This post was adapted from episode 40: “When Your ‘Health’ Obsession Becomes Unhealthy”
of the Nourished & Free podcast.
Have you ever wondered if your obsession with “healthy” is unhealthy? It’s hard to know when the purest of intentions around healthy living have taken a turn for the worst. Today, I want to talk through some of the red flags that surround an unhealthy obsession with healthy eating.
To assist in this topic, I talked with Katie Kuhlmann, PLMHP, MS, MCC, a mental health therapist from Omaha, NE. Katie has battled an eating disorder, including orthorexia, and has come full circle to helping others on their mental health journey through their own eating disorder. Katie and I are both a part of the “wounded healer” club, and have a unique perspective to offer you today on this topic.
To listen to our full discussion on this topic, listen to our podcast episode together. To see the written summary of our conversation about when your obsession with health is unhealthy, keep reading.
Understanding Health Obsession
There is absolutely nothing wrong with generally wanting to improve your health through nutritious foods and exercise. Where things take a turn for the worst is when these healthy practices become an obsession. Meaning, your food intake and exercise regimen have rigid rules and inflexible patterns.
To know if you’ve created an unhealthy obsession with food and healthy eating, Katie says one of the simplest things you can do is ask yourself, “what stresses me out?”.
If the answer is everyday things like your job, your relationships, or the economy, then you are probably in the clear. However, if your answer is “food”, more specifically “when I eat certain foods”, then we have a problem.
Not being able to be spontaneous with food (such as having a panic attack after a friend takes you to ice cream) is a clear sign that you have an unhealthy obsession with healthy eating.
What is Clean Eating Disorder?
Clean eating disorder is a way to describe orthorexia nervosa, which is an obsession around eating ‘clean’ and healthy.
What is Orthorexia?
Orthorexia is essentially an unhealthy obsession of what’s in our food. Those who are showing signs of orthorexia typically spend a lot of time thinking about healthy eating. This preoccupation may affect their quality of life, their ability to eat with others, and the foods available to that individual.
A proposed diagnostic criteria for the definition of orthorexia nervosa is:
- obsessional or pathological preoccupation with healthy nutrition;
- emotional consequences (e.g. distress, anxieties) of non-adherence to self-imposed nutritional rules;
- psychosocial impairments in relevant areas of life as well as malnutrition and weight loss.
Signs of Orthorexia
Orthorexia can look different from person to person. But some common symptoms of orthorexia include:
- Thinking about food constantly
- Always checking ingredients
- Making sure that everything is non-GMO or organic
- Requiring the ability to pronounce every ingredient on the label
- Looking into the manufacturing of how the food was made…
- Requiring foods to be “chemical-free” or “non-toxic”
- No flexibility around food
- Inability to eat food spontaneously
- Eliminating food groups
- Eating vegan for non-ethical reasons
- Distressed over food
These are not normal things. This is where an obsession with health is unhealthy, and our rules around food are highly unnecessary and cause psychological distress.
Orthorexia vs Healthy Eating
Let’s take a second to clarify something: healthy eating is great! You do not automatically have a problem if you simply want to care for your health.
You may be a non-orthorexic, healthy eater if you simply are mindful of your food choices and likely to include more things in your diet that are proven to be beneficial for your health. For example, you are intentional about including vegetables at every meal, choosing whole grains from time to time, and/or swapping out butter for olive oil sometimes.
In contrast, someone with orthorexia or a “clean eating disorder” may never allow themselves to have butter, have white bread, or to have pre-packaged food.
A red flag for when healthy eating becomes unhealthy is if someone is pouring over ingredient labels or refusing to consume foods if certain things are included in a product (or not included, such as not organic). Many of these ‘food rules’ that those with orthorexia obsess over are completely unnecessary things the media has told us are bad for us.
A normal eater should be able to navigate fact from fiction when it comes to healthy eating.
Orthorexia vs Anorexia
In the table below, I show the diagnostic criteria for anorexia nervosa. I want to note that orthorexia and anorexia can certainly be seen together, and orthorexia can lead to anorexia. However, the key features of orthorexia (on the right side of the table) are unique from the diagnostic criteria for anorexia (on the left).
|Restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
|An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’, not necessarily calorie content.
|Intense fear of gaining weight or becoming fat, even though underweight.
|Unusual interest in the health of what others are eating.
|Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
|Body image concerns may or may not be present.
As Katie describes it in our discussion, “does eating in general stress you out, or does eating a certain type of food stress you out?”. This is the biggest distinction between anorexia vs orthorexia.
How to Know if Your Obsession with Health is Unhealthy
If you are concerned that your obsession with health is getting unhealthy, then I suggest taking a quick audit of how you spend your time and your money.
Do you spend a great deal of time worrying about the ingredients in your food? Do you spend a lot of money on foods that are “healthier”, or on organic-only produce? Do you only shop in the health section of the grocery store?
While this isn’t an automatic answer that your desire to be healthy has become unhealthy, these can be some warning signs.
How an Unhealthy Obsession with Health Can Impact Your Life
To understand how a health obsession can become unhealthy, let’s dig into the tangible effects of why I say it’s “unhealthy.”
Social Impacts of Health Obsession
If your rules around food are causing you to miss out on a party, event, or time with friends because you aren’t able to eat the food there, this can have a massive impact on your relationship. It can lead to feelings of loneliness and ultimately take a toll on mental health.
Physical Impacts of Health Obsession
Eating a highly restrictive diet can be truly unhealthy for your body, too. In some cases, it may lead to undernourishment or malnourishment.
In the case of malnourishment, the body starts to break down tissue from organs and muscles in order to survive. Prolonged restriction and malnourishment may actually shrink an adult’s heart down to the size of a 6-year-old’s.
As a result, the heart will be working so much harder because it is not as strong. This is when we start to see things like arrhythmias, blood pressure issues, and honestly… heart attacks.
The gastrointestinal system (gut health) will also decrease in quality with excessively restricting food intake (especially things like dairy, grains, and fruit) because you’re not allowing the body to have healthy probiotics, prebiotics, fiber, glucose, etc. We can basically clean out our gut so much that we don’t have much of our good bacteria left. This can lead to irregular bowel, pain and bloating, nausea, vomiting, and more.
Restrictive eating can also impact the immune system. When deficient in a proper variety of nutrients, the immune system will weaken. Illness is a lot more likely, which is interesting because a lot of times people with orthorexia exhibit signs of OCD as well, and those people are typically concerned about getting sick. If you think about it, being overly concerned is actually leading them to sickness. Essentially what’s happening is their immune system is not working as well since they are undernourished.
Some other physical effects may be dry skin, brittle nails, hair falling out, fatigue, anemia, dehydration, organ failure… Our bodies can and will shut down if things like this go on for too long.
Mental Health Impacts of Health Obsession
Constantly obsessing over food may indicate misaligned values in your life – values that are not fulfilling and only lead to poor mental health outcomes such as depression, anxiety, or OCD.
Relying on a strict diet regimen to feel in control, bring you joy, or make you feel accomplished is a misplaced and misleading area to seek validation and comfort in, and will only let you down.
Why It’s Hard to Stop Struggling with Food
It is difficult to stop struggling with food. These habits, patterns, and obsessions are there because they are all tied back to a belief system. Have you ever tried to change something in your life that you had felt passionately about and truly believed in for so long? You probably didn’t unless your belief in that thing changed. We don’t often walk away from things we still believe in.
That is why changing our habits with food is so hard. There are often underlying beliefs that we aren’t even aware of, which makes overcoming struggles with food very difficult without the proper guidance and tools to understand your beliefs about food, health, and your body (and then change them).
How Eating Disorders Are Similar to OCD
According to Katie, your therapist or provider might treat an eating disorder under the addiction-based model. The problem with this is that you cannot remove food from your life like you can a substance or behavior. Eating disorders are most similar to OCD – something that we seek to control in our life.
Treating OCD involves exposures, which is not unlike how eating disorders are treated. Exposure to fear foods and working through the thoughts and feelings that arise is crucial for understanding and treating one’s eating disorder.
The Impact of Social Media on Health Obsession
It doesn’t take much for someone to become unhealthily obsessed with healthy living. Just spend 5 minutes on any social media platform and you’ll find 10 different influencers telling you about ‘non-toxic living’ and how ‘natural flavors’ will harm you (this is inaccurate, by the way).
If you spend enough time on social media, you’ll start to believe these things, too. Remember what I said about belief systems? Once something becomes a belief, it’s extremely hard to change.
As much as I would like this to be true, nobody cares about credentials, education, or formal training of the creator’s videos they see when mindlessly scrolling on social media. What they care about is whether what someone is saying is compelling or not, and whether it is entertaining them.
Many of these influencers are compelling- they strike a lot of fear by making claims about ‘toxins’, ‘poison’, and how things are ‘making you sicker’. The problem is that none of these claims stand up against basic fact-checking.
How to Focus on Your Health Without Obsessing
While health obsession is a big problem, especially in the United States, it is 100% possible to be focused on your health without obsessing. The first thing to do is be sure that you are only paying attention to health information that is validated, and the best way to do this is to check the source of the information.
Is this information validated by multiple trusted organizations? Is it coming from someone with formal training, real credentials (not a ‘certification’ that took 2 hours to complete), and an education in what they are discussing? Are they able to approach health information and biological sciences from an evidence-based, unbiased perspective?
Be wary of pseudoscientists, who are especially tricky. Words like naturopath, homeopath, alternative, complementary, and holistic are big red flags for scientific quackery. These are especially tricky because they play on the emotions of people not feeling heard/seen by their medical providers, thus baiting them into completely unnecessary and even dangerous suggestions. Simply by validating someone’s feelings better than a traditional provider does, they gain the trust of many people and end up providing horrible care to others.
Many of these pseudoscience doctors have histories of being reported to medical boards, or having their licenses taken away. Likewise, many pseudoscience influencers have a history of (or are currently battling) disordered eating and have no background in basic or advanced biological sciences needed to understand how something as simple as research works.
Where to Get Good Health Support
When it comes to nutrition, seeking help from a registered dietitian is a step in the right direction. Registered Dietitians (RD/RDN) are highly specialized nutrition professionals, trained specifically to understand nutrition and how it affects the human body.
Once you’ve decided that you have all the right information about your health and nutrition, the next step is to be sure you can work healthy practices into your life without it being a source of stress. Make simple swaps or add in one or two things that are rich in nutrients at each meal because you want to feel good, not because you have to.
Is Food Freedom Realistic?
One of the hardest parts of recovery from an unhealthy obsession with healthy eating is prioritizing your health with food freedom and without falling back into stress-inducing rules and regiments. The truth is, food freedom is realistic, but it’s the food freedom + healthy living that can be especially tricky to accomplish.
The first place you have to start is the food freedom piece. We have to challenge our beliefs and rules around food in order to eradicate the stress and unhealthy obsession of being ‘healthy’. This is 100% realistic and achievable, especially when you have the right tools and support. Just think of a friend you know who is able to order dessert without giving it a second thought. She eats what she wants, then leaves the rest. That’s food freedom, and it’s possible for you, too.
Overcoming an Unhealthy Obsession with Health
If you find yourself struggling with an unhealthy obsession with health, it’s important to understand the risks that come with this: a decline in your social life, anxiety, depression, disordered eating/eating disorders, and even serious impacts on your cardiac and gastrointestinal health are all possible (among other health issues).
It’s perfectly okay to want to be healthy, but when it starts to impact your social life, your mental health, and your physical health – then it’s important to reassess your priorities and beliefs around health/nutrition.
With the right support, you can reach a place where you are at peace with all foods and able to navigate healthy living in a stress-free, easy way. To learn more about healthy living without the unhealthy obsessive side, listen to my Nourished & Free podcast or apply to work with me today.
Intuitive Eating After Orthorexia
Intuitive eating is one of the many tools I use with my clients in order to help them transition from orthorexia to having a normal, healthy relationship with food. Intuitive eating looks like:
- Not worrying about the ingredients on the label
- Eating based on when you’re hungry instead of what the clock says
- Choosing nutritious foods because they feel good in your body
- Enjoying ice cream without having a panic attack
- Saying ‘yes’ to the latte your friend brought you, even though you don’t know what milk it’s made with.
- A quiet mind without all the thoughts of food buzzing around
Therapy for Orthorexia
Therapy can be a pivotal helpful step for battling orthorexia. Working with a mental health practitioner, such as Katie, will help you to identify the feelings that arise around certain foods, dig into your story as an individual and why food is a point of stress, and provide you with a space to talk through what’s happening internally as well as coping skills to redirect your thoughts.
Get more information on working with Katie.
Working with an Intuitive Eating Dietitian
Having a dietitian assist you in working through an unhealthy obsession with health is critical. Dietitians will help you identify false beliefs around food, educate you on what is true, and ease your mind around eating the foods you love.
Working with a dietitian who has a background in health psychology and eating disorders, such as myself, will be your biggest ammunition for putting orthorexia to bed once and for all. A dietitian who emphasizes mental health and physical health and specializes in food psychology will show you how to have an effortless relationship with food AND be healthy.
For more information on working with me, contact me today.