There is a view that any dietary discretion or avoidance of specific foods qualifies as disordered eating. By extension, dietary choices that prioritize health outcomes or lifestyles that require dietary restriction such as veganism are often labeled as orthorexic behaviors. However, orthorexia is not determined simply based on the foods you chose to include or avoid in your diet. It is much more nuanced than that! So lets explore what orthorexia is and is NOT and how veganism and healthy eating fit into that picture.
What is Orthorexia Nervosa?
Contrary to popular belief, Orthorexia Nervosa is not a recognized eating disorder in the DSM-5. Because of this, there are no standardized criteria for diagnosis. That said, orthorexia is typically defined as a fixation on healthy eating to the detriment of wellbeing. Defining characteristics of orthorexia include:
- Fixation over quality or purity of food
- Following an inflexible eating pattern with rigid rules
- Experiencing emotional distress if rules are broken
- Cutting out entire food groups and/or having a constantly narrowing list of “safe” foods
- Constantly worrying about sickness or disease
- Social isolation as a result of food rules
- Esteem and self-worth based on compliance with food rules
While restriction and food rules are a part of this picture, it is important to recognize that key piece of this pattern is the emotional impact that the restriction has on the individual. The motivation behind limiting foods and the behavioral and psychological impacts are distinguishing features of this disorder. As such, two people may follow a similar eating pattern from the outside and one person may be suffering from orthorexia while the other is not.
Veganism and Orthorexia
Someone’s motivation for adopting a vegan lifestyle is a key consideration when examining whether abstaining from animal products is a disordered eating behavior. In general there are 3 main reasons why folks adopt a vegan diet:
- Animal welfare and ethical concerns
- Environmental activism and political concerns
- Health or aesthetic benefits
Research has shown that those who adopt a vegan lifestyle for moral or political reasons are not at a higher risk of developing orthorexia or other eating disorders. Additionally, maintaining a vegan diet has not been shown to be a barrier to eating disorder recovery when these are the motivators.
When health or weight loss are the driving factors, there does appear to be an increased risk for disordered eating behaviors. In saying this, I want to be clear about the fact that vegan diets don’t CAUSE eating disorders. Rather, someone with disordered eating tendencies may gravitate towards eating patterns that include some element of restriction and so they may use a strict plant-diet as a cover for their disorder. In this case, veganism is often not the only diet pattern that someone may have tried for this purpose in their lifetime.
The key point I want to call attention to here is that while choices made for ethical and/or religious reasons (ie. veganism, kosher) do lead to specific and inflexible food rules, they tend to operate differently from disordered food rules. In both cases, breaking the rules may cause distress, but the source of that stress is often different. For the former, it has more to do with being in conflict with your values where as for the latter, it has more to do with fearing a perceived health, aesthetic, or social consequence.
Is having a focus on healthy eating disordered?
Not all people who change their lifestyle to improve their health display orthorexic behaviors. It is the degree of restriction, the underlying motivation, and the mental/emotional state of the individual that may edge it into disordered territory.
If you are wondering if you might have orthorexic tendencies, here are some great questions to ask yoruself:
How to seek help
If find that you are seeking perfection or purity in either your vegan diet or in your pursuit of health, know that you are not alone! Working with a Registered Dietitian and/or a therapist specializing in disordered eating can make a huge difference. They can act as a guide as you explore your feelings about health and diet and can support you in cultivating a more peaceful relationship with food and your body.
As a vegan dietitian specializing in chronic disease management and disordered eating I am uniquely able to help folks find food freedom while working towards their health goals and maintaining a vegan lifestyle (when it is not a barrier to recovery).