EATING a healthy diet is a vital part of staying well. But, like most things, balance is key - and if it's taken too far, even healthy eating can became an eating disorder.
Orthorexia is described by the eating disorder charity Beat (beateatingdisorders.org.uk) as an unhealthy obsession with eating 'pure' food.
That in itself might not sound too terrible, but the problem is that rather than just trying to eat healthily, people with orthorexia can feel anxious, guilty or even unclean if they eat food they've come to regard as 'unhealthy', and as a result may end up cutting out essential nutrients or whole food groups, with rigid rules around what they can and can't eat.
Tom Quinn, Beat's director of external affairs, says: "Orthorexia describes an unhealthy fixation with eating food that's considered pure or 'clean'.
"Signs may include cutting out food groups, seeming fixated on having a healthy diet, or feeling anxious about mealtimes.
"While eating disorders are mental illnesses that don't always have physical symptoms, people with orthorexia may also show signs of malnutrition, such as low energy levels or feeling cold more often."
Orthorexia isn't officially classified as an eating disorder in itself, so people with symptoms may receive a diagnosis like anorexia or 'other specified feeding and eating disorders' (OSFED), explains Quinn.
And just because you're following a very healthy eating plan or diet, it doesn't mean you've automatically got orthorexia.
Like other eating disorders, with orthorexia, the healthy or 'clean' eating involved is more complex and often used to help somebody cope with difficult thoughts and feelings, or to feel in control.
"Every person will experience an eating disorder differently to the next, and so each person will feel distress about different types of food," says Quinn.
"We know people with orthorexia often control food as a way of coping with difficult emotions, and can feel extremely anxious, guilty or stressed if they eat food they feel is 'impure' - often foods high in calories, sugar, or fat."
So what are the signs somebody might be affected by orthorexia? Here are seven possible indications to look out for.
1. CUTTING OUT 'UNHEALTHY' FOODS
People with orthorexia may eliminate foods or food groups from their diet because they think they're unhealthy, such as high-calorie foods, or those containing sugar or fat, and the types of foods they stop eating may increase over time.
2. BEING OBSESSED WITH HEALTHY EATING
Their fixation on healthy eating may interfere with their relationships or working life.
3. BEING JUDGMENTAL ABOUT FOOD
They may seem to judge what other people eat.
4. FEELING POWERLESS TO STOP
People with orthorexia may have a set of personal eating rules which they just can't ignore, even if they want to.
5. FEELING GUILTY
They feel anxious, guilty or 'unclean' if they eat a food they think is unhealthy.
6. DEPRESSION
They suffer from low mood or depression, and have difficulty concentrating.
7. PHYSICAL SIGNS
If someone with orthorexia cuts out important food groups or nutrients, they may develop malnutrition and lose weight, feel weaker and tired, take a long time to recover from illness, feel cold and not have much energy.
RECOVERY IS POSSIBLE
Quinn says recovery from orthorexia is possible, and stresses that getting specialist treatment as early as possible is the best way to recover.
Medical students currently spend less than two hours throughout their entire medical degree studying eating disorders, says Beat, and a fifth of medical schools don't provide any training on eating disorders at all.
If you're worried about your own or someone else's eating, consult your GP or contact Beat, beateatingdisorders.org.uk. The Northern Ireland helpline is 0808 801 0434, or email NIhelp@beateatingdisorders.org.uk.
