I was in my early twenties and a medical student when a personal trainer at my gym suggested that I take up body building. I enjoy a challenge, a goal to work towards so I went full steam ahead with a twice-daily training program and a nutrition program, created by this underqualified trainer that changed how I feel about my body and how I feel about food.
My diet was not only tiny, with minuscule portions, it was also highly restrictive. The list of allowed fruit and vegetables was short, the list of forbidden foods was extensive. Before it was popular, I prepared my meals in tiny little boxes that I would take to my hospital attachments.
My friends were beyond impressed with my resolve; I was actually ravenous and eventually I would end up eating half a tub of ice cream of an evening in an effort to quieten the cravings. All I thought about was food and maintaining perfection over everything that entered my mouth.
Eventually, I gave up this quest for body building glory, predominantly because I could no longer handle the obsession with food, mentally or physically. My body was breaking literally with a fractured wrist from weakened bones from the weight loss and my mind was equally as damaged.
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Years on, I still obsessed about the goodness or badness of foods as dictated by this diet. On the surface, it appeared as though I was taking the utmost care of my health with an unrivalled commitment, the reality though was that my obsession was harming my body and my mind.
What is orthorexia?
Orthorexia was first described by Dr Steven Bratman back in the 1990s when he called himself an alternative medicine doctor. He started to notice that his patients who subscribed to strict dietary rules to enhance their health were, like I was, obsessively and harmfully focussed on food.
Orthorexia nervosa is not a formally recognised psychiatric diagnosis at present but it is a condition that is being researched and even treated as we realise that you can actually eat too clean.
Orthorexia stands apart from healthy eating in that people who have this condition tend to be extremely fixated on food for its health value. In addition, this fixation causes a degree of impairment because the rigid rules start to impact on their psychological wellbeing, their social interaction and, paradoxically, can lead to nutritional deficiencies.
Their self-worth is often very dependent or tied up in their ability to stick to their ultra-healthy rules around food.
Bratman, in his original observation, noted that many people who developed orthorexia started out with intentions to just eat well or go on a diet. Dieting is very common with studies demonstrating that at least 38 per cent of American women are on a diet at any one time. But what takes us from the desire to shed a few pounds to something more sinister?
What causes orthorexia?
Research has shown that some factors such as a tendency towards perfectionism, previous eating disorders or disordered eating and poor body image may predispose us to develop more unhelpful eating patterns. In addition, questions have been raised over the impact of highly restrictive dietary patterns even rigid or restrictive vegan or vegetarian eating and how they may play into developing orthorexia in vulnerable people.
In the era of social media, healthy eating communities are a strong draw card on platforms like Instagram. Social media, and especially image-based platforms like Instagram, dish out advice on clean eating and dieting in conjunction with a lifestyle or an image that is incredibly seductive.
Concerns have been raised over the role of social media in a number of psychological issues, and members of healthy eating or clean eating communities seem to have higher rates of orthorexia. They also seem to have worsening symptoms the more time they spend on the platform.
On the surface, healthy eating is normal, even desirable. Behaviour that is pathological, like that seen with orthorexia, is so normalised or even celebrated. We celebrate people who have such self-control so as to never let a stray potato chip or chocolate bar pass their lips.
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We admire their commitment, their prioritisation of their health and many of us want to emulate that. We want their glowing skin, their perfect figure, their promise of robust health and longevity. Restraint, even to the point of being damaging to your mind and body, is still so desirable even if it makes us sick.
Orthorexia takes a noble pursuit, wanting to be healthy, and turns that into the exact opposite. The irony of this is not lost on me. How can something that is supposed to be good for you become so very bad? I believe that is one of the problems with our dogged pursuit of appearing healthy, the side effect is that it can become unhealthy.
For me, I would never go as far to say that I had an eating disorder or orthorexia. But I do look back on that time when I measured tiny cups of egg whites and placed potatoes in the same category as nuclear warfare as damaging both then and even now.
It’s taken me over a decade to allow potatoes back into my life and to cultivate a relationship with food and eating that is actually healthy, not just pretending to be. And that is what we should be aiming for.
Health is not just about looking like our favourite influencer or having the discipline to say no to foods you feel that you really shouldn’t have. Self-control to the degree it actually makes you unwell is never something that we should champion above all else because as orthorexia demonstrates, you can indeed be too clean.