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Orthorexia: The Unrecognized Monster

Orthorexia is thankfully getting a lot of media attention lately, but it’s still far from being a household word like anorexia and bulimia. Largely, this is because it’s relatively new (coined in 1996 by Dr. Steven Bratman) and it’s not yet a clinical diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Anorexia nervosa, bulimia, and other recognized eating disorders are actually mental disorders. Anorexia has the highest mortality rate of any mental disorder.

Orthorexia refers to a person with an “unhealthy obsession” with eating healthy and/or leading a healthy lifestyle. Like many types of eating disorders, it can begin innocently enough with an attempt to lose weight and get healthy. In a culture where clean eating, Paleo diets, fasts, raw food consumption, smoothie worship and Instamodels are constantly showcasing the purity of their eating, it’s easy for anyone—including doctors who don’t specialize in eating disorders—to not only glance over developing orthorexia but actually encourage it.

A Narrowing, Harrowing Path

Every day, someone with orthorexia has another chance to “be good” and flex an ironclad will over food and exercise choices. Their diet can become so restrictive that only a handful of “safe foods” are an option. Similar to those with anorexia, embracing a solitary lifestyle and pushing away friends becomes a must. Most social interactions center around food, and that’s just not feasible for someone with orthorexia.

Self-punishment is common when there’s a “slip up,” and they may try to fix that perceived mistake with hours of cardio (also known as exercise bulimia), severe food restriction in following days (anorexia), or purging/bulimia. Just like other restrictive eating disorders, orthorexia might seem to be health-driven, but there are a myriad of possible underlying motivations. Eating disorders are often linked to self-esteem, control, a person’s history, and self-identity amongst numerous other factors.

Orthorexia and Yoga + Strength

I’m solidly in the camp which believes there’s no such thing as being recovered from an eating disorder. Recovering, for life, yes.

Like alcoholism, the real goal is management for life—there’s no “cure.” Even within the most highly regarded eating disorder specialists, there’s a lot of wiggle room when it comes to best practices. Some doctors will encourage patients to never weigh themselves again, and even to avoid gyms and workouts (particularly in the most dire of eating disorder stages). “Exercise bulimia,” or using exerci

se to excessively burn calories consumed and as punishment, is common for those with eating disorders. Many people with eating disorder don’t show symptoms of just one disorder. There’s often a primary eating disorder, but it’s complemented by a sprinkling of others. For example, a person may be largely anoretic (the proper term for someone with anorexia—there’s no such thing as “anorexic” in the medical field), but also exhibit signs of bulimia (purging and/or exercising), orthorexia, and binge eating disorder.

However, with doctor approval, I also see exercise as a potentially powerful tool that can aid in eating disorder management—particularly yoga and strength training. Cardio has its place, certainly, but it’s just a part of a healthy lifestyle. The spiritual aspect of yoga and its gift of nurturing your relationship with all parts of your body introduces you to your whole self in a way eating disorders innately try to block. Strength training helps you realize just how strong and powerful your body is. Strength, growth, and power are all words that the eating disorder despises and fears.

There’s often a thin line between disordered eating and an eating disorder. Many people, especially Americans, exhibit signs of disordered eating from time to time. Binge eating disorder is proving to be especially prevalent. A diagnosed eating disorder, however, is on another level. It’s paramount to seek out doctors who specialize in eating disorders for proper help and diagnoses. Eating disorders are a silent and very deadly killer—including the ones who haven’t made it into the DSM (yet).