There is a HUGE amount of discussion about “treating” anxiety problems with diet and exercise.  In some cases, diet and exercise can actually DRIVE anxiety issues and can even present obstacles to recovery.  In this podcast episode I was joined by therapist and personal trainer Jenna Overbaugh to discuss orthorexia, obsessive focus on exercise and fitness, and the problems associated with these things.

Orthorexia, while not included in the DSM alongside other anxiety and eating disorders, involves excessive restrictions on diet. People that develop orthorexia are driven to eat ONLY foods that they feel are “safe”.  In some cases orthorexia is driven by a desire to be healthy or fit. When there is an anxiety disorder in the mix, orthorexia generally involves associating a growing list of foods with anxiety and panic. Anxiety sufferers may decide that they can remain safe from anxiety or panic by rejecting any food deemed “bad”, “toxic” or as contributing to feelings of anxiety.  The list of rejected foods grows, and in extreme cases people wind up surviving on a very limited diet of just a few foods that they think are “anxiety safe”.
Jenna did a great job of pointing out the toxic nature of the diet and fitness online culture.  I will add that the “natural healing” online culture can also be toxic in its messaging.  Repeating exaggerated claims about the power of “clean” foods and exaggerated claims vilifying certain foods or even entire food groups may lead people to believe that sugar is literally poison, or that the only truly safe foods are 100% organic whole foods.  To make matters worse, these messages can vary widely and change rapidly over time as trends based on social media algorithms and the need to keep an audience engaged take precedence over factual and practically useful information.  An anxious mind gripped by irrational fear is easy prey for messages that promise relief, but these messages can fuel excessive or obsessive eating rituals.
As with any issue we discuss on the podcast, orthorexia is treated with a cognitive-behavioral approach.  Jenna treats the obsessive and extreme behaviors first.  As always, the objective is to provide the patient with a consistent series of experiences where behavior is modified (eating something “unsafe”), feeling the fear and uncertainty without restoring to protective or escape measures, then winding up OK.  If you are afraid to eat a cookie because you are sure it will cause you to panic, the way to fix this problem is to eat …. a cookie.  If you’re a regular listener, you were probably expecting this!
Jenna and I also addressed common patterns that often arise that cause people to adopt extreme exercise or fitness habits that go beyond health goals and bleed into safety and soothing behaviors. In some cases exercise and fitness routines can become soothing rituals, or can even become false proxies for anxiety recovery.  Rigidity vs flexibility is always a key indicator of potential problems. Be on the lookout for behaviors and routines that become compulsive in an effort to escape from feelings of anxiety or discomfort.
1. An extreme diet driven by the need to remain “safe” from foods that you feel might trigger your anxiety can become a problem.  Orthorexia is more common that you might think.
2. Breaking orthorexic food and diet rituals and rules involves changing your food and diet related behaviors even though these changes may trigger anxiety or even panic.  As always, the goal is to leverage experiential learning to teach your brain that you are safe even when anxious, and that extreme dietary rules are not required.
3. Coping skills, including exercise, are helpful so long as we remain on guard against letting them become compulsive or extreme.  “Portable” coping skills that do not require special rituals and routines and are not dependent on context are always the best varieties.
Next week, Jenna returns to discuss post-partum anxiety and depression issues, and her experience having to deal with those problems as a trained therapist and mental health professional.
Find Jenna, including her podcast “All The Hard Things”, at https://www.jennaoverbaugh.com/

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Podcast Intro/Outro Music: "Afterglow" by Ben Drake (With Permission)






Founder and host of The Anxious Truth podcast. Graduate student and therapist-in-training. Author and educator on the topic of anxiety disorders and anxiety recovery. Former anxious and depressed person.