Eating nutritious foods and getting regular exercise are fantastic ways to improve your physical and mental health. However, even healthy behaviors taken to an extreme can become problematic. At least 39 percent of people with eating disorders exercise compulsively as well. If this sounds like you, you might have orthorexia and exercise addiction.
Signs & Symptoms Orthorexia
Orthorexia is not currently recognized by the American Psychiatric Association (APA) as a mental health disorder. However, experts in the field of eating disorders have been advocating for its official classification in recent years. The condition is marked by an intense desire to eat foods that are considered to be healthy, “clean” and “proper.”
While anorexia nervosa focuses on the quantity of food ingested, orthorexia focuses on the quality of food. If a food is not up to a person with orthorexia’s standards, they will not eat it, no matter how hungry they are.
Since the APA does not currently classify orthorexia as a mental health condition, there is no unified set of signs and symptoms mental health professionals can use to assess the condition.
In general, orthorexia symptoms include:
- An obsession with healthy eating
- Concern over the risks and benefits of ingredients
- Cutting out foods or groups of foods like sugar, carbs, dairy and meat
- Compulsively checking labels or what other people are eating
- Inability to eat foods viewed as “unhealthy”
- Spending a lot of time thinking about and researching foods eat
- Experiencing stress when desired foods are unavailable
Some individuals with orthorexia may also be overly concerned with their appearance, but others might not be. Orthorexia is especially common among physically active people. A published study found that roughly 30 percent of athletes exhibit symptoms of the condition.
Hallmarks of Exercise Addiction
Exercise addiction is also not listed in the APA’s list of mental health conditions. However, people can become addicted to behaviors in the same way they can become addicted to substances. Exercise addiction involves an unhealthy focus on exercise and profound cravings for physical activity.
A person might have an exercise addiction if they:
- Spend excessive amounts of time, effort and energy exercising and recovering from exercising
- Attempt to cut back or stop exercising without success
- Cannot fulfill other responsibilities because of compulsive exercise
- Experience conflict with relationships due to exercise
- Continue to exercise despite risks to mental and physical health
- Feel odd or uncomfortable when not exercising
Like other addictions, it may be challenging for you to notice the signs of exercise addiction in yourself. Be sure to consult with a friend or loved one for their perspective.
Similarities Between Orthorexia and Compulsive Exercise
Perhaps the most notable similarity between orthorexia and compulsive exercise is how difficult it can be to distinguish these unhealthy behaviors from healthy behaviors. Since no overarching guidelines are currently available, each person must be assessed individually. The signs and symptoms of orthorexia and compulsive exercise often overlap with diagnoses like obsessive-compulsive disorder or anorexia.
Both conditions also focus on perfection and an attempt to achieve an impossible ideal. Whether it’s a number on a scale, a lower cholesterol level or a new personal best on the bench press, orthorexia and exercise addiction can cause people to obsess about the unobtainable without ever being satisfied.
The Obsession with Being “Healthy”
An obsession with health doesn’t only affect the person involved: it can also impact their relationships with the people they love. Take the example of a woman focusing on clean eating. Gone are any snacks, treats and desserts in her home as she inspects every label for sugar and artificial ingredients. Her husband might not be against her eating well, but still worry that his wife’s focus on food is excessive and beginning to hurt their relationship. Disagreements and arguments may begin to stem from food issues. Over time, the obsession with being physically healthy can be damaging to the mental health of the family.
Side Effects of Excessive Dieting and Exercising
With long duration and high intensity, the negative effects of orthorexia and excessive exercise can be dramatic. The side effects of exercise addiction involve mental and physical health impairments like:
- Multiple injuries, including stress fractures and sores that worsen from lack of rest
- Higher rates of anxiety and depression
- Poor social relationships
Similarly, excessive dieting results in many adverse mental and medical results in individuals with orthorexia. Eating an overly-restrictive diet can cause:
- Slowed heart rate or abnormal heart rhythms
- Loss of bone mass
- Organ damage
- Dehydration and electrolyte imbalance
- Low blood pressure
- Stomach pain
- Anxiety, stress and depression
- Getting sick more often from a lowered immune system
Individuals with orthorexia and exercise addiction focus intently on staying healthy. Ironically, excessive exercise and orthorexia tend to deplete both mental and physical wellness.
Treatment Options for Orthorexia and Co-Occurring Exercise
Whenever you have two or more mental health disorders, all conditions must be treated in a planned, comprehensive way to produce the most beneficial effects. It seems that orthorexia and exercise addiction may respond best to a combination of psychotherapy and medication.
Cognitive behavioral therapy is one evidenced-based therapeutic option that produces favorable outcomes for addictions and eating disorders. This approach aims to:
- Provide education about the risks of current behaviors
- Identify self-defeating thoughts and feelings
- Plan healthier alternatives
- Reward desirable levels of moderation
- Build additional positive coping skills
- Boost social skills
An evaluation from a psychiatrist can help people find medications that can limit symptoms of your co-occurring disorders and make therapy more effective. A psychiatrist may prescribe medications like antidepressants, antipsychotics and mood stabilizers to alleviate symptoms.
In-person or online support groups can also serve as a helpful complement to professional treatment.
Orthorexia and exercise addiction are complex topics that require extra attention. For more information about these conditions, consult the following resources:
- U.S. Department of Health and Human Services guidelines for diet and exercise for clear recommendations regarding eating and exercise
- National Institute of Mental Health overview of eating disorders for information about other eating disorders
- National Institute on Drug Abuse overview of treating addictions to learn more about treatment options for addictions and dual diagnosis
- Substance Abuse and Mental Health Services Administration treatment locator and helplines for those experiencing dangerous physical or mental situations linked to their conditions
Key Points: Orthorexia and Exercise Addiction
Some important points to remember include:
- Although not yet recognized by the APA, orthorexia is an eating disorder based around only eating healthy foods
- While also not currently recognized by the APA, exercise addiction involves frequent and intense exercise, even when doing so is harmful
- Orthorexia and exercise addiction often overlap with each other and other mental health conditions, including OCD and other eating disorders
- The long-term effects of orthorexia and excessive exercise can lead to numerous psychological and physical problems
- A combination of therapy and medications can help people recover from these co-occurring conditions
In some cases, orthorexia or exercise addiction may also co-occur with drug or alcohol addiction. If you or a loved one lives with these co-occurring addictions, help is available. Call The Recovery Village for help making sense of your eating or exercise habits and learning the connection with your substance abuse. When you do, a knowledgeable professional can offer treatment plans and additional information.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013. National Eating Disorders Association. “Orthorexia.” (n.d.) Accessed on March 4, 2019. National Institute of Mental Health. “Eating Disorders.” February 2016. Accessed on March 4, 2019. U.S. National Library of Medicine. “Compulsive Exercise: Links, Risks and Challenges Faced.” March 30, 2017. Accessed on March 4, 2019.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition.” 2013.
National Eating Disorders Association. “Orthorexia.” (n.d.) Accessed on March 4, 2019.
National Institute of Mental Health. “Eating Disorders.” February 2016. Accessed on March 4, 2019.
U.S. National Library of Medicine. “Compulsive Exercise: Links, Risks and Challenges Faced.” March 30, 2017. Accessed on March 4, 2019.