive for perfection as a way to overcompensate for poor self-esteem is often found in many eating disorders, and therefore treatment is aimed at understanding why the individual is struggling with their self-esteem.

Orthorexia can breed loneliness

Individuals with orthorexia may become socially isolated, or have little ability to do anything other than thinking about, researching, and planning their food intake. This obsession with perfectionism can push away others and leave the individual in a state of isolation. Typically conversations are limited, and when engaging in discussion, it generally is around food, meals, chemicals, purity of foods and so forth.

Treatment for Orthorexia Nervosa

Orthorexia Nervosa, like many other eating disorders, results from underlying unresolved feelings and Orthorexia Nervosa gives individuals a way to overcome their low self-esteem and vulnerable ego. When an individual’s concept of self-worth and identity are wrapped up in such stringent and unhealthy behaviors, the pressure to maintain perfection only worsens, resulting in the continuation of the disorder. No matter what is behind the relationship between orthorexia and perfectionism, the simplest way to combat it is to remember a fundamental truth: perfection does not exist. More often than not, eating disorder treatment is necessary to overcome this battle. The psychotherapy approaches offered in eating disorder treatment can allow an individual to acknowledge the underlying feelings and triggers associated with their Orthorexia Nervosa and find strategies to develop healthy coping mechanisms and ways to live in reality without striving for perfection. In other words, treatment for Orthorexia Nervosa is more than “just treating an eating disorder”; there are so many deep underlying triggers that must be addressed.