Whether physical or emotional chronic pain creates and sustains a cycle of suffering. Each bout of pain reinforces and deepens emotional and fear circuits, the brain’s suffering pathways. And that makes it easier for the next wave of pain to follow.
In Change Your Brain, Change Your Pain, psychiatrist and brain health expert Dr. Daniel Amen introduces the concept of the Doom Loop. This self-perpetuating Doom Loop remodels the brain’s circuits, hardwiring them to expect and feel more pain—a case of neuroplasticity gone horribly wrong.
The more this Doom Loop repeats, the more automatic it becomes, locking the brain into a pattern of suffering.
But if the Doom Loop is the villain of your pain story, then the Healing Loop is the hero. This groundbreaking framework can guide you out of the suffering that has taken over your life and into lasting pain relief.
Whether it’s an injury, stress, or repressed emotions, recognizing what sets off your pain is the first step toward healing.
When trapped in the Doom Loop, you may feel escape is impossible. But instead of letting these triggers control you, you’ll learn how to take charge of them. Think of the Healing Loop as your road map to calming your brain, soothing your body, and taking control of your pain.
In his new book, Dr. Amen reveals that he uses the term RELIEF as an acronym that spells out the steps for interrupting the Doom Loop. It will set you on the path to healing, using the following techniques:
The RELIEF Healing Loop starts by helping you recognize the triggers that activate your pain. We know that a multitude of factors can create chronic pain. Whether it’s an injury, stress, or repressed emotions, recognizing what sets off your pain is the first step toward healing.
Next, you’ll ease your brain’s suffering pathways. This means calming the emotional and fear cir-cuits that have been keeping you stuck. Through targeted strategies that enhance brain health, you’ll strengthen your brain’s ability to handle pain without overreacting to it.
Strategies are inspired by Dr. Amen’s BRIGHT MINDS model, which outlines the 11 major risk factors for brain aging and memory loss:
One of the most critical steps is learning to let go of negativity and ANTs (Automatic Negative Thoughts). These thoughts fuel your pain, making it worse. But with positivity bias exercises, you’ll retrain your brain to predict the best instead of the worst.
As you start to initiate muscle relaxation and emotional expression, your body will follow suit. You’ll practice techniques that reduce muscle tension and release trapped emotions—two often-overlooked contributors to chronic pain.
The next step is to embrace brain-healthy habits that support your journey toward healing. By adopting a lifestyle that boosts your brain’s health, you’ll enhance the effectiveness of every pain-relief strategy you use.
Your brain has an incredible ability to heal and adapt, and with the right strategies, you can often improve how it processes pain. Therefore, finding relief is not about blaming yourself for your pain. It’s about empowering you to take control of it.
Finally, all of this will help you foster lasting healing, motion, connection, and purpose. Living a pain-free life allows you to improve your relationships, remain physically active, and fulfill your most important goals.
We know that individuals with chronic pain can suffer from depression, anxiety, and negative moods or emotions. The RELIEF Healing Loop helps prevent these and other issues that can rob you of your mental health, destroy your well-being, and even shorten your life.
By following the RELIEF Healing Loop, you’ll find yourself breaking free from the grip of pain and embracing a life filled with peace and vitality.
Just as the brain can wire itself into a negative cycle, it can also be rewired for healing and relief. By interrupting these patterns and guiding your brain towards healthier pathways, you can harness neuroplasticity for good, ending the cycle and paving the way for recovery.
In other words, pain doesn’t have to control your life. With the RELIEF Healing Loop, you’ll have the tools you need to reclaim your health and happiness, one step at a time.
Pain doesn’t have to be a life sentence—and understanding its connection to your brain is the first step toward relief. Dr. Amen’s latest book, Change Your Brain, Change Your Pain, will teach you how to achieve lasting physical and emotional pain relief.
Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015 Apr;72(4):334-41. doi: 10.1001/jamapsychiatry.2014.2502. Erratum in: JAMA Psychiatry. 2015 Jul;72(7):736. doi: 10.1001/jamapsychiatry.2015.0937. Erratum in: JAMA Psychiatry. 2015 Dec;72(12):1259. doi: 10.1001/jamapsychiatry.2015.2246. PMID: 25671328; PMCID: PMC4461039.
Have you ever felt anxious or guilty after eating something you didn’t consider “clean” or “pure”? Or do you spend so much time planning and preparing “healthy” meals that it interferes with work, relationships, or joy in life?
If so, it may go beyond healthy living—it could be a sign of orthorexia nervosa, a lesser-known eating disorder. Unlike eating disorders such as anorexia or bulimia, , orthorexia isn’t driven by weight loss or food quantity. Instead, it’s an obsessive fixation on food quality, purity, and “optimal” nutrition.
At first, striving to eat well might seem like a positive thing. But when that pursuit becomes rigid and all-consuming, it can actually harm both your physical health and emotional well-being. In fact, the restrictions of orthorexia can even lead to malnutrition—the very opposite of what was intended.
In this blog, you’ll learn the warning signs, symptoms, and treatment options for orthorexia, so you can recognize when healthy eating has crossed into unhealthy territory.
Unlike other eating disorders, orthorexia is not driven by a desire for thinness or food quantity control. Instead, it's focused on food quality and purity for optimal health.
The term orthorexia was first coined by Steven Bratman, MD, in an article published in the October 1997 issue of Yoga Journal. “Ortho” is an ancient Greek word that means straight, upright, true or correct—suggesting the fixation on eating purely. “Exia” is borrowed from anorexia, the Greek word that means “possession or condition.”
In the article, Dr. Bratman recounts an earlier time in his life working as a cook and organic farmer at a large commune in upstate New York. At the time he was a staunch believer in nutritional medicine for healing.
However, in trying to serve the dietary needs of the spiritual community—which was a broad, diverse group of vegans, vegetarians, macrobiotic followers, Hindu-influenced visitors, raw foodists, and others—he noticed how often their food theory principles contradicted each other. And he observed how his own obsessive-like ideas around food purity impacted his mental and physical health.
It occurred to him that the overfocus on pure and healthy eating was harmful. Hence, he used the term orthorexia nervosa to describe people whose extreme diets—intended for health reasons—may lead to malnutrition and/or impairment of daily functioning.
Although it is not listed as an eating disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), orthorexia is a serious mental health problem. In a review study Dr. Bratman co-authored, he proposed diagnostic criteria for the condition, including:
Additionally, the mental obsession and compulsive behavior surrounding healthy food and eating becomes clinically impairing in any of the following ways:
In 2022, a group of international eating disorder researchers and specialists met to create consensus on how to further define orthorexia. Their work was published in Eating and Weight Disorders.
Based on their consensus, orthorexia is defined as a mental health disorder associated with reduced wellbeing and falling within the DSM-5 eating disorder category called “Other Specified Feeding and Eating Disorders.”
They also restated known behaviors and added that orthorexia involves:
If these behaviors sound like you, it could be a red flag that you might be struggling with othorexia.
It is not clear yet how prevalent orthorexia is, but experts estimate it to be less than 1 percent of the U.S. population, according to one study. It is thought to be higher among specific populations.
While there’s no one cause of orthorexia, research points to a number of psychological and sociocultural conditions that lead to its development. At the individual level, certain personality traits are associated with the disorder, including:
Related: What Is Obsessive-Compulsive Disorder (OCD)?
An individual with these personality traits may be more likely to engage in the rigid, extreme dietary behaviors that characterize orthorexia nervosa. Also, a history of body image issues and dieting can drive disordered eating patterns centered around health obsessions and consuming pure foods.
Sociocultural influences can add a lot of fuel to the fire with this disorder. Idealized body images and clean eating trends across social media platforms are pervasive. They can create a tendency for comparison and mounting pressure in individuals to conform to impossibly high and unsustainable health and nutrition standards.
Of course, social media is notorious for spreading misinformation and unscientific health claims stoking fears about “toxic” foods and promoting dangerously restrictive and narrow dietary choices.
Western culture has long prioritized physical appearance and equated dietary purity with health, which are believed to play a role in the development of orthorexia nervosa as well.
Experts have also noted the following risk factors for orthorexia:
What’s so insidious about orthorexia is that it often develops from a good-intentioned desire to improve health. Often, an individual will adopt a certain diet or eating plan because of a health condition or simply to feel healthier or have more energy.
Gradually, these good intentions grow more consuming and extreme, and at some point, the obsession with healthy and pure eating starts to cause more harm than good.
Based on brain-imaging research involving nearly 300,000 brain scans at Amen Clinics, it is clear that brain activity plays a role in eating disorders. Brain SPECT scans show that the following brain regions are involved in eating disorders:
In orthorexia, this can look like obsessively rereading nutrition labels or replaying a single worry about whether a food is “clean enough,” even when you try to focus on something else.
If you have orthorexia, this might mean intense anxiety when eating at a restaurant where food preparation feels out of your control, leading you to avoid social meals altogether.
In orthorexia, this could contribute to misperceptions about how food choices are affecting health—such as feeling “unclean” or “toxic” after eating a single processed item, even if their body shows no real signs of harm.
Here’s the good news. Orthorexia is highly treatable. As it can have severe consequences (malnourishment, loss of relationships, and poor quality of life), it’s important to get treatment as soon as possible if you suspect you or someone you love is suffering from orthorexia.
Simply acknowledging the problem is the first step to recovering from it. Understanding if other mental health disorders, such as obsessive-compulsive disorder (OCD) or anxiety disorders, are involved is another critical step. And knowing how your brain functions and if your it needs optimization is yet another essential piece of the puzzle.
Seek the help of a medical doctor as well as a qualified mental health professional. Especially in cases of malnourishment and/or severe weight loss, it’s important to seek treatment from a medical care provider.
Orthorexia treatment can involve a wide range of therapies and techniques. Cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are two types of therapy that are used to successfully treat orthorexia, according to research.
Related: Cognitive Behavioral Therapy: What Is It and Who Can Benefit?
A mental health professional can also address any co-occurring mental health conditions such as obsessive-compulsive disorder or other eating disorders.
Orthorexia is characterized by an unhealthy obsession with eating only “pure” or “clean” foods. Unlike anorexia nervosa and bulimia, it’s not about weight loss but about food quality. When taken to extremes, it can harm both mental and physical health.
Some orthorexia warning signs include spending excessive time thinking about food purity, avoiding social situations involving food, feeling anxious or guilty after eating “unhealthy” foods, and tying your self-worth to how well you follow strict eating rules.
Orthorexia is treatable. Cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and integrative brain-based care can help challenge obsessive food-related thoughts and reduce anxiety. A mental health professional can create a personalized treatment plan.