I used to have orthorexia. Orthorexia is an eating disorder that includes symptoms of obsessive behavior in pursuit of a healthy diet. Many other eating disorders involve pursuit of an ideal weight, but a person with orthorexia is obsessed with defining and maintaining a perfect diet.
I break down my experience with orthorexia into 4 sections:
12/26/17 update: I feel like I've mostly gotten over it, so I wrote a song about my experiences and my body image issues.
My unhealthy relationship with food started when I moved to a new state for 3rd grade. I hated that year because my classmates often teased me for being fat. I take remarks personally, and their words really got to me. Even in elementary school, the word “fat” works as an insult because of diet culture.
Diet culture perpetuates the idea that women will be happier if they are smaller. Millions of dollars are poured into advertising products for weight loss, such as juice cleanses, detox pills, and “guilt-free” foods. Diet culture skewed my self perception. I thought that no matter how smart or kind I was, first and foremost, I had to be attractive and skinny. My exposure to diet culture made me think that being fat was bad, so I adjusted my eating to become thinner.
That year, I started following diet tips and paying strict attention to nutritional information. Before I started following food blogs such as Serious Eats and The Kitchn, my favorite food site was Hungry Girl. Diet tips say that sugary beverages and refined carbs are unhealthy, so I stopped having orange juice and rice at dinner. In addition to learning restrictive tips, I did learn some useful information, such as meal prep tips and calorie counts for many common foods.
However, I failed to recognize the onset of a problem. I read about eating disorders, but most of the information was for anorexia and bulimia. I never had extremely low food intake or desires to purge, so I thought I was okay. People eventually stopped teasing me for being fat, but the restrictive behaviors I developed continued.
I became overly obsessed with what foods I ate, which affected my social life and personal dietary choices. Timberline Knolls has more information about the signs and symptoms of orthorexia as well as information about other eating disorders.
I avoided many social gatherings that involved food, such as potlucks, study breaks, group dinners, and cooking co-ops.
My freshman year at MIT, I seldom went out to eat. When I did, I was fraught with anxiety because restaurant meals tend to be high in fat and sodium, low on vegetables, and heavy on carbs, meat, and who knows what else. Instead, I learned how to cook, and I prepared all of my meals myself. Compared to restaurant meals, home cooking costs less and gives you control over ingredients and preparation. To justify my behavior, I used to tell myself that I was frugal. However, having control over meals was the primary reason I cooked so much.
Cooking with friends was also stressful. I hated showing people how to cook because I focused on perfectly executing the food instead of enjoying the process. Once, I was teaching my friend how to make pancakes for the first time. It was frustrating when he couldn’t mix the batter or cook the pancakes as well as I could, and I couldn’t stop worrying about the food. Would there be too much baking soda or flour? Would the pancakes be fluffy enough and perfectly golden brown?
Instead of making plans with my friends, I scheduled around my particular meals. I wasn’t eating enough food, so I was often slightly hungry even after meals. When I was hungry at night, I would avoid snacks (don’t midnight snacks make you fat?). I was almost always thinking of food and craving my next meal or snack. Because I had such rigid plans, I would become inappropriately upset when they were disrupted, such as if a friend accidentally ate my food.
Personal dietary choices
In my head, the typical eating disorder involved weighing lettuce leaves or buying 0-calorie products, but I never did that. My personal dietary choices were restrictive based on perceived healthfulness, not calorie count.
For the longest time, I didn’t eat more than a few bites out of any regular pasta or rice dish. When I did, it would always be whole wheat pasta or brown rice. There are health benefits to whole grains, which prevented me from enjoying the occasional meal with refined carbs.
At restaurants, I often picked the healthier option over something I craved. I ordered many salads (dressing on the side), and I don’t even like salad. When given the option to substitute salad greens for rice, I did. On the rare occasion when I did eat rice, it was always brown rice.
I hate when some food blogs aggressively market these healthy substitutions. Promoting raw, gluten-free, vegan, Paleo “brownies” that are just cocoa, dates, and walnuts or promoting blended up frozen bananas to be as satisfying as “ice cream” is misleading. The recipe themselves are fine and tasty in their own right, but the language is harmful. There were many times when I tried these guilt-free desserts, remained unsatisfied, compensated by eating a lot of other food, and still remained unsatisfied.
These restrictive behaviors became habit, so I didn’t even think there could be a problem. For several reasons, I found it difficult to admit that I had orthorexia:
- Similarities to healthy eating
- Relationship to foodie culture
- Co-occurrence with other mental health problems
- Personal variation in orthorexia symptoms
- Mental health stigma
Similarities to healthy eating
Both orthorexia and healthy eating involve following particular dietary restrictions. However, the key distinction between an eating disorder and healthy eating is whether eating gets in the way of your day to day life. Only you can diagnose this. For me, orthorexia resulted in awful mental health, but few external effects. I was still productive, except for the occasional day spent crying about how fat I was. I only cried in private to a dear friend, so most other people didn’t see the problem.
Relationship to foodie culture
A foodie is a person who seeks new food experiences as a hobby, and in foodie culture, it’s normal to be a picky eater. I did recognize that my eating behavior was abnormal, but by identifying as a foodie, I found it difficult to recognize a problem. There’s nothing inherently wrong with cooking as a hobby, and I thought I just really liked to cook. However, my motives were the issue. Worrying about food and body image was my top priority in life, and cooking was about control.
Co-occurrence with other mental health problems
Mental health problems often come bundled together, and it’s hard to come up with a precise list. My symptoms matched those of two other disorders: anxiety and cyclothymia.
Back in the third grade, I hated the fact that my peers thought I was fat, so I associated being fat with being shunned. I had body dysmorphia, a disorder involving obsessive focus on a perceived flaw in appearance, so I perceived my weight as heavier than it actually was. As a result, my anxious thoughts went something like “I’m fat and ugly and nobody likes me.”
Cyclothymia is a milder, more chronic form of bipolar disorder, which involves cycles of highs and lows. A small incident, such as somebody accidentally throwing away my food, could instantly change my mood from being happy to being really sad.
Personal variation in orthorexia symptoms
Each person with orthorexia has a slightly different story to tell. There is no clearcut guideline for diagnosing orthorexia because it’s not about what somebody eats, but why they are eating it. For the longest time, I didn’t read about any person with a similar story, and trying to compare my life to some rigid list of symptoms got me nowhere.
Mental health stigma
There seemed to be a mental health stigma because I never heard about other people’s mental health problems. Often, people only talk about these issues with their close friends, and none of my friends had similar issues. It was scary to admit, even just to myself, that I had a mental health disorder because I felt weak, vulnerable, and broken. It was even scarier to seek help.
Getting over orthorexia
I first started taking action to improve my mental health in January 2016. Here are the concrete steps I took over the past 1.5 years:
In my early stages of recovering, I focused more on general mental health (sections 1-3) because I didn’t diagnose orthorexia. Only recently did I start directly addressing orthorexia with intuitive eating (section 4).
Going to therapy
Deciding to seek help for my mental health problems was the hardest part I had no idea how to start because there is no quick fix - you can’t just take antibiotics. At the time, the solutions I heard about were taking medication, undergoing hospitalization, and going to therapy.
I was terrified of medications and hospitals because I didn’t want awful side-effects or solitary confinement. Hearing about fellow students getting hospitalized after going to MIT medical made me terrified of therapy as well. My very first therapist appointment confirmed my fears. During the entire hour, they constantly took notes, so I thought that I could be reported to the authorities for being too sad.
It took me a few months to go a second time, and I felt much more comfortable. During the appointments, I learned an important, but rarely taught skill, mindfulness, which is making sense of my own thoughts. My new therapist provided me a framework for understanding my emotions and motivation to improve my mental health.
Talking to friends
For a while, I didn’t talk to anybody when I was sad. Instead, I kept on bottling up various stressors until I finally broke down. I found it difficult to start conversations about my mental health problems because everybody around me seemed so busy. Also, other people didn’t seem to have similarly severe problems, so I didn’t think that other people could empathize.
I first started having deeper conversations with my friends in January 2016. No one conversation fixed all of my problems. However, the process helped update several false worldviews about people. I feared dismissal, but found that people were surprisingly kind when I asked them, “I’m feeling glum. Do you have a minute to talk?” I feared lack of empathy, but found that people were happy to listen.
Keeping a journal
My therapist suggested that I keep a emotional journal, and they gave me a paper handout for tracking my emotions. I didn’t like the rigid structure, so I didn’t starting journaling for a while. However, in January 2017, I found a form of mood tracking that I enjoyed. I keep freeform ramblings that I type up on my laptop because it’s faster than writing on paper. I don’t keep any formal structure, and I just write down all of my thoughts when I’m emotional.
One entry is titled “Worry Time!”, and it’s a list of every single thing I was worrying about at the moment. There are 18 distinct items. Some are general concerns, such as finding purpose in life and dealing with stress at school. The most amusing ones were meta-worry: I worry too much, I worry about worrying too much. Many were self-criticism: I feared that I was ugly, fat, lazy, stupid, and out of shape. Listing out all of my concerns made it much easier to think about why I felt that way. Empirically, I am not fat, lazy, stupid, or out of shape. Concerning whether or not I am ugly, I prefer not to care rather than question whether people think I’m ugly. Beauty is subjective, and there are more interesting self-descriptive adjectives than “pretty” or “beautiful.”
Similarly to how I keep a journal with general mental health ramblings, I keep a food journal on occasion so I can reflect on the connection between eating and my emotions. It’s different from a food log because I don’t focus on precise intake or calories.
Instead, I write when food makes me sad. For example, one blurb says, “I eat too much food, and I feel kinda sick and gross. Today, I ate 2 egg tarts when I really only wanted one egg tart. I have no clue why I do this.” Re-reading my logs helps me eat more mindfully so I can honor my hunger, not my emotions.
For a while, I didn’t know anybody else with an eating disorder. Here are some things that helped me realize I wasn’t alone in my experiences:
- I follow many pro-recovery women on social media. Seeing idealized versions of other people’s lives makes me sad, so they are about only people I follow (the rest of my feed is puppies and kittens). Here’s some of them:
- NEDA, the national eating disorders association, exists. It’s comforting to know that there’s an organization dedicated to solving this awful problem.
- Recently, I read Brave Girl Eating: A Family’s Struggle with Anorexia. This gave me perspective on how an eating disorder doesn’t just hurt you, but also hurts the people around you.
Then, I was able to recently diagnose orthorexia, around April 2017. To directly address the problem, I focused on intuitive eating, which is how babies and a lot of my male friends eat. I started keeping a food journal to help me modify my diet.
“Intuitive eating is a philosophy of eating which is based on the belief that the vast majority of people are born with all of the intuitive wisdom they need to have to know how to eat. That includes knowing when they're hungry and full, knowing what taste preferences they have, and knowing how their bodies feel after making their food choices. Unfortunately, many people, for various reasons, become distracted from this wisdom. These people need to challenge their diet thinking and distorted cognitions and myths in order to find their way back to their inborn wisdom.”
In this context, diet refers to the foods I habitually eat, not the foods I eat to lose weight. I have mostly recovered from orthorexia, and I made 2 main diet modifications:
1. Adding in fear foods
Starting in the 3rd grade, I cut certain foods out of my diet. Now, I’m finally adding fear foods back in. I used to avoid refined carbs and meals with no vegetables. In April, for the first time in years, I had a full pasta meal with regular bowties, tender chicken, and creamy sauce. I used to avoid “unhealthy” options at restaurants out of guilt. Recently, I’ve learned how to enjoy these meals, such as fluffy white rice with stir-fry or cheesy grilled sandwiches.
2. Giving up rigid control of meal prep
Starting in the 3rd grade, I took more and more control over preparing the foods I ate. Now, I’m finally giving up this rigid control. Instead of thinking about meal prep 24/7, I have time for other activities, such as socializing with friends, bouldering, and playing ukulele.
That doesn’t mean that I’ve stopped thinking about food altogether. I know too much about food to do that: the calories in a banana, the ingredients in a Hollandaise sauce, the preservatives in bread. Sometimes, the knowledge is enjoyable. I do love buying groceries (Trader Joe’s is one of my favorite places!), preparing meals, and baking muffins for my friends. Sometimes, the knowledge colors my meals, and the nagging fears return (won’t eating this make you fat?).
To be honest, I don’t know what to do about my complicated relationship with food. Recently, I’ve been keeping food logs to help me address the old fears. I hope that one day, I’ll be completely at peace with food and my body, and the pain of orthorexia will be just a pale memory.
Language side note
Language shapes thoughts, so I elaborate on some of my word choices.
- I write “person with orthorexia” instead of “orthorexic.” Consider the word “leper.” It means a person suffering from leprosy, but also means a person who is avoided or rejected by others for moral or social reasons. The noun “orthorexic” is an inappropriate label for a person suffering from an illness.
- I generally write “recovering” instead of “recovery.” I prefer using the verb form because it is more active. Recovering is a process I initiate; recovery sounds like a process I am forced to undergo.