NEDA Week 2014: Considering Orthorexia
February 28, 2014

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When I asked folks on Facebook what topics they’d like me to write about for NEDA week, the most immediate and popular response was orthorexia. It’s a topic I’m both excited and intimidated to discuss. Of all the many forms of disordered eating, orthorexia may be the one most relevant within the so-called healthy living blogosphere. It’s also incredibly difficult to define, and writing about it leads me into complex personal history, so it’s not easy to put words on paper. But I’ll try.

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Orthorexia is defined (on Wikipedia, anyway) as “an extreme or excessive preoccupation with avoiding foods perceived to be unhealthy.” I think most of us have an instinctive sense of what this means, but it’s hardly a straightforward working definition. What’s an “an extreme or excessive preoccupation?” How is being fixated on healthy eating any different from the diet/clean eating crazes that are so culturally prevalent here in the US? How is it different, for that matter, from being a health-oriented, plant-based eater? Is everyone who focuses on healthy food choices orthorexic?

I’m being dramatic, but you see where I’m going with this. It’s tempting to wonder whether the idea of orthorexia stems from a need to problematize everything, healthy eating included. And of course, health consciousness is not a crime, especially within the context of our heavily flawed and often destructive food system. With that said, I do think that orthorexia is a real problem. And to whatever extent that it is, I think it’s a problem I’ve had.

Last summer, Sayward mentioned to me that she’d heard Steven Bratman—the doctor who is famous for coining the term”orthorexic” in the first place—describe the condition as a tendency to assume that every single physical symptom is a direct result of something we’ve eaten. It’s the suspicion that any ailment, no matter how routine (the common cold, say) must have been caused by some insidious, toxic, or unfit food. I think this may be a more insightful definition of orthorexia than the oft-used “unhealthy fixation on healthy eating,” because it better accounts for the disorder’s power. It plays upon our most fundamental impulse, which is to protect our physical well being. It’s important to be health conscious in ways that it’s not important to be thin, which is often the putative goal of other kinds of disordered eating. Whereas it’s easy to say that a disease like anorexia emerges from the “unhealthy” desire to lose an extreme amount of weight, orthorexia seems to emerge from an intention we all applaud, which is to take care of ourselves.

Anybody who feels strongly about the healing potential of a healthy diet is probably tempted to ask, “isn’t it true that many physical ailments are the result of poor food choices?” And the answer is yes: there’s a well established correlation between plenty of diseases, including type II diabetes, heart disease, high blood pressure, and certain types of cancer, and diet. If this weren’t true—if it weren’t the case that certain foods really can be detrimental to health—orthorexia would be an empty concept (and vice versa: if it weren’t true that certain foods can be profoundly healing, then the preoccupations from which orthorexia arises wouldn’t be so powerful). The problem isn’t believing that food and health are meaningfully intertwined. It is believing that we can control our health 100% through what we eat, worrying that each and every “imperfect” food choice will wreak havoc on our bodies, and then narrowing our diets dangerously in an effort to avoid the foods we fear.

The fact that orthorexia stems from a wise intention—healthy eating—makes it difficult to recognize, both from the outside and from the inside. When I was anorexic, or when I was borderline, I couldn’t really kid myself that my behaviors were healthy. I denied their severity and consequences, but I was well aware that obsessive exercise, calorie counting, and crash diets weren’t good for me. I just wanted what they enabled, which was weight loss most immediately, and a sense of power and control and accomplishment more deeply. When I was orthorexic, some time after my last relapse, I actually believed, for a while at least, that I was taking good care of myself. When a friend of mine suggested otherwise, I was indignant. Orthorexia, I thought, was nothing but the unfair scapegoating of health conscious people. It was clearly a defensive posture, which grew from people’s internal guilt about their own poor food choices.

I wish I’d recognized sooner that those are exactly the kind of thoughts I used to have when when people confronted me about weight loss and dieting: “it’s them, not me.”

My friends who were concerned had every right to think that my interest in healthy eating had become excessive. This was the period when my passion for raw foods–originally so celebratory and fun–turned obsessive. It’s when I got seduced by “detoxing” and fasting and eating “light to heavy” and food combining. It’s when I started to eliminate ingredients I’d proudly embraced when I became vegan, including sweets (because I’d somehow managed to convince myself that I had candida). I felt as if I my diet was varied and abundant at the time. “Look!” I’d say to myself. “I’m eating all these avocados, all this nut butter. I never used to do that when I was sick. I can’t possibly still have a problem.”

But all of the avocados in the world couldn’t justify how narrow my diet had become, how obsessively oriented toward “health,” how joyless. It was hard to recognize the dangers here because I wasn’t exactly thinking about weight loss, which had been my ED point of focus in the past. In fact, I was still trying to gain weight from my final relapse, and feeling perplexed that the pounds weren’t coming on quicker. But of course they weren’t; my diet was still narrow and controlled, and the hyper-vigilance I brought to eating was holding me back.

Thankfully, the phase was short lived. I was in therapy at the time, which helped me to identify what was going on faster than I would have on my own. I recalled how enthusiastic and happy I’d been when I first became vegan and got into raw foods. That moment had marked the end of my excessive, self-destructive focus on weight and shape. But what good had any of my strides forward been, I wondered, if my obsession with having a thin body simply morphed into an obsession with having a “clean” body? I was tired of saying no to more foods than I said yes to, of fearing foods I’d previously enjoyed, and of feeling (justifiably) that my diet had been drained of fun. I looked enviously at my friends, who went out to eat and enjoyed every bite, and I recognized that their robust approach was far healthier than my ostensibly “health-oriented” self-denial. And I began to loosen up, big time. I expanded my diet and stopped focusing on raw for raw’s sake (in other words, I allowed raw foods to be something I really enjoyed, not something I felt I had to eat). The more inclusive my diet became, the stronger and healthier I felt. Anyone who has been reading CR for a long time has seen a chapter of that process unfold, and has no doubt seen how much richer my diet and perspective is because of it.

It’s hard for all of us to distinguish health consciousness from health fixation. If you feel that you’re walking a fine line between these two states, though, you don’t have to struggle alone. Please consider reaching out to someone who is in a position to help you out, even if that just means an honest conversation. It could be a friend or family member, a therapist, a school nurse, a physician, or a dietician. Once again, I offer a link to resources via NEDA.

In the meantime, these tips can help you to draw the line between dedication and obsession.

1. Remember that your body may be more resilient than you think it is.

My experience of orthorexia included a sensation of fragility, a certainty that if I ate one wrong thing, my body would be instantly compromised. As someone who lives with a digestive illness, it’s true that I have to be a bit more mindful of what and how I eat than others. But it has been a delight to realize that I can eat all sorts of foods, not all of them roughage or quinoa, and feel perfectly fine; that I can savor my morning coffee; that I can enjoy a glass of wine if I feel like it; and that I can travel, eat out, eat foods that might be a little richer than what I make at home, and feel tip top. We all have an instinctive sense of what feels right for our bodies, and I’d never suggest you eat foods that will make you feel unwell. But there is a good chance that your body is actually stronger and more resilient than you think it is.

2. Be discerning with what you read.

I often tell nutrient clients that they only “detox” they need is a detox of health and wellness reading material! Spend a day perusing any mind/body health website and you’re likely to be bombarded with articles to the tune of “why sugar/bread/wheat is the devil,” “could ________ be destroying your health?!” or “ten foods you should never eat.” There is a point to these articles, which is to help folks identify ingredients that don’t help them to thrive. But that point can be taken much too far, and if you ask me, “everything in moderation” has far more science and research behind it than this kind of cheap alarmism.

3. Variety is healthy.

Orthorexia can often manifest as a very narrow (and ever narrowing) range of acceptable/safe foods. While this can seem like the “healthy” choice, remember that dietary variety will help you to get a wider array of macro and micronutrients, which will in turn help to keep you better nourished. Know, too, that dietary variety also helps to help bolster digestive strength—a fact I’ve witnessed firsthand working for a GI doctor.

4. “Heatlhy” goes beyond nutrition.

Another lesson I’ve learned working in a physician’s office, as well as through my own experience, is that “healthfulness” is not only a matter of eating certain nutritious foods, or avoiding foods that are less nutritious. Pleasure and stress reduction also contribute enormously to good health, which is why I believe firmly that savoring something indulgent is far healthier than constant stressing out about maintaining a rigidly “healthy” diet.

5. Eating healthily is not a black or white affair.

My friend Laura left a comment on Monday’s post that stuck with me. She said, “it’s not either-or. Not either thin or happy. Not food or self-esteem. Not all the food or none of the food. Not good-weight bad-weight. I’m still working on this one, but enjoying the challenge of uncovering how I construct and maintain those equations myself, and can write new ones with some effort.”

I would add that it’s not either/or when it comes to health. It’s not necessary to choose between leafy greens, whole grains, and legumes and lovingly prepared comfort food, exciting or unusual restaurant meals, local delicacies, and rich desserts. It’s not necessary to choose between establishing a routine with movement you love (yoga, dance, running, whatever) and focusing on rest and relaxation. Eithor/or thinking was for me, as it seems to have been for Laura, a major part of the disorder. My tendency toward extremes remains a part of who I am, and at times, it’s a part that I love. But recognizing that I don’t have to operate exclusively in dichotomies has been a vital part of my recovery process.

My intention with this post is not to disavow healthy eating. I believe wholeheartedly that my recovery was aided by nutrient dense, plant based ingredients, which helped to restore my body after so many years of restriction. And I know that eating a conscious vegan diet showed me that food didn’t have to be the enemy: it could contribute to my sense of well-being, rather than compromise it. For this reason and so many others, I’ll always advocate the importance of good nutrition. The lesson I’ve learned, though, is that healthful choices can coexist peacefully—even synergistically—with ones that are (superficially, anyway) less healthful. My love of vegetables is not undone by the extra cups of coffee I drink when I know I’ve really had enough, the vegan treats that delight my senses, no matter how sweet they are, the late nights I sometimes spend out or listening to music or chatting with friends when sleep might be more prudent. My life can accommodate all of those pleasurable moments, and many more.

Such are my thoughts, friends. I would of course love to hear yours. Good night from the West Coast!

xo

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Categories: Food and Healing

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    83 Comments
  1. it’s been quite a while since you’ve posted this, but i’ve just seen. and how timely too, i’ve been struggling not only with my own attitudes towards foods, but those of people close to me as of late. i always appreciate your balanced and encouraging posts on body image, disordered eating, and mental wellness. i found your post very grounding.

  2. Thank you so much for sharing this with us Gena. It’s nice to see the person behind the food sometimes. You are so real & genuine & down to earth – it’s refreshing =)

  3. The eating disorder awareness campaigns are only starting to touch on orthorexia as a part of the “family” (I would hate to see their Christmas parties…).
    I have felt these tendencies for many years and feel like the more people know, the better they are able to draw the line between healthy eating and disordered eating.

  4. I was directed to this post by a blogging friend and I’m so glad I was because this hits so close to home for me. I chose to recover from anorexia through a vegan diet and it has done so many amazing things for my body and mind but at the same time, I’ve gotten very sucked into restricting many vegan things because they’re processed or because I read an article saying it’s unhealthy. I recently ate fully raw for almost a month and while I was feeling great at the time, it wasn’t until I was called out for being restrictive that I realized I had a problem and I needed to get back on track because I was starting to fear legumes, gluten free grains, and other perfectly healthy foods that I deemed unsafe simply because they weren’t raw and 100% ‘clean’. I still prefer to nourish myself with the best vegan food out there, but for me, it can all too easily lead to fearing food and cutting things out because I start seeing them as unhealthy in some way. This post is such a great reminder that orthorexia is a problem that may affect even more people than traditional eating disorders, even in very small ways that can eventually lead to a very unhealthy place.

    • Ashley, I’m so happy that you found this post, and that you’re moving toward a more relaxed approach. Thanks for this thoughtful and revealing comment. XO

  5. Gena, another genuine wake-up call! I just read your post on Body Dysmorphia and found some sound truths for me to reflect on. This post has most definitely hit home. Even that small quip about how you convinced yourself you had candida. That was me a few weeks ago!! It’s incredible how you can attribute every single feeling you have in your body to whatever seems to be the most prevalent in social media, or the healthy living websites, etc. It’s far too easy to get caught up and give the explanation that it’s all about being healthy when sometimes it could be a way of wanting to draw attention to ourselves. Not to say that all of it is for that reason, I have just come out of extreme adult onset acne that I have been able to successfully heal through food. But through that experience, I have felt that I need to keep that restrictive diet going far beyond what I really need to. This is not a long-term elimination and I have to get back to a much healthier frame of mind and let some of this go and relax! Every part of the journey has something that I have learned from and have taken pieces of with me. It’s allowing those lessons to form a lifestyle that I can be happy in and be proud of.

    Thank you for sharing these posts Gena, I haven’t been reading for a few months and I am so glad I was drawn back in!

  6. Gena, your maturity just keeps amazing me. You’re my inspiration, my stepping stone, my lighthouse. You have no idea what increadible impact your articles have on many people. By helping me understand and deal with my tendency toward extremes, even unknowingly, you have given me the strength to heal myself and furthermore help others in need.
    Thank you so much for being here for all of us.

  7. So informative, as usual. For better or worse, during ten odd years of anorexia and many years post-recovery, I’ve managed to avoid the orthorexia trap. As I’ve shared many times, I’m a very picky eater, and if may look to others as if that pickiness stems from orthorexia if not lingering anorexia, but in truth, it’s rooted in a kind of obsession with quality/taste and has nothing at all to do with healthfulnss much less cleanliness of this or that food. It so happens my tastes skew healthy – I genuinely prefer raw, unadulterated, minimally processed food – so I can see how appearances might deceived. Interestingly, as a recovered anorectic, while I have enormous compassion for people who are still suffering from restrictive eating (underweight, counting calories, etc.), “orthorexia,” when I encounter it, just annoys me. I just have no patience for it. I know I need to work on that, but I must I’m curious why it is that I react the way I do.

  8. Thank you for sharing this article/post. As someone who has Celiac Diesease and knows I tend to be an emotional eater (for which I see a therapist for), reading this made me feel like I can easily make the transition to vegetarian/vegan with ease and without food obsessing.

    I too write about food and feel sometimes “the writing” about celiac disease and food in general can make me a little neurotic and focuses too much on what I am eating.

    I loved what your friend Laura said “it’s not either-or. Not either thin or happy. Not food or self-esteem. Not all the food or none of the food. Not good-weight bad-weight. I’m still working on this one, but enjoying the challenge of uncovering how I construct and maintain those equations myself, and can write new ones with some effort.”

  9. Thank you so much. Turning to vegan and some raw eating after ED recovery, and going through a bit of this right now (no matter the intention, it’s hard to get out of the food-obsessing habit I guess). Thank you for your wisdom, nuanced commentary, and compassion!

  10. the definition of orthorexia (above) states that “Avoiding certain foods in the belief that they may be unhealthy” is a Medical Condition ???? !!!
    so,, anyone that doesnt drink coffee (coz of its depleting effects on teh body, or people that dont eat excessive salt (in fear of high blood pressure) and countless other people avoiding countless other processed and junk foods are all Orthorexic patients ???

    Then i pity people that are NOT orthorexic !!!
    coz anyone that just eats ANYTHING (junk etc) ends up with digestive problems in their mid-30’s and worse conditions in their latter years.

    • Maybe read the rest of the entry and all the comments. Maybe you’ll stop, eh, entirely missing the point then?

  11. Thank you so much for this post. As a 17-year-old girl who’s just recovering from 4 years of orthorexia, this is reassuring and inspiring. My whole life I’ve had OCD about certain things- but when I turned 13 my parents got divorced and healthy eating became my new obsession. It was my comfort in a time of uncertainty, and I thought I was doing the best thing for myself even though I drastically lowered the variety of my diet, cutting out entire food groups. Within 3 months I dropped 15 pounds off of my already underweight and tiny frame. My doctors, family, and friends became extremely concerned but I assured them I didn’t have an eating disorder- I mean, I was eating (so not anorexic) and I wasn’t bulimic. My weight stayed at an extreme low of 72 pounds for 4 years. It wasn’t until the beginning of last year that a doctor finally saw that something was truly wrong and threatened to have me hospitalized if something didn’t change. I was dying because of my weight- the exact opposite of my intentions (obviously). It was the wake up call I needed and I started to re-expand my diet and quickly put on weight. I am still on the road to recovery, and somedays are harder than others, but it feels good to be “free” again! It’s helpful to know that there are other people out there that have gone through what I did and that there is a happy and healthy life beyond it.

  12. What a great post Gena!
    “The problem isn’t believing that food and health are meaningfully intertwined. It is believing that we can control our health 100% through what we eat” I think this is such a great point, because it also creates a lot of guilt if we then do get unwell despite such a ‘clean’ diet (a term I absolutely hate. In my opinion no food should never be seen as dirty)

    I would love to see some more information on the impacts of stress / anxiety / guilt on your health. I recently heard someone describe sugar as ‘poison’ and wondered what the stress and anxiety caused by this attitude does to your body from a scientific perspective. We all hear that stress is bad, but I don’t know much more than that. If you have further knowledge I would be very interested.

  13. This post just inspired me to have a slice of blueberry pie for lunch! It’s a raw vegan recipe by Amber Shea Crawley 🙂 There’s a line in the book Eat, Pray, Love that says something about true balance involving being a little out of balance sometimes.

  14. Just popping in to say I, like everyone else, really enjoyed this post Gena! Your personal posts like these are far and away my favorites.

    Thank you for always being so candid with your readers. I imagine it must make you feel vulnerable to discuss your own personal history so openly on a public forum, but it’s truly what makes your blog stand out in the crowd (supplemented with your exquisite writing skills). Cheers!

  15. Outstanding entry! Thank you so much for sharing your experience and all this great info, Gena!

  16. Yes, yes, yes. I could not agree more. I’ve found that the more I’m fixated on “healthy” eating, the more unhealthy and unhappy my life becomes. For me, I guess distinguish between healthy and mindful eating. I feel like the former has a tendency to exhibit orthorexic symptoms because it conditions individuals to eat what they’re told is good and avoid like the plague what is bad (eat leafy greens with every meal, never eat soy, etc.). Whereas the latter focuses on eating what makes you feel good, whether that be in body, mind, and/or spirit depending on the context. Thought it may sound tiny, I’ve found immense pleasure and recovery in simply eating fun foods like Vegenaise and Daiya cheese. No, they’re not the least processed, most wholesome foods I could be eating, but they’re tasty, dammit, and they nourish my soul. Thank you for this post, Gena.

    • Ali, we’ve had such similar experiences with this one. It’s always meaningful to me when you share your perspective, and I so appreciate that we’re both enjoying foods that make us happy.

  17. I think one of the features of an eating disorder is when food is tied up to one’s identity or where there is some sort of “purpose” attached to food other than enjoyment or getting the energy needed to fuel daily activities. In anorexia, the goal of eating is achieving a certain look — thinness. With orthorexia, the goal is achieving a certain health status — superior health. With veganism, the food becomes a way to achieve a certain ethical outcome. In all three cases, food becomes tied up with meaning and self-identity in a way that can become unhealthy.

    • You (and everyone else here) might be interested in Tom Billings’s essay, Functional and Dysfunctional Lunch-Attitudes. He identifies “lunch-mindfulness” as a functional attitude and “lunch-identification” (which is pretty much what you’re talking about in your comment), “lunch-obsession”, and “lunch-righteousness” as dysfunctional attitudes. Good food for thought (pun intended). The section on lunch-mindfulness contains good tips on how to reduce emotion-driven eating.

  18. I guess you could look at any type of eating in this way. If, for example, if it is a form of restriction and obsession to be overly conscious about the health value of our food, is it not also perhaps a form of restriction and obsession if someone is excessively preoccupied about whether what they are eating is truly vegan. If you go to a pot luck and you start worrying about whether the mashed potatoes might have butter in them, or whether the cake might have some honey in it (and therefore whether some animal might have been exploited to create that dish) could that also be a form of disordered eating? I am talking about being so worried about whether some food is or is not 100% vegan that you forget to enjoy the company of the people around you and sharing food together. I think if orthorexia is a problem, then strict veganism could be seen as a problem too.

    • Terri,

      Thanks for your thoughts. I can see how being vegan might be perceived that way. For me, it’s so much more an ethical position at this point than it is a health position, so when I take care to ensure that my food is vegan, it’s not really because I think that a bit of egg or butter would have insidious health effects. And my own experience of orthorexia really did overlap with health fears, and perhaps hypochondria, if you want to call it that. Jeanette’s comment, above, frames the ethical component in a context that might be seen as orthorexic, and I think it’s interesting. But it doesn’t really jive with my experience of what orthrexia felt like, which was the conviction that I was harming my body with what I ate. I hope this makes sense!

      • Yes, that’s true. But eating a vegan sandwich made of conventionally grown wheat flour might be unethical: vast amount of pesticides have been used to kill pests (animals) and the soil and the ecosystem might be impoverished as result. Eating a piece of grass fed beef from an unarable land, responsibly raised and mercifully killed (animals have not the same perceptions of life/death as humans, it’s not the same thing as somebody on the death row) might be more ethical as more environmentally friendly and supportive of small farm economy (more jobs and more ecological).

        • Sorry, pressed enter by mistake.
          What I mean, it’s that you made a distinction between obsession and mindfulness. Provided that you don’t have an allergy/intolerance, then worrying for a teaspoon of honey might be too much a focus on a detail rather than the bigger picture.
          I myself follow a restricted diet (which has avoided me pain and surgery, two very good reasons to stick to it), but I try not to obsess and instead be conscious about my choices.

  19. Excellent, excellent post. This is so important for so many people to read. Aside from all the great facts, my favorite part is that you tell clients that the only detox they need is a detox from ‘health’-focused reading. So funny!
    (also there’s a typo in that line – it says ‘that they only ‘detox” and i think you mean ‘that the only ‘detox”.)

  20. Orthorexia is a tricky beast. It’s also very subjective. What might
    be restrictive to one is not so to another. For example, Bratman describes a vegan diet as “extreme” in his book. What is the boundry? What if you really
    do feel physically crappy after eating most foods society deems perfectly OK.

    • Dee, for the record, I totally agree. Because of my GI problems, it has often been the case that I have to avoid foods that others might enjoy easily (not just so-called “unhealthy” ones — onions, which are perfectly healthful, are a big trigger, for example!). So I know what it is like to have to think very mindfully about food choices for the sake of health, and I don’t think it’s the same thing as orthorexia.

      As wildly subjective and tricky as it may be, I suppose that the best I can say is that there is a difference between mindfulness and obsession, and perhaps all we can do is vow to be conscious of it as we make choices for ourselves. If I had to pick or choose some of the differences, I’d say that my experience of being orthorexic was far more extreme than my experience of being a conscious eater, and the fever pitch of fear that I felt was always higher. I’d also say that it became a global approach to food, rather than a specific one (ie, rather than identifying particular GI triggers, I became incredibly fearful and anxious about all food choices, always wondering if there was something new I should eliminate, and it was not limited to consciousness about my IBS so much as an overall sense of fragility, as I mention in the post). Finally, I would say that orthorexia, for me, manifested as frequent doubt about whether or not every single health directive also applied to me. In spite of not having any history of trouble digesting a certain food, for example, I’d read that it *might* be harmful online or on a blog, and vow to eliminate it — even if it didn’t really seem to match my own experience. That’s something I don’t do anymore; I’m so much more capable of knowing what works for me and what doesn’t.

      This is all murky territory, as you note. But such are my thoughts 🙂 Thanks for commenting!

  21. Thank you for another great post! It blows my mind that orthorexia is not yet an officially recognized disorder—it would be wonderful to see coverage for treatment become more readily available.

    I loved what you said about “detoxing” from health and wellness reading material! Totally agree!

  22. I’m so happy that my friend Lindsey directed me to this post! As a current PhD student in health education and promotion, I’ve spent most of my first year studying the whole spectrum of disordered eating behaviors, and, while orthorexia is highly contested in the literature, there is a validated measure for it. I actually have taken that measure and collected survey responses from members of the blogging community—data I’m in the process of analyzing now. So often I try to explain ‘signs of disorder’ and I am met with many questions about “How can restraint or focusing on health be a sign of disorder?” and I am SO happy you addressed that it is a fine line, yes, but it is the INTENTION behind the behavior that is so concerning. There is a reason why eating behaviors and disorders are classified as mental health issues and not necessarily physical ones. (The physical health is a side effect, really.) Anyways, thank you for sharing your story…I used to think I had some version of orthorexia, but the more I’ve studied, I’m not sure if it was just a combination of that an a variety of other disordered attitudes. Thank you, again!

    • Lindsey, I saw your exchange on Instagram and am so happy you read the post! I really appreciate your perspective as a health professional. Yes, that distinction is SO fine and so fragile, but I do think that mindset has everything to do with it. This may make it harder for those on the outside to understand or intervene, because so much of knowing whether or not orthorexia is a problem will ultimately depend on the intuition and self-awareness of the person who may be struggling. But I don’t think that the ambiguity should compel us to overlook the potential risks, you konw?

  23. This was a great read. Orthorexia has been a difficult topic for people to write about–it’s often understated, over generalized or just plain misunderstood. I feel like you got it! I still struggle with the either-or issue. I often find myself eating either all healthy, good for me foods OR all candy/chocolate/junk. It’s hard to get out of this pattern.

    • Jill, I wish you luck with your own journey. I agree that the topic is difficult and had a hard time with this post, but I’m happy it struck a chord.

  24. I don’t think I could add anything to this Gena. You cover everything and say it so articulately as usual.
    Although orthorexia isn’t really something which has plagued me terribly. I like to eat healthily but I never swore off certain foods for good I’m still susceptible to the pressures to eat a certain way and particularly food “trends”. The thing I find hard is finding what suits my body. I’ve had crummy digestion for my whole life and I’m pretty sure my years of anorexia damaged it even more, such that I get bloated and constipated easily. I often end up blaming certain foods and getting myself worked up about my diet. Any advice on this front?

    • Emma, your experience of feeling persuaded by food trends and/or struggling to know what works for you is very common, and I’d hazard to say it’s particularly poignant for anyone who struggles with a chronic health issue. Because of my GI stuff, I have myself flirted with all sorts of approaches, few of which were actually helpful. In the end, I think that managing a digestive illness is a remarkably and sometimes frustratingly individual process — and I see evidence of this all the time in Robynne’s practice. I’ll try to put more thoughts down in another post. And email me, anytime, if you wanna chat digestion 🙂

  25. Hi Gena,
    Thank you so much for writing this. I have been vegan for a few years but I think recently I have found myself obsessing over food more, and thinking about the elements of my diet nonstop. I think it can be hard to find that balance between a love of healthy eating, and a having it take over your life. This opened my eyes and I will now check in with myself to make sure I am not going overboard. I love reading about plant based eating (e.g. your blog) but its good to remember there are other things to focus on in life!
    -Margaret

    • Margaret, I could not say anything better than this. I’m so glad you’re striving for that balance — don’t stop!

  26. I love how you extended my comment 🙂 So true. In fact I have a lot of this tendency in other areas of health and life- chemicals in skin care products and cleaning products, perfectionism in school, etc. It’s a mix of anxiety and ocd tendencies, I guess. It’s especially hard with food because food habits are so powerful. Without some rules or structure I can slide into poor habits, but with structure, I can become overly rigid and the effects of anxiety can far outweigh the effects of the food choices. I’ve been thinking about ways to reinforce my good habits without making them rules or restrictions. I like the idea of a “mantra” as opposed to a rule or restriction. My mantra is more visual than verbal but something like “lots of fresh plant food plus other good things.” Something that doesn’t tell me what I must eat for dinner, but reminds me what I value and what choices keep me healthiest. Getting away from either-or thinking is also very helpful for over-eating. If I slip into over-eating I can label that day or that mood as “bad,” but if I frame it as a joyful deviation (which is how it feels when eating junk food with friends, as opposed to sulking on my own), I can better accept my actions and avoid the cycle of anger and self-loathing.

    • I have anxiety and OCD as well, Laura. It makes my eating fears all the more worse because not everything is about the food itself. Chemical contamination, germs, unclean silverware–that all affects the food, without the food itself even being the problem! But then add in the problems with the food (calories, grams of sugar or fat or what have you), and it all becomes unmanageable. I don’t struggle today like I used to (you can see my story in the comment above yours), but disorderly thoughts never completely go away. Even though I no longer give them the credibility I did back when I was in the depths of my struggle, they still whisper little reprimands at me when I do/eat something that throws off my sense of self-control. I love what you told Gena about black and white thinking. It’s a very hard thing to overcome when you suffer from anxiety and OCD, as the tendencies that go along with both behaviors are very black or white. Thank you for your insight. It’s always nice to hear someone speak honestly about their troubles, and shed light on how others can deal with the same issues in a positive way. 🙂

  27. I feel like my response to this is about to be as long as the post itself! I can’t resonate with your words enough. With the exception of a few vague references, I’ve never really talked about my disorderly eating past online. I think it’s because I don’t know how to word it. But wow, this definitely sums up a lot of my former struggles (and sometimes current, when the going gets rough). I’m 5 foot 6, and my lowest weight was 103. This was about six or seven years ago. In my own mind, even though I knew I had taken it too far, I never classified my weight as low enough to warrant the ED title. (As if it’s something you earn!) I also never purged my food, so I wasn’t bulimic, and I didn’t fast for long periods of time. I think there might have been only one day when I didn’t eat a single thing, so in my opinion, I was not anorexic either. I didn’t have an “ED.” Nevertheless, I considered a baggy of dry cereal to be lunch, spent time browsing pro-ana websites, and was googling things like “calories in lip balm.” It all started with an obsessive need to be “pure” and healthy. I stopped dressing up my food. No sauces or flavor. There was a list (definitely mental, but I wouldn’t be surprised if at some point I had a physical one, too) of foods I could and couldn’t eat. I honestly thought I was being healthy. Nonfat milk, 0% greek yogurt, steamed broccoli, plain black beans, unseasoned tofu straight from the package. Ew. But I also ate dried fruit, cereal, honey in my yogurt. Now it seems weird to me that I allowed myself those things. “Safe” foods are so random! Goes to show what lack of logic there is when it comes to eating disorders.

    There was no variety, I was lifeless and dull (or “not fun anymore” as my younger brother and cousins would say), and everything was black and white. Health didn’t go beyond weight and food. I never intended to drop so much (over thirty pounds in a handful of months) when I first started eating a “clean” diet. It’s a slippery slope. Orthorexia can range from a mild obsession (for lack of a better term…is there even such thing as a mild obsession?) to a life-threatening obsession, when it can lead to “unintentional anorexia”…as I later deemed this time in my life. Mine started out a lot less severe than it ended up. At my lowest point, I wouldn’t have been able to tell you the moment it all got so bad. It happens over time, almost without you realizing it. Orthorexia is scarier than it seems. I still battle residual thoughts from that time in my life. Like you said about yourself, I’m also a very extreme person. I’ve learned to live much more moderately, but it doesn’t come easily for me. It’s why I’ve gone back and forth between being vegan so many times. There are moments when I think it’s not healthy for me to have any sort of narrowed viewpoint. But I love veganism. Always have. My first vegan phase came when I was recovering. I learned to love cooking and put my attention on the fun of creating vegan food, versus how many calories I was consuming. Recently I made the decision to become vegan again. It just feels right in my heart, as corny as that sounds. I think it keeps my orthorexic tendencies at bay, because the important factor of my diet becomes the vegan aspect, not the “clean” aspect. Anyway, I better wrap this up, before I post an entire Green Recovery story in your comments section. Haha! Thank you for this. Really. If this essay I just wrote doesn’t give you enough of a hint, you really struck a cord with me here. I agree wholeheartedly with your five tips. They’re all extremely important for keeping a healthy mindset when it comes to living life. Beautiful job on this post. You never fail to inspire.

    • Wow, Jenni, I am tremendously inspired by this comment! Thanks for sharing so much of your journey with me and with everyone reading. I don’t think I can add anything to your remarkably candid and insightful thoughts, but I so appreciate them.

  28. Thanks for your honesty in this post!

    I can so relate because I have gone through a similar dip in orthorexia. But now have evolved to realize that the stress of my rigidness was probably causing way more harm than the “bad” foods would. I so relate to now not eating greens one day, drinking too much coffee, enjoying a few glasses of wine, or some luxurious other treats. They are so good for the soul, and food’s function is not only to feed us and nourish our bodies, but also it’s a pleasure that is one of the best parts of life! I truly believe that enjoying these kind of foods is as much a part of being healthy and happy as is eating nourishing healthful foods as well. After all veggies, and other wonderful healthy foods are also delicious!

  29. Hi Gena! Great post.
    I was wondering, do you have any tips for a better body/self image?
    I’m 14 and recovering from orthorexia and anorexia. I have gained about 10 pounds so far, but I’m still pretty thin (5’5″, less than 90 pounds). I know that I should probably gain more, but when I look in the mirror all I see is fat 🙁
    If you have any tips for this, they would be greatly appreciated.
    Thanks in advance,
    Audrey

    • Hi Audrey,

      It does sound to me as though you are still progressing toward a healthy weight, and I think you probably know that you need to gain more. I strongly encourage and urge you to chat with someone who is an ED professional about all of this; you may already have a care team, but even if you do, don’t be afraid to open up about how difficult the gaining process is. What you are experiencing is normal, but it’s important for someone to a) help you understand that what you feel when you look in the mirror is a subjective experience — not a real indication of your shape and b) help to support, motivate, and continue to encourage you. So — lean on others, if you can. Don’t struggle through this alone.

      I believe fully that it will become easier for you to embrace the recovery process. Hang in there, and know that wonderful things lie on the other side.

      Gena

  30. Gena,

    You did a fantastic job with this topic!

    I wonder if you have come across people (like myself) at
    the practice where you work who don’t tolerate whole foods
    very well.

    I have a horrid time with IBSC. Unfortunately, fibrous foods are
    the worst. I find I have to eat refined grains and limit, fruits/veggies to keep
    things working.

    I wondered if you had any information on this, meaning how
    common is such a thing? I do at times get angry about it.
    I love big salads and, fruit. Curious if there is something to
    help, that I don’t know about?

    • Betty, I have this problem too. It has been an issue for years but it’s only in the last year that I realized it was severely exacerbated by fruits and vegetables. I finally made the connection, which was difficult, because over the last few years I have been purposely expanding the amount of greens and raw foods in my diet and I was dismayed when it became obvious that my veg-dominant diet was causing problems. In fact, it was at its absolute worst when I spent a few months being about 95% raw. I was sprouting and soaking stuff to… no better. It was just all the raw fruit and veg. I also realized that the problem is linked to any consumption of protein powder, which has has been incredibly frustrating as a vegan.

      When the IBS acts up, my only recourse is to spend about a week eating mostly carbs (like oat bran, quinoa, buckwheat, millet) and cooked vegetables. During this time I have to nearly eliminate raw vegetables/greens, fruit, and nuts. It actually works pretty well and after a week or two I can begin reintroducing big salads, fruit and nuts. For some reason, the high fiber of the oat bran does a lot of good while the fiber in the greens/fruit gives me intense bloating and stabbing pains from the trapped gas.

      I find that the IBS problems come up less often when I do a better job controlling portions, balacing the amounts of foods – not too much of one thing – and eating with more variety. So if I add cooked vegetables, root vegetables, and a carb like lentils to my salads, I feel much better than if I eat a salad of raw greens, raw vegetables, fruit, and nuts.

      I used to feel guilty eating a carb (like buckwheat, the usual) for breakfast because it was… I don’t know… not a fruit or vegetable. Touch of orthoexia here I suppose. But in many ways it’s a huge relief. It never causes a stomachache or bloating, whereas a protein smoothie will definitely do that, and a green smoothie probably will too.

      When my body reacts badly to all types of vegan protein, I eat fish. It’s difficult to get past the guilt of being a ‘fake vegan’ because I eat fish like once a month if that. It’s the only restriction I care about holding to 100% because it’s the only one with a moral content. But there are times when chia pudding is not adequate for all my protein needs.

      The releif of NOT being bloated and nauseous far outweighs the guilt over my diet not being ‘good enough’. As soon as figured out how to deal with the IBS by changing my eating, I realized I’d been making everything harder for myself and that I didn’t need to feel sick and bloated all the time. Soo much better. And like Gena has been emphasizing… it’s not either-or. There are still plenty of ways for me to get the greens in, raw or cooked.

    • It is INCREDIBLY common, Betty, and so is the guilt that preoccupies healthy eaters when they go through it. Do not beat yourself up. To manage IBS, you simply have to do what works for your body. If that isn’t fibrous food at the moment, then give yourself time. If you get the syndrome under good control, then it may be possible for you to incorporate a few more fibrous foods once again.

      FWIW, I’d say a solid portion of IBS folks with IBS-C seem to experience improvement with massive amounts of fiber (I was one of those in the past). Others have the polar opposite experience. If you focus on lower fiber foods for a while, as well as blending, you may turn a corner for long enough to slowly make salad and fresh fruit part of how you eat again (even if they’re not everyday foods). Hang in there.

  31. Thank you for writing this, Gena. I did not know about orthorexia before this post. I am a little worried I may have this… Time to reassess my eating habits.

    • Well, Amber, the goal isn’t to freak you out 🙂 And it’s normal to be a little too preoccupied with health — FWIW, I think that’s a very broad societal phenomenon right now! That said, I do think that there is a difference between preoccupation and obsession, and I hope you find a way to navigate it and experience some mental rest from it soon.

      • Thanks, Gena. I have always found that I walk a fine line between preoccupation and obsession. This blog brought it to my attention and helped me put a name to it. I feel like that is a very healthy step forward. Thanks again, Gena.

  32. It’s a really slippery slope into darkness and you don’t even notice you’re there until you’re deep in it, sometimes.

    Last winter I caught myself scouring the menu at a favorite vegan restaurant of mine for something “appropriate” to eat and ended up ordering plain steamed kale and quinoa as a meal. And that’s when I knew I had a problem. My friend intervened – I got a really strict talking to about how that sort of behavior is literally not appropriate for me, and I agree… Climbing back up has been more difficult than I thought.

    Thanks for being open and honest always, Gena. Love to you.

    • Ugh, god, Ilana, that describes so many nights, so many restaurant meals. Looking for the safe option. I applaud you on seeing that moment as a wake up call. It took me forever. All the love back to you. See you soon on the mat.

  33. As per usual, your post is well-articulated and I think you are addressing a subject that is especially applicable to our inclination towards a “food as medicine” sort of mentality. I personally know I can give myself anxiety over food choices, and this was especially true last summer when I reached out to you about allergies. Sidenote: Thank you so much for encouraging me to see an allergist, because had I not had testing done, I would never have been able to pinpoint the environmental (not food!) triggers on my own and would have continued to drive myself crazy with elimination diets and similar things.

    I love what you said about our bodies being more resilient than we think. I think we often forget this as we read about how wheat/sugar/processed anything is “evil.”

    • I’m so happy you like the post, friend. And as a fellow sufferer of pesky environmental allergies, I’m delighted that you’ve found some insight into them! They suck, but isn’t it nice to know that we don’t have to manage them by eliminating all sorts of tasty foods? 🙂

  34. Gena,
    Thank you for addressing this so well. I know I have had to move away from certain places online at times simply because I felt there was an either/or going on, and I am far more moderate. Whilst I know we can all learn from each other and there are good ideas in all directions, I’ve found the best thing I can do is find a blend for myself which makes me personally feel the most alive. That is the light that guides me. And I don’t mean just the food, but the whole experience, as you addressed here too.
    Thanks again for such a thoughtful post.
    Emily.

  35. The balance is expressed in such a well-explained way. I agree with Marlena here, this are the posts that keep me coming back to your blog. It’s like sitting with a close friend over a cup of coffee really listening to your side of a serious conversation we’re having. It gives great insight into the subject and into you, AND it helps me/us to get a better insight into ourselves and our own views and behaviors. Great read, and great points made. Even now it is hard to admit that balance is OK, and 100% “perfection” is not actually perfect. Perfection is balance, joy, and self-love. Tricky tricky, but life isn’t a standardized test, though it is marketed that way, especially in the healthy eating world a lot of times. All those articles misguiding minds new to this environment that have been taught to follow the rules and score high. It’s all the same to overachievers, school scores, healthy eating, good etiquette, etc.

    • Lia, isn’t it funny how there’s a certain shame attached to balance, rather than espousing an extreme? I’m so happy you like the post.

  36. I love this article! I want to print it out and hang it on my refridge. This whole article describes me perfectly. It is almost scary. I thank so much for writing about this and you did a wonderful job! Thank you, thank you! xo

  37. Thanks for this, Gena! I’m moving to NYC tomorrow & have been simultaneously been feeling crazy excited to be living in a city with so many wonderful vegan options & worried about indulging too much in plant-based sweets & comfort food. But you have reminded me that our bodies are intelligent & resilient & listening to it will let me know when I want to enjoy a doughnut & when I want to sit down to a delicious salad. Both really do keep me balanced in body & mind.

    • Absolutely, Cassandra. And these foods give meaning to each other as well. Having some of one will allow you to appreciate the contrast of the other. I hope you savor all of the amazing vegan options that NYC has to offer!

  38. Gena, Posts like these are why I continue to keep up with your blog after all of these years. The either-or issue is something I’ve identified in myself recently, and I’m working towards getting beyond it.
    I especially loved this:
    “Pleasure and stress reduction also contribute enormously to good health, which is why I believe firmly that savoring something indulgent is far healthier than constant stressing out about maintaining a rigidly “healthy” diet.”
    This is so true, and while I can mentally grasp this (and have for years), behaviorally I’ve found this to be more challenging.

    Thanks for continuing to share your journey with us! You continue to be a huge inspiration for me. XO

    • Marlena, you are a big inspiration to me as well. It means a lot that my blog still feels relevant and helpful to you, even after all this time! Sending you hugs.