Health Conscious or Eating Disorder: Take This Orthorexia Quiz — Registered Dietitian Columbia SC

Are you obsessed with healthy eating? How do you know whether you’re health conscious, or whether your eating is disordered. This post discusses what is orthorexia, and includes an orthorexia quiz to help you understand if your interest in nutrition could be harming your health.

Health Conscious or Eating Disorder: What is Orthorexia?

Early on in my dietetics career, I used to teach a series of classes on heart healthy eating for cardiac rehab, a program for people recovering from heart attacks and other cardiovascular events. At the beginning of each class, my way of grabbing the participants attention and getting them on board was by telling them that nutrition was a drug without any side effects.

At the time, I really believed that to be true. And while now I’m more likely to preach that “health is more than food and fitness,” back then, I thought nutrition was the end all, be all of health. I truly believed “eating right” could be a miracle cure, and that when it came to nutrition, there was no downside to the pursuit of “healthy” eating.

Today, I feel quite differently.

Every single day I see the harm caused by our cultures obsessive pursuit of “wellness.” Putting nutrition up on a pedestal creates stress, anxiety and confusion around food and eating, which ironically, more often leads to eating less healthfully. And while certainly, when nutrition is gentle and flexible, it is a pretty harmless and sometimes powerful way of improving health, nutrition is rarely approached in this way. Instead, food is given WAY more power than it deserves, which makes it easy for a seemingly innocent interest in food and nutrition to spin out of control and become an obsession.

When You’re Obsessed with Healthy Eating: What is Orthorexia?

Six years ago, wellness blogger Jordan Younger* shared a stunning (at the time) secret. She was suffering from an eating disorder called orthorexia.

At the time, most people (myself included) had a very narrow image of what an eating disorder looks like - a skeletal young woman, wasting away without food. Not a happy (according to her instagram pictures) and athletic appearing woman who gleefully shared pictures of her bright and colorful salads and green juice for the world to see. But behind the scenes, she had restricted her food to vegetables, fruits, green juices and occasionally whole grains, beans, nuts and seeds, and thought about food constantly. Yet, her obsession wasn't about getting thin - it was about “health.”

*While for a time she was sharing some more positive, pro-recovery messaging, she’s now back to sharing really restrictive stuff around food, so would not recommend checking out her IG.

At the time, clean eating was at it’s height of popularity, as was considered the epitome of health. To me, it felt comparatively “abundant” next to the carb and calorie restricted diets that were previously more popular. So when Jordan shared her battle with orthorexia, it was one of the first times I realized that “healthy” eating could have a dark side. I didn’t realize you could become obsessed with healthy eating, and that the obsession could rise to the level of eating disorder. That was when I learned what orthorexia is.

While orthorexia is not an official diagnosis in the DSM-5, the diagnostic manual for mental health disorders, it is a condition that is well recognized among eating disorder specialists, and we have seen it rapidly on the rise in recent years. I think it’s important to pause here and mention that most people with eating disorders don’t fit into a neat little diagnostic box. While anorexia and bulimia are well recognized, binge eating disorder, ARFID (avoidant/restrictive food intake disorder) and relative energy deficiency in sport are lesser known diagnoses. Also, someone doesn’t need to have an official diagnosis to be suffering and deserve help! Disordered eating is a spectrum, and because we live in a world that is pretty messed up around food, most people fall somewhere closer to the disordered side. So diagnosis or not, any time thoughts and/or behaviors around food are affecting physical or mental health, you deserve help.

Health Conscious or Eating Disorder: Take This Orthorexia Quiz

Orthorexia is an eating disorder in which one becomes obsessed with healthful or “pure” eating, rather than weight loss. Rather than the brain getting fixated on calories, it gets fixated on “cleanness,” often leading to cutting out an increasing number of food groups, compulsive checking of ingredients lists, and extreme distress when safe foods aren’t available. The malnutrition and medical consequences of orthorexia can be just as medically severe as anorexia.

I think what can feel confusing in the conversation about what orthorexia is, is that because of the wellness/diet culture, it can feel like almost everyone has some degree of it - and that may be true. One study found 75% of women either fit the criteria for an eating disorder, or engage in disordered eating behaviors. Understanding the difference between being health conscious and having an eating disorder may feel blurry.

Now, don't get me wrong, there's absolutely nothing wrong with valuing nutrition. Where it veers into problem territory is when those efforts are detracting from your overall physical and mental health, and quality of life.

Health Conscious or Disordered Eating? Take This Orthorexia Quiz

Worried your interest in healthy eating may be more of an obsession? Take this orthorexia quiz, developed by Dr. Steven Bratman, who coined the phrase orthorexia, to find out if there may be a problem:

1. Do you spend 3 or more hours a day thinking (or talking) about food?

Is your day consumed by reading nutrition blogs? When you hang out with your friends, does the topic of conversation quickly go to dieting? Is there a pile of nutrition books by your bed? Do you spend hours thinking about what you will eat for your next meal? It’s normal to think about food, but when thinking about food sucks up valuable headspace, and crowds out room for other interests, that’s when it becomes a problem.

2. Do you plan your meals in advance?

There's nothing wrong with meal planning or prep. Making sure you have food available to prepare satisfying, and even nutritious meals may be helpful (here’s a post I wrote on meal planning in intuitive eating). However, meal planning becomes a problem when it comes from a place of control and turns into an exercise in crafting the "perfect" diet. Is your meal plan rigid, or is there flexibility? Are you planning around food you enjoy, or planning around limitations and restrictions?

3. Is the nutritional value of your meal more important than the pleasure you receive from eating it?

Nutrition can plan a role in your food decision making, and sometimes it may even be the priority. But if pleasure is routinely undervalued, that’s a concern.

4. Has the quality of your life decreased as the quality of your diet has increased?

When you're obsessed with healthy eating, it's hard to have the time or energy for other things in life that nourish you - friends, relationships, self care, sleep, hobbies, etc. Nutrition and healthy eating may be an interest, but I don’t think it’s an appropriate hobby.

5. Have you become stricter with yourself lately?

First it was sugar, then it was dairy, and then it was white flour. As you layer on more and more food rules, less and less foods are considered healthy to eat, until your diet gets to the point where it is nutritionally inadequate.

6. Does your self esteem get a boost from eating healthfully?

Do you feel morally superior because of the way you eat? Although healthy eating has a lot more to do with privilege than individual choices, in our culture, being a "healthy” eater (i.e. controlled, restrictive eater) is considered a positive attribute that’s often praised. When that praise is internalized, and your self esteem rides on it, that’s a problem.

7. Have you given up food you used to enjoy in order to eat the food you think is right?

We all have foods we love that may not be super nutritious, but are healthy in other ways, by providing pleasure, comfort or social connection. Unless you are allergic to it, there is no justifiable health reason to give up food you love.

8. Does your diet make it difficult for you to eat out, leading to isolation from friends and family?

Would you cancel plans with someone if they picked a restaurant that couldn't cater to your nutrition needs? If the thought of breaking your food rules is more distressing than missing social events, then there's a problem.

9. Do you feel guilty when you stray from your diet?

Unless you stole food from someone, there’s no reason to feel guilty for eating.

10. Do you feel at peace with yourself and in total control when you eat healthfully?

Having complete control over what's on your plate gives the false illusion of having complete control in life. But life is messy and complicated, and while you might feel more at ease when you’re following the rules, real life doesn’t allow for that.

Obsessed with healthy eating? Take this orthorexia quiz.

If you answered yes to any of the questions in this orthorexia quiz, then there may be some food issues going on that are worth doing some deep thinking about. Or better yet, working with a non diet dietitian or therapist on if it’s available to you.

This post on orthorexia and orthorexia quiz was originally published August 2016. Images and text have been updated to give you the best possible content.

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