Orthorexia – The Not-So-Healthy Obsession with “Healthy” Eating

Orthorexia = Eating Disorder + OCD

Individuals suffering with Orthorexia exhibit symptoms
similar to those of OCD and Eating Disorders.

Orthorexia Nervosa (also simply known as Orthorexia) is a relatively new term within the psychological and medical fields. Simply defined, Orthorexia is an eating disorder in which an individual has an excessive and ultimately unhealthy obsession about maintaining a diet that is totally “healthy” and “pure”. Because of their extremely restrictive eating, individuals with Orthorexia are often severely underweight, and frequently lack the proper nourishment to perform basic daily activities. Like most cases involving an eating disorder, the outcome of Orthorexia can be severe malnutrition and a significant reduction of one’s quality of life.

Orthorexia has not yet been accepted as a formal diagnosis by the psychiatric community, and has not been defined within the Diagnostic and Statistical Manual (DSM-IV). However, since first being described by Dr. Steven Bratman in 1996, many health professionals have observed the often debilitating results of this condition. Read More »


In part one of this two-part series, we discussed the experience of the Social Anxiety sufferer.  In part two, we examine how to treat this condition with Cognitive Behavioral Therapy (CBT), and how Social Anxiety relates to other Obsessive Compulsive Spectrum Disorders.

Treatment of Social Anxiety

Social Anxiety

Social Anxiety can be successfully treated with
Cognitive Behavioral Therapy (CBT).

The most effective form of treatment for Social Anxiety is the same as in other Obsessive Compulsive Spectrum Disorders – Cognitive Behavioral Therapy (CBT).  This is because, like the other disorders in the spectrum, Social Anxiety involves an obsession and a series of compulsions which form a cycle.

The fundamental obsession in Social Anxiety is the fear of being evaluated negatively.  This generally includes fears of being rejected, as well as the fear of being singled out for humiliation and traumatized by emotional abuse from others.  The primary compulsion in Social Anxiety is the phobic avoidance of social situations in which one fears rejection and/or humiliation (thus its synonym, Social Phobia).

It is tempting to look at avoidance as the absence of engaging in social behavior.  However, avoidance is an overt physical and mental behavior, the primary goal of which is to reduce or eliminate anxiety.  For the individual with Social Anxiety, the act of choosing not to go to the party thus serves the same function as the act of choosing to wash one’s hands serves for the individual with OCD.  Further, those with Social Anxiety who are able to commit to a social interaction may find themselves escaping mentally in the process by spending their energy focusing on things other than the present situation. Read More »



Many people mistakenly think of Social Anxiety as nothing more than shyness.  In this two-part series, the OCD Center of Los Angeles discusses Social Anxiety, its treatment with Cognitive Behavioral Therapy (CBT), and its relationship to other OC Spectrum Disorders.

Social Anxiety

Social Anxiety is more than just shyness.

When we initially began treating people with Social Anxiety Disorder (also known as Social Phobia), it seemed that this condition was primarily a problem of interesting people not realizing that they are interesting.  While this is a significant element of the disorder, there is more going on than one might initially expect.

In reality,  Social Anxiety and Social Phobia are terms used to describe a cluster of symptoms that center around the fear of being negatively evaluated by others.  This is often confused with being shy or introverted, or even schizoid.  An introvert may genuinely prefer the quiet solitude of turning inwards to the self rather than outwards to other people, while someone with schizoid personality disorder may simply not find the presence of other people to be pleasing.  In either of these cases, the experience of isolation from others is essentially rooted in ego-syntonic thoughts, which simply means that the thoughts are consistent with the individual’s true beliefs and values.  In other words, those who are truly introverted or schizoid genuinely prefer to be alone.

Read More »


“If I knew then what I know now.”

Chances are, if you’re reading this, you’ve found yourself saying the same thing at some point in your adult life.  Nowhere is this more relevant than from the perspective of someone looking back on a childhood with Obsessive Compulsive Disorder (OCD) or an Obsessive Compulsive Spectrum Disorder.  When I meet a new client under 18, there is a powerful sense of traveling through time.  I think, “If only I had someone like me to go back and talk to me when I was someone like this.” How much time might I have saved being able to resist repetitive, unnecessary rituals?  How many more events, relationships, and simple moments of peace might I have been able to enjoy if only I had known what was really happening to me? Read More »


Last week, we discussed recent news reports about professional baseball players struggling with Social Anxiety.  This week, we broaden the topic to cover athletes in numerous sports with various anxiety disorders.  Second of a two-part series.

As we noted last week and in prior posts, the past few years have seen a significant increase in the number of professional baseball players going on the disabled list due to Social Anxiety.  This trend is remarkable for numerous reasons, the most noteworthy being that the issue of mental health in baseball is being openly discussed at all.  The overall issue of mental health has long been shrouded in secrecy and shame, leading many public figures to go to great lengths in order to ensure that their mental health issues remain private.  So when professional baseball players not only acknowledge their psychological issues, but actively seek help for them, this is a sign of cultural progress. Read More »


People with Obsessive Compulsive Disorder (OCD) who experience the pain and terror brought on by unwanted intrusive thoughts will use whatever means necessary to alleviate their discomfort. If they can’t make themselves feel sure about something internally, they reach out to the nearest person who they think can do it for them. If they are unavailable, the person with OCD will often reach out to the cold, unforgiving internet where the answers they hope not to find will always be waiting. Read More »


Obsessive Compulsive Disorder (OCD) and anxiety were in the news throughout 2009.  Some news was good, some bad, and some flat-out ugly.  Here are our votes for the top stories of the year related to OCD, Social Anxiety, Body Dysmorphic Disorder (BDD), Trichotillomania, Phobias, and Cognitive Behavioral Therapy (CBT): Read More »


Baseball’s best story of 2009 just got better.

As reported in a previous entry here (July 2, 2009), major league baseball has in recent years seen a spike in the number of players reporting symptoms of Social Anxiety.  Perhaps the most noteworthy example of this trend is Zack Greinke of the Kansas City Royals, who missed much of the 2006 season due to his struggles with the condition.

What a difference a few years makes. Read More »


Exposure Therapy for OCD and Anxiety

Exposure therapy is the key to
effective treatment for OCD and anxiety.

At the heart of Cognitive-Behavioral Therapy for OCD and related anxiety disorders is the process of “exposure therapy”. There are numerous variations on exposure therapy, depending on which specific condition is being treated – for example for OCD, the treatment of choice is a specific therapy called Exposure and Response Prevention (ERP). All variations of exposure therapy focus on the same core principle, which is that those suffering from these conditions will experience the greatest reduction in their symptoms by repeatedly doing the very thing that most terrifies them, without responding with any behaviors that are meant to reduce or control their anxiety.

For someone with OCD focused on contamination fears, exposure therapy will likely include purposely touching doorknobs or other allegedly “dirty” items without then washing. For those with variants of Pure Obsessional OCD (Pure O), effective treatment will almost certainly include imaginal exposure, in which the client purposely and repeatedly thinks the very thoughts that they would prefer to avoid, such as thoughts of being a pedophile or a murderer. A person with Body Dysmorphic Disorder (BDD) may be asked to go out for a walk without the hat they usually wear to hide their face, or to go to a brightly-lit restaurant with a group of friends. For those with Panic Disorder, exposure might mean driving on the freeway or taking a plane flight. And an individual with Social Anxiety may be urged to go to the mall to initiate conversations with strangers. Read More »

  • Excoriation (Skin Picking) Disorder, aka Dermatillomania

    Excoriation (Skin Picking) Disorder is an obsessive-compulsive spectrum condition in which sufferers repeatedly pick at their skin. Crystal Quater, MMFT, of the OCD Center of Los Angeles discusses her personal experience with, and recovery from, Excoriation Disorder, and how she treats clients struggling with this condition.

  • OCD is Fake News

    OCD is just fake news that your brain makes up. From the OCD Center of Los Angeles. Helping clients in California and around the world since 1999.

  • HOCD: 30 Things You Need To Know

    HOCD is a type of OCD in which the individual obsesses about their sexual orientation. Here are 30 things you should know about HOCD. From the OCD Center of Los Angeles.

  • Doubt, Denial and OCD

    A discussion of “The Denial Obsession” in OCD, in which sufferers obsess that they don’t really have OCD, but are merely “in denial”. By Lauren McMeikan, MA, and Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • Dermatillomania: A Skin Picker’s Guide to the Dermatologist

    How one woman with Dermatillomania finally opened up to her dermatologist about her longtime struggle with skin picking.

  • Imaginal Exposure for OCD and Anxiety

    Imaginal exposure for the treatment of OCD and anxiety is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • ROCD: Relationship OCD and The Myth of “The One”

    ROCD (Relationship OCD) is an often misunderstood variant of OCD. By Sheva Rajaee, MMFT and Tom Corboy, MFT of the OCD Center of Los Angeles.

  • Moral Scrupulosity in OCD: Cognitive Distortions

    Cognitive distortions are common in the Moral Scrupulosity subtype of OCD. Part three of a multi-part series.

  • OCD in the Family

    One mom’s story of her son’s battle with OCD and its profound impact on their family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity in OCD: Cognitive Distortions

    A discussion of cognitive distortions in the religious Scrupulosity subtype of OCD. Part two of a multi-part series.

  • OCD and Eating Disorders

    Diagnostic similarities and differences between OCD and eating disorders are discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment With ERP

    Harm OCD treatment using Exposure and Response Prevention (ERP) is discussed by Tom Corboy, MFT, Executive Director of the OCD Center of Los Angeles .

  • My Life with OCD

    The impact of OCD and related anxiety based disorders on the family is often overlooked. In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity: Where OCD Meets Religion, Faith, and Belief

    The Scrupulosity sub-type of OCD is discussed by Kevin Foss, MFT, of the OCD Center of Los Angeles. Part one of a four part series.

  • Mindfulness for OCD and Anxiety

    Using mindfulness to enhance traditional CBT for OCD and anxiety is discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Hoarding, Cluttering, and Compulsive Shopping: My Childhood Story

    One woman’s story of her life as the child of multiple generations of hoarders.

  • OCD and Thought-Action Fusion

    Thought-Action Fusion is a frequent problem for those with OCD. This issue is discussed by Laura Yocum, MFT, of the OCD Center of Los Angeles.

  • OCD, Anxiety, and Resistance

    Resistance and acceptance in OCD and related disorders is discussed by the OCD Center of Los Angeles.

  • Harm OCD Treatment: Cognitive Restructuring

    Harm OCD is often misunderstood, but it can be effectively treated using an integrated treatment plan that includes Cognitive Restructuring. Part three of our ongoing series that explores “Harm OCD” and its treatment .

  • OCD & Anxiety: Five Common Roadblocks to Treatment

    Learn the five common mistakes that interfere with successful treatment of OCD and anxiety. By Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.


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