Content warning: disordered eating, self harm.

orthorexia nervosa, (n). ; an obsession with proper or healthy eatingIn the world’s current state of #fitspo and #cleaneating, orthorexia nervosa flies under-the-radar compared to more common eating disorders such as anorexia or bulimia. But that doesn’t make it any less dangerous. Orthorexia is the disordered obsession with healthy and clean foods. Though it is not officially recognized by the National Institute of Mental Health, the term was coined in 1996 by Dr. Steven Bratman and reports of orthorexia have since increased. With the rise of health and wellness trends, it’s difficult to differentiate between the health-conscious and the health-obsessed; thus, leading to further misunderstandings of this mental health disorder.Now I’m not here to discount the merits of healthy eating because obviously we should all be mindful of our health and nourish our bodies with wholesome foods. But orthorexia is something I want to bring attention to because not only is it overlooked, but also because it’s affected the people I admire the most. My best friend, Emily, developed orthorexia during her recovery from anorexia. Awareness and understanding are the first steps to helping those with eating disorders, so I picked Emily’s brain to better comprehend orthorexia and its complexities.Emily and I competitively swam together from the age of 11 all the way through to our senior year of high school. As high-level athletes, we were taught that healthy eating was crucial for athletic success and that, if anything, we should be more disciplined about our eating habits. For most of us, that meant shrugging it off and sneakily eating candy in the change rooms, but for Emily it was encouragement for a disordered mindset.At the cross-section of OCD and anorexia, orthorexia is marked by a person’s need to control their food. However, unlike other eating disorders, orthorexia is an obsession with controlling the quality of food eaten, not the quantity. Signs include: compulsive checking of ingredient lists and nutritional labels, cutting out certain food groups, inability to eat anything but narrow group of foods that are deemed “healthy” or “pure”, spending hours per day thinking about food at upcoming events, and high-levels of distress when “healthy” foods aren’t available. I didn’t even need to ask Emily if she exhibited these behaviours because over the years, I had witnessed them all.Though technically “recovered” from anorexia, orthorexia allowed Emily to “channel [her] disordered behaviours and rituals into something more socially acceptable and easily veiled by our current, common, and less worrisome preoccupation with clean eating”. Because the disorder is so easily concealed, she says that “the issue was often compounded by those who praised [her] discipline or expressed their own desire to follow a regimented diet”. She describes being “absolutely convinced that there was nothing inherently wrong with leading a healthy lifestyle” because “there cannot possibly be a problem with eating healthy”.

I didn’t even need to ask Emily if she exhibited these behaviours because over the years, I had witnessed them all.

At the same time, Emily was “desperate for this obsession to stop so [she] could enjoy food, life, friends, and family” — not just “vegan, sugar-free, dairy-free, joy-free garbage”. This contradiction was exhausting, she said, as she was completely consumed with food (despite refusing to eat most of it). Feelings of “overwhelming dread” ruined her favourite foods (like grilled cheese) and meal times became an inevitable, “full-blown screaming and crying argument” with her family. When I asked her how it felt to be in situations where healthy food was not available, she said “it was absolutely terrifying because, at the time, it felt like her life depended on it”.Further encouraging her behaviour was social media. In this digital age, in which the camera eats first and foodstagrams flood our feeds, I suspected that social media fuelled disordered eating. Emily confirmed this, saying that it “definitely worsened [her] relationship with food as it was an outlet that promoted [her] obsession”. While food and recipe blogs can help motivate people to improve their lifestyles, she found herself spending hours looking at food on Instagram and reading articles by health and wellness influencers; “few of which actually made claims based in any substantiated evidence”. When #cleaneating is aspirational, highly Instagrammable, and celebrity-endorsed, an obsession with health seems normalized because the cheat days and treat yourself moments aren’t shown, fostering a toxic community for those struggling with orthorexia.After all this, you’re probably wondering what you should do if you know someone struggling with orthorexia, or any eating disorder for that matter. After all these years, I still didn’t know the answer. Pre-eating disorders, my best memories with Emily revolved around food. From making chocolate chip pancakes after sleepovers to sharing snacks at swimming competitions, we were constantly sharing our joy for food together. However, as her mental health deteriorated so did parts of our friendship. There were many reasons for this happening, but a small part was this looming eating disorder. On my part, I regret not making more of an effort when she probably needed it the most, but I’ve since then done my best to remind her that I am always with her in her recovery. That overwhelming dread mentioned earlier? Now (mostly) replaced by pride as she enjoys grilled cheeses and conquers small victories. Better than before, we can cook and eat together again without the stress on both of our ends. And as if I wasn’t already proud enough of her, her willingness to share her story has shown me strength in her vulnerability. So, I’ll leave you with something I wished I knew ten years ago, when I first met Emily. The answer to the question: What is the best way to support someone with orthorexia and/or any eating disorder?

“What helped me most was all the patience from those who were really going through it with me. I was honestly such a terror when I was sick but was so fortunate to have friends and family who were endlessly forgiving. It took a lot of time and tears for my family to learn that my anger and sadness was not directed at them and that they couldn’t really cure it. Often, the best thing was to just have them there to eat or sit with me. Trying to comprehend an eating disorder is frustrating and complex for those who have never personally lived with one, so I am so thankful to have had a support system that fought relentlessly for me and reminded that they would not give up when I needed to hear it”. – Emily Goodwin, 2019

If you are struggling with an eating disorder and are in need of support,

please call the National Eating Disorder Information Centre at 1-866-633-4220.

Mariana Uemura is an online contributor for MUSE.