Whole Full and Alive Podcast
Adolescence is genuinely a complicated time for food and bodies. Teenagers are undergoing real physiological changes. They are developing their own identities and testing independence, including around food choices. They are swimming in a social media environment that is saturated with diet culture, fitness content, and body commentary. Some food experimentation and self-consciousness about appearance is developmentally typical. This makes it genuinely hard to know when something has shifted from normal teenage behavior into something that warrants real concern. The line is not always obvious, and teenagers are often skilled at minimizing what is happening, whether or not they are doing so consciously.
In New York City, most therapists list eating disorders as one of many things they treat. You will find eating disorders alongside anxiety, depression, relationship issues, life transitions, and trauma on the same profile. That is not necessarily a red flag. A therapist can genuinely work well with a client whose eating disorder co-occurs with depression or anxiety. What matters is whether eating disorders are a genuine clinical focus, not just a checkbox. And there are ways to tell the difference.
Orthorexia nervosa is an eating disorder characterized by an obsessive focus on eating what one perceives to be perfectly healthy or pure food. Unlike anorexia, which is primarily about restriction for the purpose of weight loss, orthorexia is about purity and control. The person is not necessarily trying to lose weight. They are trying to eat correctly, and the definition of correctly becomes increasingly narrow and rigid over time. Orthorexia is not currently listed as a formal diagnosis in the DSM-5, but it is widely recognized by eating disorder clinicians and researchers as a real and clinically significant pattern that causes genuine harm. The absence of a formal category does not mean it is not real or that it does not deserve treatment.
