Most of us are trying to make the best choices when it comes to eating healthily. But when does this healthy habit turn into something more concerning? This is where understanding orthorexia, or orthorexia nervosa, becomes crucial. Unlike the common perception of just being overly health-conscious, orthorexia is a complex and potentially debilitating condition that can severely disrupt daily life and overall well-being. Despite these challenges, however, orthorexia is a condition that can be managed and overcome. UKAT’s Banbury Lodge offers comprehensive care to help you rebuild a healthy relationship with food and reclaim your life from the grips of orthorexia.

What is orthorexia?

The term “orthorexia” derives from the Greek words “orthos,” meaning right, and “orexis,” meaning appetite or desire. At its core, orthorexia is about an unhealthy obsession with healthy eating. Orthorexia differs from other eating disorders as it focuses more on the quality of food rather than quantity or body image. The condition often starts innocuously but can quickly escalate to a point where your diet becomes extremely limited and consuming, filled with rigid rules and self-imposed restrictions.

Orthorexia does not discriminate; it can affect individuals of any age, gender or background. It is often seen in conjunction with other eating disorders or in people who are overly health conscious. Orthorexia can manifest in various ways, from obsessive research about food’s health benefits to extreme dietary restrictions that eliminate entire food groups deemed ‘unhealthy’ or ‘impure.’

It is crucial to understand that while orthorexia may seem like a commitment to healthy living, it can take a severe toll on your life. The tragic irony of orthorexia is that while you intend to improve your health, you end up doing the exact opposite, both physically and mentally. The constant preoccupation with food purity and quality can lead to social isolation, anxiety and a significantly diminished quality of life, while on a physical level, a restrictive diet may lack key nutrients or produce a serious calorie deficit.

Identifying orthorexia symptoms

Recognising orthorexia in yourself and others means identifying the various orthorexia symptoms that go beyond just ‘eating healthily.’ Some of the most prominent orthorexia symptoms include:

Obsessive concern with food ‘purity’: This can manifest as an excessive focus on food labels, ingredients and the origins of their food.

Extreme dietary restrictions: Orthorexia often leads to cutting out large groups of foods based on their perceived impurity or unhealthiness. This can include processed foods, fast foods, and food groups like sugars, carbs, fats, and even foreign or unfamiliar food whose content you are unsure about.

Significant distress or anxiety: A key symptom of orthorexia is the intense distress or anxiety experienced when ‘pure’ or ‘healthy’ foods aren’t available. This anxiety can be so overwhelming that it disrupts daily activities and social interactions.

Moral judgement of self and others: People with orthorexia may judge themselves and others based on dietary choices. This can lead to feelings of guilt or superiority, depending on how well they (or others) adhere to their dietary standards.

Social isolation: Due to the strict dietary rules, individuals with orthorexia may avoid social events or situations where food is involved, leading to social isolation and loneliness.

Physical effects: Over time, the diet’s restrictive nature can lead to nutritional deficiencies and associated physical health problems. This can include malnutrition, weakened immune function, anaemia, bone density loss and heart issues.

What causes orthorexia?

Understanding the causes of orthorexia requires a deep dive into various contributing factors. It is a condition that does not have a singular cause but rather stems from a complex blend of psychological, social and possibly biological factors. Key contributing factors include:

Cultural and social influences

We live in a society that often glorifies health and fitness, sometimes to unrealistic extents. This societal pressure can be a driving force behind the development of orthorexia as the constant bombardment of messages promoting “clean eating” and vilifying certain foods affects people’s behaviours to an extreme level.

Personal traits

Certain personality traits can potentially predispose some individuals to orthorexia. Perfectionism, a need for control or a tendency towards obsessive-compulsive behaviour are often seen in those with orthorexia, driving the focus on diet purity.

Psychological factors

Underlying mental health issues such as anxiety or obsessive-compulsive disorder (OCD) can contribute significantly to the development of orthorexia. The disorder can be a way for individuals to cope with or gain a sense of control over their anxiety or obsessive thoughts.

Biological aspects

While less understood, there may be biological factors at play, such as genetic predispositions or biochemical imbalances, that contribute to the development of orthorexia.

The orthorexia diagnosis process

Diagnosing orthorexia is a nuanced and multidimensional process, particularly because it is not officially recognised as a distinct eating disorder in the DSM-V. However, experienced healthcare professionals can identify orthorexia through a careful examination of behavioural patterns and a comprehensive assessment encompassing physical, psychological and nutritional aspects.

In-depth physical assessment

The physical assessment for orthorexia diagnosis is designed to uncover any health issues that may have arisen as a result of extreme dietary restrictions. This step is critical because individuals with orthorexia often experience various physical health problems due to their unbalanced diets. The assessment includes:

  • Complete medical history review: Understanding your past and present health conditions, including any history of eating disorders.
  • Physical examinations and tests: These may include blood tests to check for nutrient deficiencies, bone density scans to assess bone health and other relevant tests to evaluate your overall physical condition.
  • Assessment of physical symptoms: Identifying signs of malnutrition, such as hair loss, skin problems, fatigue or menstrual irregularities in women.
  • Comprehensive psychological assessment

    The psychological assessment aims to understand your mental and emotional state and to identify any underlying or co-occurring mental health disorders. This assessment is crucial because orthorexia is often intertwined with psychological issues. Key components include:

  • Detailed interviews: These are conversations to explore your thoughts, feelings and attitudes towards food, eating and health.
  • Evaluation of mental health history: Understanding any history of anxiety, depression, obsessive-compulsive disorder or other mental health issues.
  • Cognitive and behavioural assessments: Using standardised tools to evaluate your cognitive processes and behavioural patterns related to food and health.
  • Thorough nutritional assessment

    The nutritional assessment is focused on understanding your dietary habits and identifying any nutritional deficiencies or imbalances caused by restrictive eating patterns. This involves:

  • Dietary history analysis: A detailed review of your typical eating patterns, food choices and any avoidance or elimination of specific food groups.
  • Nutritional status evaluation: Assessing signs of malnutrition or specific nutrient deficiencies may involve blood tests and other diagnostic tools.
  • Discussion of eating behaviours: Exploring the emotional, psychological and social factors that influence your eating habits, including any rituals or rules around food.
  • Throughout the orthorexia diagnosis process, it is essential for healthcare providers to approach the assessments with compassion and understanding. Many individuals with orthorexia struggle to recognise their behaviour as problematic, often viewing their extreme dietary restrictions as beneficial or even virtuous. Acknowledging this mindset is crucial in establishing trust and rapport, which are key to effective diagnosis and subsequent orthorexia treatment.

    What does orthorexia treatment involve?

    When it comes to treating orthorexia, there is no one-size-fits-all solution. At Banbury Lodge, we understand your unique challenges and offer a tailored rehab treatment plan designed to meet your individual needs. The journey to recovery from orthorexia is multifaceted, addressing not just your eating habits but the underlying psychological patterns, your emotional well-being and your relationship with food and your body. Our orthorexia treatment includes:

    One-to-one therapy
    In your one-to-one therapy sessions, you will work closely with a therapist to uncover the psychological underpinnings of your orthorexia. They are a safe space to explore the thoughts, emotions and experiences contributing to your condition and develop healthier thought patterns and coping strategies.
    Group therapy
    Group therapy sessions provide a supportive environment where you can share your experiences, learn from others and realise that you’re not alone in your struggle. This can foster a sense of belonging, while the insights and encouragement from peers can be incredibly validating and empowering.
    Cognitive behavioural therapy (CBT) / dialectical behaviour therapy (DBT)
    CBT and DBT are evidence-based therapies that are particularly effective in orthorexia recovery. In CBT, you will learn to identify and challenge the distorted thoughts and beliefs about food and health that fuel your orthorexia. DBT, on the other hand, focuses on helping you develop skills to manage stress, regulate emotions and improve relationships damaged by the condition.
    Family therapy
    Family therapy sessions are designed to educate your loved ones about orthorexia, helping them understand what you’re going through. These sessions also aim to improve communication, resolve conflicts and build a supportive home environment that facilitates orthorexia recovery.
    Nutritional counselling
    Nutritional counselling involves working with a dietitian to understand your nutritional needs and learn how to maintain a balanced diet. You will receive guidance on making food choices that support your physical health without falling into restrictive patterns.

    Begin the orthorexia recovery journey

    Embarking on the journey to recovery from orthorexia is a brave but life-changing decision. At Banbury Lodge, we understand the complexities of this disorder and offer a supportive, nurturing environment to help you heal and grow. Our team of professionals is dedicated to providing the care and guidance needed to overcome orthorexia and build a brighter future. Contact us today to get started.

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    What happens after orthorexia treatment?
    Recovery from orthorexia is an ongoing journey, and post-rehab support is crucial. That is why UKAT offers an aftercare programme of weekly group therapy sessions for a year. These sessions help reinforce the skills you have learned and provide a safety net as you navigate the challenges of everyday life post-treatment. This continued support is crucial for maintaining your progress and preventing orthorexia relapse.
    How long does orthorexia treatment last?
    This depends on your individual needs and response to treatment. Banbury Lodge offers varying lengths of orthorexia treatment programmes to fit as many needs as possible. These range from two weeks to twelve weeks but we strongly recommend you commit as long as you can to orthorexia treatment for the best possible outcomes.