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When Eating Healthy Becomes a Problem

Eating Disorder Treatment

Perhaps never before has disordered eating been so normalized by broader society than it is today. This is true in way too many ways, but one of the increasingly common ways I see it manifest is in the cultural obsession with healthy eating.

But what’s wrong with wanting to take care of your health?

Well, for one, it assumes that health is largely in our control and is mostly dependant on our diet and exercise, though neither are true. It’s a gross oversimplification of health and ignores a multitude of other important factors (I discuss this more here). It also tends to be health-ist in that it devalues people who don’t meet the conventional definition of physical health. It further devalues people who don’t place the pursuit of health as a high priority—or who even appear to not be pursuing health. Fatphobia disguised as a concern for health is a common way people in larger bodies are attacked.

Another issue is that it can be taken to such an extreme, it becomes unhealthy in and of itself. Enter orthorexia nervosa.

What is Orthorexia?

The term orthorexia was first coined in 1997 to describe an unhealthy fixation on eating “healthy” or “pure” foods. It is not yet an official psychiatric diagnosis, but is gaining recognition as a distinct condition. There is currently no consensus on the prevalence of orthorexia, but research estimates it ranges from 6.9% to 57.6%, suggesting that a significant proportion of the general population may suffer from orthorexia. In my experience, both personally as well as professionally, I believe people who are recovering from other eating disorders are at higher risk of developing orthorexia. Such was the case for a 22-year old woman named Helena Nuich.

In a recent article on NewsHub, Nuich talks about how she developed orthorexia at 17 years old while in recovery from anorexia nervosa. Nuich got into a “health food phase” after following fitness Instagram accounts.

“I got really, really into food, which was really weird after being scared of it for so long,” Nuich told Newshub. “But it was all ‘health’ food. Everything I was eating had to be clean, had to be ‘no refined sugar’, ‘no dairy’ – I convinced myself I was allergic to dairy and gluten… and I’m neither.”

Nuich’s experience is not uncommon. What often starts out as a well-intentioned effort to be healthy ends up becoming an obsession. Like those with other eating disorders, people with orthorexia experience immense anxiety around food and adopt strict food rules. This often worsens over time, leading people to restrict their food variety more and more. It can take a toll on people’s mental health, relationships, and ironically, even their physical health. Some of the medical consequences of orthorexia include:

  • Cardiac dysfunctions
  • Muscle loss and weakness
  • Kidney failure
  • Osteoporosis
  • Problems with cognition
  • Lowered immune system
  • Malnutrition
  • Infertility
  • Nutritional deficiencies

How Orthorexia is Normalized

Because being “healthy” is so valued in our society, symptoms of orthorexia typically get missed. People often view the dietary restriction as a positive thing, even going so far as to admire and compliment it. Nuich says people were consistently praising her for being ‘healthy’. “I was really praised for looking the way I did. You get people like: ‘You look so good what are you doing? What are you eating?’ – It’s constantly boosting your ego.”

I hear this all the time from clients who are praised for their “self-control” and “discipline” when it comes to food, which is really hard for people to get past when a treatment team is telling them something very different. The approval and admiration for their eating disorder just reinforces it and makes it that much harder to even realize there’s a problem. Even when they do realize it, it’s tough to choose recovery knowing it will mean sacrificing all that applause.

We need to seriously rethink our approach to health, and stop seeing it in such black-and-white terms. That leads to extremes that aren’t helpful. We also need to stop elevating physical health over mental health. Both are important. And when someone’s mental health is suffering because their relationship with food is colored by fear and anxiety, then that’s a problem. Health is about way more than cucumber water and acai bowls.

If you think you might struggle with orthorexia, take The Bratman Orthorexia Self-Test.


Much love,
Cherie Signature


I’m Cherie Miller, MS, LPC-S, founder of Nourished Soul Center for Healing and @foodfreedomtherapist on Instagram. We offer therapy and nutrition counseling for chronic dieting as well eating disorders like Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other food issues. As anti-diet professionals, we are passionate about intuitive eating and Health at Every Size philosophies. Contact us here to schedule a therapy or nutrition appointment.

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