What is Orthorexia and How it Impacts the Nervous System
Orthorexia Nervosa is explained as an unhealthy obsession with healthy eating and while it is not recognized as its own eating disorder diagnosis, the struggles felt by those with orthorexia are very real.
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People with orthorexia nervosa are super-focused on the quality of their food and view their diet as an indicator of their health and worth.
They often have a list of food habits they obey, including a set of foods or ingredients they intentionally avoid out of fear for health consequences. It is characterized as an obsession with not only “pure” foods but also a belief that the body must always be a “clean" vessel - and that the food (and sometimes products) one consumes can harm the cleanliness and "integrity of the body.
characteristics of orthorexia:
Cutting out foods or food groups leading to limited variety in the diet, usually eating only fruits and veggies or organic foods
Focusing on food cleanliness and purity (e.g. “clean eating,” “whole foods” or only organic)
Reading nutrition facts and ingredient lists
Concern for nutrition, including a heightened interest in the health quality of food of others
Dedicating large amounts of time to meal planning and cooking foods that comply with their dietary restrictions; including strict behaviours around preparation of meals
Anxiety at social events where food is served
Refusing to go to social events because of the food served
Body image struggles
Getting stressed out when “safe” foods are not available
A worry, concern and/or deep fear about the ingredients in food products
Foods rituals take over the daily schedule
Isolation from others
There is nothing wrong with wanting to eat to support your health. Everyone has their individual values, medical histories, and the ability to choose what works best given the resources they have.
The main distinction with orthorexia is that one’s food behaviours jeopardizes one’s quality of life and well-being, often resulting in feelings of distress or lack of flexibility that stop one from living the life they desire.
how do you know if you might be suffering from orthorexia?
Food fear and anxiety. In orthorexia, food choices are made from a place of external influence (aka diet culture). The food rules and patterns prevent people from honoring internal desires, and making choices from a place of peace and authenticity. Fear, perfectionism, stress, or anxiety show up when in the presence of food. One may experience self-judgement in the act of trying to craft the “perfect” diet.
A lot of control and little flexibility. Individuals may experience distress when they do not have full control over the menu. Social events and travel bring up anxiety because the “safe” foods are not accessible, or don’t meet the criteria of healthy enough. With the many rituals around food preparation, people cannot enjoy foods spontaneously in the moment.
Mindset. Food takes up a lot of headspace, like with all disordered eating strategies. Reading the wellness articles, shopping for safe foods, meal planning, daily cooking and preparation, and researching restaurant and menu items time up a lot of time.
Orthorexia is a complex eating disorder to understand, especially since many of us have been conditioned to believe that food and diet are the only determining factors for our health. However, health encompasses mental, social, emotional, spiritual health, and more. Additionally, everyone holds a different definition or view of health as well, so as there are many factors that make up health, there are many ways to define it too.
the impact of diet culture
We live in a diet culture work that demonizes one way of eating and celebrating anther, resulting in hyper-vigilance and shame around food choices. This causes us to ignore what we desire, cutting up from our pleasure, as well as what brings us joy, including passions and purpose. Diet culture is sneaky these days - whilst we don’t hear about the typical Weight Watcher-style diets anymore, thinness is still very much part of what it means to considered healthy (as is whiteness, youth, physical ability, and wealth). Detoxes, cleanses, elimination diets, gluten hysteria, and clean eating all form part of diet culture today, masking the ultimate goal of weight loss behind “healthy lifestyle changes.”
Whilst some people have health conditions (e.g. celiac disease), most of us who benefit more by exploring how we eat, and how the role of disordered eating may play a role in our health, rather than cutting out foods or food groups.
The heavy mental and emotional load of weight stigma, and anxiety and obsession around food may play bigger roles in determining health outcomes rather than actual weight or food habits. Putting too much emphasis on our day-to-day food choices don’t lead to improved health, but rather to a preoccupation with food and panic about our health.
tip: Look at how you relate to food rather than what you eat.
When is healthy food unhealthy?
If you’re restricting, bingeing, over-exercising, or treating some foods as “bad” or “off limits”, you may experience certain physical symptoms because eating disorder or disordered eating behaviours impacts the GI tract; and these symptoms worsen when we feel anxious about the food around us.
Perhaps you’ve experienced this: You think about gluten and you feel constipated, bloated, or fatigued. This is called the “nocebo” effect, whereby thinking about something causes you to feel pain or sick. This is the opposite of the placebo effect, which describes how positive thinking can reduces symptoms.
Additionally, changes in routine often cause people with orthorexia to feel anxious, triggering reactions like IBS, regardless of what foods one is actually eating. In other words, it’s not always the food itself causing symptoms, but simply the fact that the food is not considered part of the “safe foods list”, prepared by someone else, and/or consuming new combinations of food.
patriarchal purity mindset
The relationship between body size and health is not so straightforward - there are many fat people who are healthy, and many thin people who are not. Being in a larger body leads to certain diseases not because of size but because of the social stigma that keeps fat people from getting the resources and health care they deserve, as well as being impacted by poverty (people in larger bodies are paid less and stereotyped as less capable than people in smaller bodies), and other risk factors.
Patriarchy keeps us busy and keeps us spending - which is key for people with orthorexia who often spend a lot of money on expensive healthy things like superfoods, supplements, and organic produce.
Part of my recovery journey included recognizing my own internalized fatphobia which came from oppressive patriarchal forces that tells people who identify as female to be small, quiet, good and meek. Dominating patriarchal values have seeped into our food choices and how we relate and control our bodies. By fixating on making ourselves small, we don’t have the time and space to go after our dreams and help to change the world.
we can’t fight patriarchy or follow our purpose on a growling stomach.
“A culture fixated on female thinness is not an obsession about female beauty, but an obsession about female obedience. Dieting is the most potent political sedative in women’s history.” - Naomi Wolf, The Beauty Myth
The dulling of the wild, powerful woman, who is raw, wildness, spiraling, in the unfolding present moment, creative, and spontaneous is shunned, is so virtues of reason, rationality, austerity, and order are elevated. All that is neat, pure, lean, white and precise are acceptable whilst anything that is implicitly fat and feminine, flowery, lavish, and excessive are redundant.
The soft borders of our bodies mean that we don’t have enough discipline; roundness being associated with weakness of will. The human appetite is considered to lack purity and willpower, and should be tamed and shamed. Those who stick to a restrictive diet are seen to have achieved something good or virtuous. The quest of diminishing ourselves makes us feel like we are getting somewhere, and thus more acceptable, into a reasonable body.
When our bodies are palatable for society, there is a sense of belonging.
our nervous system wants us to be safe
Our nervous system is constantly on the lookout for safety and threat, known as “neuroception” (termed coined by Steven Porges, author of Polyvagal Theory), which is essentially the nervous system assessing whether we belong or don’t belong in the environment in which we find ourselves. This is an evolutionary advantage - by perceiving what is threatening and what is safe, we have learnt how to get away from or move towards situations for our survival.
When we are in a state of panic and anxiety around food and weight, we are activating the sympathetic nervous system which engages our flight or fight stress responses. Our bodies don’t know why we are stressed, it just recognizes that we are stressed and thus in some kind of danger. Long-term, chronic stress leads to all kinds of health issues (refer to why diets don’t work).
However, we need the sympathetic part of our nervous system to get away from danger, as well as to get out of bed in the morning, and to find food. When we get hungry, we feel agitated and that response of agitation mobilizes us to find food.
When we override these feelings, our bodies continue to simulate the stress responses, which are amplified by our internal rumination around weight and worth, and over time this impacts our digestion. The more stressed we are, the harder it is for our food to digest.
If we are in this state for a long time, the sympathetic response may go into a dorsal response which is akin to a collapsed state. The digestive system may no longer work in this state which can lead to constipation, poor nutrient absorption, and a holding onto any food that comes in (fearing it will not get food for a long time - again).
Ultimately, the nervous system must feel safe in order to digest food properly, and the proper digestion can only happen when the nervous system is in a relaxed, balanced and calm state.
we digest food when we are safe, and when we are safe, we can digest food.
This points to the importance of nervous system regulation in eating disorder recovery, orthorexia included, meaning that we see the body as a resource and that we must learn how to resource the body in and for the recovery journey (see somatic therapy for eating disorders and an embodied approach to eating disorders), especially when we are constantly bombarded by activating or triggering diet culture messaging.
All coping is rooted in wisdom no matter how much it may be getting in the way of you having a more peaceful relationship with food. The orthorexic or eating disorder adaptations did not show up out of nowhere. It may have helped you to get through some tough things and have helped you get to this point in your life - it’s part of the Hero’s Journey.
Now it’s possible that you see how these adaptations are no longer serving you in the ways they used to. And this takes time, and it is not a linear or perfect process either.
Healing your relationship with food “imperfectly” is the way out of diet culture – not being perfectly polished, expecting the “relapses”, embracing the imperfect path of healing, getting out of the rigid competitive mindset of diet culture – and instead just keep showing up as you are, and keep trying, researching, experimenting and expanding.
Freedom will not be found in another plan or program focused on “the problem of your body.” To begin the healing process, start by calling out diet culture, observing the mind patterns (aka zooming out), observing the thoughts (questioning “Who would I be without this thought”), and engaging in grounding, soothing and empowering embodiment practices, with support from a coach, therapist or community.
trust is key in healing from orthorexia work.
In orthorexia there is often the belief that the body is sensitive and fragile and can’t be trusted, and so we have to do all that we can to keep it healthy - otherwise it will collapse into chaos. Through orthorexic tendencies, trust in our bodies is destroyed and we end up feeling more disconnected, relying on the external rules from diet culture to tell us what to do, rather than listening to internal cues.
Just like when you’ve lost trust in any relationship in your life, it takes time to regain it. When it comes to trusting the body, this relationship building is reciprocal - you are working on trusting your body and your body is working on trusting you to give it enough to eat consistently.
Quick exercise: Imagine a close connection with friend or family. If you lost trust with that person in your life, what would you need in place to rebuild trust? It goes the same for our bodies.
Here are some journal prompts to keep the reflection going:
What does it mean to trust your own body?
How has your body, just as it is, helped you survive in the world?
What are some ways your body shows up just for you?
If there were to be no more judgment about your body - from yourself or others - what would you want to do to take care of yourself?
This work is revolutionary. Our bodies cannot breathe when they are overtaken by constructed and prescribed societal demands and standards. Our stories and bodies are too complex to fit into one body size, or skin colour, or gender. Our bodies, claimed as they are now, are an act of breaking free, empowering and liberating ourselves, bringing us closer to humanity, connection, and embodiment.
We are learning to reconnect with our innate wisdom, and unapologetically stand our ground, in our values and truth. Keep going.
Photo by Tangerine Newt on Unsplash