Orthorexia in Young Adults: When Healthy Eating Isn’t Healthy
Reading Time: 6 minutesBeing health conscious is usually a good thing. We’ve all been told that eating vegetables is good for us. But young adults who have an obsessive focus on healthy eating may be suffering from orthorexia.
Ironically, orthorexia in young adults can potentially damage health and well-being. And the disorder is more common in college students than in other demographics. So it’s important for young adults and their loved ones to be aware of when healthy eating crosses over into orthorexic behavior.
Key Takeaways
- Orthorexia nervosa is an emerging eating disorder characterized by an obsessive focus on healthy eating.
- College students are at higher risk of developing orthorexia because they’re prone to trying new things, and clean eating is a growing trend on social media.
- Orthorexia can cause unintentional weight loss, anemia, malnutrition, digestive issues, hormonal imbalances, and a weakened immune system.
- Like other eating disorders and disordered eating behaviors, orthorexia should be assessed and treated by a mental health professional.
What Is Orthorexia?
Orthorexia (also called orthorexia nervosa) is an emerging eating disorder characterized by a fixation on healthy eating and food “purity.” People with the condition are so vigilant about the quality of their food that their eating habits interfere with daily life and can negatively affect their health.
Similarities exist between orthorexia and anorexia nervosa, the eating disorder in which people restrict their food intake in the pursuit of thinness. Orthorexics eat restrictively, too, but not to lose weight. Instead, they restrict what they eat because they perceive various foods, or food groups, to be unhealthy or “impure.” They obsess over ingredients and may eliminate entire food groups as part of adhering to a particular diet. For example, they may adhere to vegan, dairy-free, sugar-free, grain-free, gluten-free, and/or all-organic diets.
Orthorexia is not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders–5 (DSM-5). But awareness of the disorder is rising. It’s estimated that between 1 and 7 percent of people suffer from orthorexia. Rates appear to be higher among healthcare workers, vegetarians, vegans, and college students.
What’s the Difference Between Orthorexia and Clean Eating?
The difference between orthorexia and clean eating comes down to two things: how strictly someone adheres to clean eating and whether the adherence creates distress. By itself, choosing to eat nutritious, unprocessed food at home, a party, or a restaurant is not a cause for concern.
But if a person’s anxiety skyrockets when confronted with food that doesn’t fit within their parameters, they may suffer from orthorexia. Or if they’re unwilling to attend a party because the food served won’t be “clean” enough, orthorexia may be the reason.
Because healthy eating habits are seen as virtuous in our society, it’s easy for people with orthorexia to convince themselves (or others) that they’re just “eating clean.” However, people with orthorexia are often quick to demonize certain food or food groups (dairy, sweets, grains, etc.). Thus, they hide their illness behind the pretense of healthy eating.
How Orthorexia Develops
For some, what starts out as a simple desire to eat healthy food can cross over into an eating disorder. Someone might begin eating nutritiously in conjunction with a new fitness plan, for example.
Then, over time, their dietary restrictions escalate. They might start avoiding social events because they’re concerned the food served won’t fit within their guidelines.
These are all signs of disordered eating. While healthy eaters have a relaxed relationship with food, people with orthorexia are rigid about what they eat. They feel nervous when faced with the possibility of consuming anything outside their self-imposed dietary rules.
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Why Are College Students at Higher Risk for Orthorexia?
The transition to college marks a huge shift in a young adult’s life. The increase in freedom and independence brings with it an openness to exploration. Hence, college students are more apt to try new things and experiment with whatever’s currently popular. That might be clothes, substances, or health trends like clean eating. Furthermore, the many options provided in a typical college dining hall, along with the lack of oversight by parents, can set the stage for orthorexia.
In addition, young adults are heavy consumers of social media, where they’re exposed to an endless scroll of influencers promoting “healthy” lifestyles and diets. When young people look at images of perfect “clean eating” faces and bodies enhanced by social media filters, they may be persuaded to give clean eating a try. If they’re also grappling with stress, low self-esteem, and body image issues (which also occur in young men), what begins as clean eating could turn into orthorexia.
How Many College Students Have an Obsession with Healthy Eating?
Although orthorexia can affect any college student, those majoring in health-related subjects appear to be at higher risk. For example, one study of 176 undergraduate students within a Department of Nutrition and Dietetics found that 68 percent demonstrated orthorexia.
Another study looked at whether student athletes were more likely than non-athletes to develop the disorder. Interestingly, researchers found neither group was at greater risk than the general college population. They did note, however, a small but significant increase in orthorexia among students who exercised more than 10 hours per week.
What Causes Orthorexia?
Research on the exact causes of orthorexia is limited. In some cases, orthorexia is linked to obsessive-compulsive disorder (OCD). One study found that people with low self-esteem and high levels of obsessive perfectionism are more likely to exhibit orthorexic tendencies. Another study found a significant correlation between orthorexia and the characteristics of other eating disorders. These characteristics include the drive for thinness, bulimia symptoms, body dissatisfaction, perfectionism, asceticism, impulsiveness, and interoceptive awareness (the awareness of internal physical and emotional sensations).
Those with a history of anxiety and/or disordered eating patterns may be at greater risk. Moreover, young adults with an interest in optimum health, heavy exposure to social media, and an obsession with exercise may be prone to the condition. Young adults who were bullied about their weight or who have unresolved childhood trauma may also be susceptible. The need for control is another common factor.
One study noted that gastrointestinal (GI) disorders—which can produce abdominal pain, nausea, bloating, constipation, and diarrhea—are common in people with eating disorders. Individuals with GI disorders may develop dysfunctional dietary beliefs because they associate eating with discomfort and pain. Moreover, abdominal distension, a common symptom of GI disorders, can increase body image issues. In turn, that may lead to orthorexia or another serious eating disorder.
10 Signs and Symptoms of Orthorexia
The signs of orthorexia are varied, but they center around a rigid adherence to a healthy diet. Some people with orthorexia eliminate entire food groups like carbohydrates, dairy, or gluten. Others participate in cleanses and fasts as a form of “detoxification.” And many young adults feel inordinate levels of shame, guilt, or anxiety if they break their dietary practices.
Signs of orthorexia include:
- Being extremely preoccupied with food quality and purity
- Obsessively checking ingredient lists on food labels
- Spending unusual amounts of time meal planning and preparing health-conscious meals
- Reviewing restaurant menus for extended periods of time
- Bringing pre-made meals to events to avoid eating “unclean” food
- Completely avoiding social events that will include food prepared by others
- Worrying that eating “bad” food at one meal could lead to sickness or disease
- Demonstrating an inability to deviate from established eating patterns
- Becoming anxious in the presence of food perceived as “unclean”
- Being critical and judgmental of others’ food choices
How Orthorexia Impacts Physical and Mental Health in Young Adults
Young adults with orthorexia suffer from physical, emotional, and mental health consequences. If they cut out entire food groups, they may experience unintentional weight loss, anemia, or malnutrition. Serious malnutrition can cause digestive issues and hormonal imbalances. Additionally, it can also weaken the immune system and negatively affect the function of vital organs.
Because their eating behaviors are so rigid, young people with orthorexia are at risk of becoming socially isolated, too. Their unwavering dietary restrictions can lead to difficulty forming relationships, fractured relationships, depression, anxiety, and reduced productivity.
Moreover, their self-worth is often tied to their ability to adhere to a restricted diet. Thus, if they make food choices they perceive as “bad” or unhealthy, they can experience self-loathing and severe emotional distress.
Treatment for Young Adult Eating Disorders at Newport Institute
At Newport Institute, we treat young adult orthorexia as we treat other eating disorders—in relation to associated mental health issues. Along with providing dietary consultation and education, our eating disorder treatment addresses the psychological conditions that often co-occur with eating disorders, such as anxiety, depression, body image issues, self-esteem, or OCD.
In our locations around the country, young adults receive an individualized treatment plan tailored to their unique needs. Our multidisciplinary treatment team provides psychiatric care, medication management, nutritional counseling, and group and individual therapy.
Young adults participate in modalities including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, EMDR Therapy, and experiential therapy (yoga, art, music, and outdoor adventures). To help them gain autonomy while feeling supported by family, each client’s treatment plan also includes Attachment-Based Family Therapy.
Contact Newport Institute today to schedule a free assessment and learn more about the many ways we assist young adults on the path to recovery.
Frequently Asked Questions
What is the meaning of orthorexic?
Is orthorexia in the DSM-5?
Are people with orthorexia underweight?
Where do you draw the line between healthy eating and orthorexia?
Who is most affected by orthorexia?
What are some of the signs of orthorexia?
