As orthorexia encourages a feigned image of health, intense diets like intermittent fasting only push those who struggle with the eating disorder further away from recovery

By: Olivia Wiens

This piece contains discussions of eating disorders and eating disorder behaviours

Rachel Barich remembers biting into a bagel for the first time in five years — a task that her eating disorder (ED) never allowed her to do. The calories were always too condensed, the carbs were too heavy, the pounds were too easy to gain and the risk was never worth the reward. But as she finally allowed herself to sink her teeth into that bread, swallowing her fear along with it, it became the “aha” moment that kickstarted her path to recovery.

The nutritionist and dietician-to-be is paving a career to help those with EDs improve their relationship with food and with themselves — but Barich’s journey with nutrition has not always been a smooth path. Oddly, her struggle with unhealthy eating was bred from her desire to eat healthier. 

In an effort to become a faster runner in high school, Barich began watching her food intake. As she got faster, she began to directly correlate her improvement with her consumption — or lack thereof — of food. 

“It became very obsessive, very quickly,” Barich said.

Soon enough, the track runner was counting less than 1,000 calories a day, meticulously scouring the ingredient lists on everything she ate and fabricating allergies to avoid eating in group settings — all in the name of being healthy. According to Barich, this lasted for five years, from which she developed amenorrhea and osteoporosis — meaning she lost her regular menstrual cycle and her spinal bones were progressively becoming fragile and brittle — at the age of 19.

It wasn’t until Barich took a fall as a National Collegiate Athletic Association (NCAA) Division I track and cross-country athlete in her first year at the University of Buffalo in 2015, resulting in a fractured leg due to brittle bones caused by malnutrition, that she finally started to come to terms with her ED: orthorexia.

“Orthorexia would be an obsession with clean eating or the pursuit of health,” said Natalie Mulligan, a registered dietician at EatWell Health Centre in Toronto. She explains that an individual oftentimes develops this ED without the intent to lose weight and actively wants to become healthier, but over time, the foods and diets needed to reassure the individual’s health become severely extreme and restrictive.

“That’s when you see the secondary effect of weight loss,” said Mulligan. “With the weight loss, it triggers something and it becomes intrusive — the fear of consuming these foods.”

Mulligan goes on to say that the diet culture that has consumed social media does nothing but encourage this fear, acting as an echo chamber and throwing back similar content that social media algorithms know you like. “Unfortunately, eating disorders are magnets for that kind of information, so [people with EDs] will find that and that will validate what they’re doing.”

That’s the trap that Barich fell into when she was struggling with orthorexia — and it not only encouraged her to keep restricting herself, but it gave her new ideas for how to do so. With countless videos instructing her on how to eat only 1,200 calories a day or what ingredients to buy for an inventive new juice cleanse, it was incredibly easy for her to find new ways to starve herself. 

While it is extremely difficult to step away from the online world these days, Mulligan advises her patients to take a hiatus from social media in order to truly recover from that toxic environment. 

But to avoid cutting herself off from her social circle by deleting her apps when she started her healing journey in 2017, Barich took to blocking accounts that encouraged extreme diets. “As I became more educated and I learned how to nourish myself — especially as an athlete — and how to eat more and how to be comfortable with the discomfort of eating foods I once feared, I slowly started to change my own feed.”

While actively fighting against the pressures of online diet culture is vital while on the path of recovery, Mulligan advises those struggling with ED behaviours to avoid dieting altogether, as it can easily trigger a relapse. She makes a point to note that there are exceptions to that rule for people who are diagnosed with diabetes or similar health conditions.

“And when we feel our fullness, it allows us to trust ourselves and to give ourselves the foods we desire when we want them.

The need to avoid dieting is especially true with ones that are inherently more restrictive, like intermittent fasting (IF).

IF has blown up as one of the most recent weight loss fads across social media with celebrities like Jennifer Aniston, Kourtney Kardashian and Ellie Goulding raving about the benefits and often taking it to extremes. 

Though the diet can take many forms, the most popular is the 16:8 method, in which the individual fasts for 16 hours a day and eats their restricted number of calories within the remaining eight-hour window. 

While IF has been shown to rapidly increase weight loss, among other benefits, the controlling nature of IF easily plays into orthorexics’ desires for food restraint, according to EatWell Health Centre’s Natalie Mulligan.

However, IF expert and co-creator of The Fasting Method, Dr. Jason Fung, believes that IF is for everybody, so long as they listen to their bodies. “If you’re not feeling well, then you should stop. You just have to go by, sort of, natural conventions.”

Some experts like Mulligan disagree with Fung, saying that the ability to listen to one’s body becomes inherently more difficult when battling an ED; the mind-body trust that is assumed of someone is not necessarily present when an ED is overtaking a person. It becomes far too easy for the disorder to take complete control, according to Mulligan.

“Intermittent fasting is a defined way of eating. It influences this loss of satiety on top of a loss of trust for the body,” Barich noted, recalling her own experiences with orthorexia. “It invades our personal boundaries that we just really haven’t been taught to respect from a very young age.”

On her way to becoming a licensed dietician, Barich is able to use her past experiences to help those currently struggling with EDs, encouraging them to practice intuitive eating rather than conforming to an invasive diet culture. “When it comes back to intermittent fasting, it really goes against one of the principles of intuitive eating, which is feeling your fullness — and when we feel our fullness, it allows us to trust ourselves and to give ourselves the foods we desire when we want them.”

While it is shown that IF, or any diet, doesn’t cause EDs to form, many of the signs indicative of an ED relapse look similar to behaviours seen in restrictive dieting, such as excessive exercise, food avoidance, frequent weight check-ins and obsessive calorie counting. When it comes to orthorexia, the line between a simple diet and unhealthy eating behaviours becomes extremely blurred. “I think that’s the danger with diets that are inherently more restrictive: there’s way too much space for the eating disorder to feel comfortable,” explained Mulligan. 

This is why Mulligan advises seeking professional help to all those who struggle with an ED. 

Even though her fractured leg prompted her path to recovery, with a ‘do-it-herself mentality, Barich says her journey was anything but smooth. Her rehabilitation was a long process full of relapses and micro-behaviours, like refusing to buy anything sweet at the grocery store and counting the calories on every package, that held her in that restrictive mindset. Eventually, Barich pivoted her recovery methods by switching her major to nutrition and devoting her life to the betterment of everyone’s health — including her own. 

Since orthorexia has yet to be established as a diagnosable disorder, many doctors still don’t know how to properly treat it. In Barich’s case, her doctor simply gave her permission to “go home and eat a plate of garbage” without offering any further guidance when she was first recovering. But as it becomes more known that EDs have the highest mortality rate of any mental illness, it is vital to encourage a healthy relationship with food rather than encourage the next weight loss fad. 

“It is ingrained in us from a very young age that dieting is the answer to our physical, mental and emotional woes,” Barich explained, “which is not true, and it becomes dangerous.”