It started with a desire for health and self-improvement. It ended with a societally reinforced god complex, dangerous coping mechanisms, and a convoluted sense of identity tied to a ‘mortal fear of death’.

This twisted web of consequences is Alex’s story of her experience with Orthorexia.

Warning: this article contains mention of disordered eating, eating disorders and Orthorexia. Continue reading at your own discretion. If you, or someone you know is seeking help for this issue, you can contact the Butterfly Foundation at 1800 334 673.

Alex* was first told by a friend at the age of 16 that she had an eating disorder. Sitting at a table during her high school lunch break, she picked at her daily two-ingredient salad of rocket and walnuts. Alex denied what her friend was telling her.

“No, I don’t”, she said, convinced she knew what an eating disorder was. She wasn’t restricting her calorie intake as is typical of Anorexia Nervosa or struggling with the binge-purge cycle of Bulimia, she was just ‘eating healthy’.

Growing up with a life-threatening peanut allergy, Alex was used to being hyperaware of what she was consuming. Reading nutrition labels, attributing ‘good’ and ‘bad’ labels to food and removing foods from her diet was a part of her childhood. From one year old, Alex was faced with a “fear of God, [a] mortal fear of dying”, that would change her future.

Eating disorders are not a typical topic of conversation. Friends and family may talk about their new diets, wanting to lose weight or to ‘eat healthier’, but these societally accepted phenomena are such a part of everyday life that they are considered normal.

What is less often spoken about is overwhelming sense of morality that has been placed on food and ‘health’. Those who carefully ensure they are eating only ‘good’ foods are placed on a pedestal; but like all other pedestals, the top is isolating and lonely.

Orthorexia

Orthorexia nervosa is described as an obsession with eating foods that one considers healthy. It was coined by alternative medicine practitioner, Steven Bratman, in 1997 as a way of making sense of a new form of obsessive control over food that both he and some of his clients had developed while trying to find the healthiest diet.

For Alex, this Orthorexia is “a behavioural eating disorder, characterised by a hyper fixation on the quality of food, rather than the quantity of food”. This fixation often makes sense only to the individual.

“My diet is better than theirs.” 

Orthorexia became a coping mechanism for struggles in Alex’s life. Always seen as mature and high achieving, food became a societally accepted way to deal with her need for success and control. Her diet could become ‘better’, and her hard work was recognised amongst the influx of diet culture propaganda. Feelings of superiority became more important, with the need to be the best, or the healthiest.

“It was so arbitrary” she said, with an ever-changing list of ‘good’ and ‘bad’ foods that were exactly in line with her goals.

First, she eliminated red meat, then starchy carbs, then milk, sugars and rice. Foods often demonised in mainstream media were quick to go, while superfoods like avocado, plain fruit and low-fat Yoghurt – all of which Alex deemed ‘pure’ enough – became food staples.

On the surface nothing seemed wrong. However, it consumed most of Alex’s time and energy. An article stating that carbs were bad would lead to hours of research and eliminations from her diet. She convinced herself and those around her that she didn’t like certain foods, like white chocolate and ice cream, to avoid being offered or eating them.

Navigating diet culture online

The rise of social media has garnered new ways for diet culture to spread.

Social media platforms Pinterest and WeHeartIt were Alex’s first exposure to diet culture. At thirteen years old, friends and family were beginning to talk about ‘becoming healthier’ and losing weight. These conversations were the first step to seeking these topics in an online space, through hashtags and influencer accounts.

“At first it wasn’t sinister at all”, she says, “it was about creating healthier choices for myself”.

An aesthetic lifestyle of beach workouts and healthy meals became society’s epitome of healthy womanhood. But it was no longer about the food or exercise. Perfectly constructed yoghurt bowls were equal to success. Influencer accounts portraying tanned women with long beachy hair were the ideal. Their bodies reflected their hard work, that they had ‘earned’ this.

Alex’s weekly routine of scripted meals became compulsory, and exercise was used to “cancel out” any unhealthy foods. The elimination of more ‘bad’ foods was reinforced with feelings of success and becoming a better person, and friends and family were supportive. Barely a teenager, she was seen as ‘mature’ and ‘responsible’ for the choices she was making, a pressure that over time, would cause more harm than good.

Unknown to her or those around her, she was suffering multiple deficiencies from her highly limited diet, and due to severe dissociation and depression, remembers little of 2018 after leaving high school.

Diagnosing Orthorexia

Orthorexia is not currently recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a diagnosis. While some symptoms may overlap

with OCD, anxiety and/or Anorexia Nervosa, the lack of diagnosis means that sufferers are not always able to receive the help they need.

Eating disorders affect 9% of the population worldwide, including 4% of the Australian population (approximately one million people) in any given year. They also have the highest mortality rate of all psychiatric disorders, alongside substance abuse. Approximately 26% of all eating disorder sufferers attempt suicide.

Credit: Inside Out

Alex had not heard the term ‘Orthorexia’ until she was 16 years old. Her mum discovered the word on the radio and recommended Alex to investigate it for her school project. After researching the term, the words hit her like a bus. Convinced until this point that she was still eating healthily, Alex felt as if the condition was directly describing her, and it made her angry.

“The wake-up call that that was … I felt stupid that I had fallen victim to it”.

While finding the term helped, the self-diagnosis she had given herself fed into the superiority complex of Orthorexia. Alex refused to admit that she needed help. Without a diagnosis, she did not seek help from a therapist, and instead relied on her own ‘self therapisation’. This was positively reinforced by her peers. “Oh, you’re so strong”, they would say.

Already feeling a sense of isolation from those around her, the gap only grew wider. Alex was able to ‘cure’ herself of her eating disorder enough to pass as having a typical relationship with food, but still retains many habits to this day. Lists of ‘good’ and ‘bad’ foods still constantly echo around her mind, habits of the past creeping back in for a sense of safety and reliability.

While still without a diagnosis, Alex is now seeing a therapist for the underlying issues behind her eating disorder. Her need to belong, to be responsible, ambitious, and reliable for those around her, combined with a fatal food allergy and exposure to diet culture were wound up into a ball of string that is beginning to unravel as she unpacks the causation beyond her simple need for control.

A more complex issue than food

While Alex’s struggles manifested themselves in the form of controlled eating, she emphasizes that it’s much more than food.

“Calling it an eating disorder, I think, is actually regressive or redundant, because yes, it’s showing up with food, but it’s like a metaphor, it’s a means to an end. It is a symbol of the achievement that it creates.”

 For an eating disorder which is glamorised by society, it highlights how we have been socialised to criticise ourselves. Trying to have the ‘immaculate’ diet, the ‘cleanest’ lifestyle and eat the ‘purest’ foods is about elevating oneself to the highest pedestal possible, the most isolated, and the most destined to be lonely.