Restrictive eating and orthorexia: When does healthy eating become unhealthy?

With the rise of social media and sharing our food, eating habits and lifestyles, judging them has quickly become part of the norm. There are now millions of accounts dedicated to sharing food, clean eating, fitness journeys, weight loss journeys and more. All inspiring (or pressuring) people to follow along and get involved. 

Emma Hanton

While many of these accounts have positive intentions and being healthier is undeniably beneficial for our long-term health, when does it cross the line and become unhealthy, or even dangerous? Restrictive eating and eating disorders are on the rise, the eating disorder charity, BEAT, estimates that 1.25 million people in the UK have an eating disorder 

Many more people struggle with obsessive dieting and restrictive eating, most women have been on a diet at some point in their lives. So, what exactly is restrictive eating and what should you do if you are suffering?  

My personal journey

I’m Emma, registered associate nutritionist, food blogger and massive foodie! My own journey with restrictive eating is part of what led me into nutrition and now informs all of the work I do, so I would like to share a bit of my journey with you. 

I was very active growing up. I did gymnastics all throughout school which is a very aesthetic sport, with very little clothing. At an age where you are already self-conscious of your body, this just puts a spotlight on it even more so and is roughly where I can pinpoint my issues starting. By 14, I was already very aware of healthy eating and my gymnastics coach would regularly make comments about what we should and shouldn’t be eating, and I would avoid certain foods and feel guilty about others.  

Girl performing gymnastics

University was really where things spiralled for me. I joined the cheerleading team which I loved, but this combined with the stress of starting uni, moving countries, a rigorous course and being away from home, all resulted in me restricting my diet. It was all under the guise of ‘health’ of course, but I would obsessively track my macros, calories and weight. I followed lots of healthy eating and fitspo accounts and was heavily influenced by what I saw on social media, even starting my own account in my final year.  

I had extreme anxiety around foods and hated eating out at restaurants that didn’t have the calories and menus available online. Social situations became so stressful for me and I would ‘make up’ for what I ate at a party, by restricting even more the next day. On top of my four cheer training sessions, I would go to the gym and hot yoga multiple times a week. I completely cut out certain foods and food groups, flitting between low carb, veggie, vegan, really whatever I felt was ‘cleanest’ at the time. 

I was very aware of what I was doing, and studying physiology meant that I was aware of the science too. I lost weight, had no energy, my hair started falling out and I started fainting regularly. I would clamp down for a few months and things would worsen, then I would relax again for a while and things would improve.

These cycles continued throughout uni and into my master’s degree. It was really only learning about nutrition while studying for my MSc in nutrition, that made me realise what I was doing, and look for help. 

Although I was never diagnosed with a clinical eating disorder, I certainly suffered and it took a long time to recover, and take a step back from it. My own journey is now what makes me so passionate about helping others, so I hope it inspires you. 

What is restrictive eating? 

Clinical eating disorders have a specific set of symptoms. For anorexia nervosa, it is an overall restriction of the amount of food or number of calories eaten and is often associated with a low body weight. For bulimia nervosa, the key symptom is the purging of food. Restrictive eating and orthorexia nervosa are much vaguer and can incorporate a number of behaviours, with a blurry sliding scale existing between the two. 

Ranging from something like occasional restriction or healthier swaps of certain foods, all the way up to constant obsessive, heavily restricted eating – as seen in a severe eating disorder. However, you do not need to be suffering with a clinical eating disorder to be restrictively eating. Some people may dip in and out of it, or for some it can be a progression towards an eating disorder.  

A few key behaviours that would flag restrictive or obsessive eating: 

  •     Cutting out particular foods or food groups.
  •     Obsession with a healthy or “clean” diet.
  •     Feelings of anxiety or guilt over certain foods.
  •     Food tracking, whether that be calories, macros or a general food diary.

These are also all symptoms of orthorexia nervosa, which is an eating disorder characterised by an unhealthy obsession with eating “pure” or “clean” food. There is a very blurred line between what is generally restrictive eating and what is enough to be classified as orthorexia, but BEAT suggests that orthorexia is defined by the eating behaviour involved, where the behaviour is being used to cope with negative thoughts or to feel in control. 

Woman silhouette

When does dieting or eating healthily become unhealthy?

Not everyone that goes on a diet or makes a few changes to their eating routine is obsessively restricting or suffering from an eating disorder, but again, this is a grey area and it can become a slippery slope. What starts out as well-intentioned goals to eat well, can quickly morph into an unhealthy obsession with eating certain foods.  

As a nutritionist, the key questions I would ask are:

  1. Is it affecting other areas of your life? Work, school, activities or social life? A common struggle with restrictive eating is eating at a restaurant where food is out of your control. If this causes anxiety, menu checking or even skipping social occasions all together, I would say this is having a negative impact on your life. 
  2. Is it affecting your emotional well-being? Is it taking up so much space in your head where you are thinking about and planning your food constantly? Is it causing you to judge what other people eat or giving you anxiety?

If any of those apply, that is when I would suggest that it is definitely becoming a damaging behaviour and is something that should be addressed. That’s not to say that it must have reached this point to deserve attention, anyone who is worried about their relationship with food at any point should reach out for help.

Tips to manage restrictive eating

First and foremost, if you are struggling with any sort of negative relationship with food, reaching out to a qualified healthcare professional is the best thing you can do. Speak to your GP or reach out to a registered nutritionist or registered dietitian. 

Some general tips that can help include: 

  1. Try and stop any sort of food or weight tracking, whether that is through an app, writing it down or even mentally counting. Specialist support to help you manage this is available with a trained counsellor or therapist.
  2. Unfollow any accounts that make you feel negative about food or make you compare yourself to someone else’s body or eating habits. Even if you think you don’t pay attention to it, it’s likely you do.
  3. Stop labelling foods as ‘good’,‘bad’, ‘clean’ etc. All foods have a place in our diet and foods aren’t good or bad. Instead think about what that food can offer you.
  4. Include all food groups, excluding if you are vegan for ethical or environmental reasons or if you have an allergy or religious belief. Don’t force yourself to eat things, but try not to rule out entire food groups, especially if you enjoy them!
  5. Find the joy in food. We all have foods that we love and eating is a true delight so let yourself enjoy it and focus on nourishing your body with delicious food rather than depriving it. 

Follow Emma’s journey on her blog Essentially Emma.

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Written by Emma Hanton
Emma Hanton BSc is a Registered Associate Nutritionist, food blogger and massive foodie. Follow Emma (@essentially.emma) on Instagram.
Written by Emma Hanton
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