The Difference Between Orthorexia & Anorexia
While eating disorders all share certain commonalities, it is essential to distinguish between each type of eating disorder to receive proper individualized care. Orthorexia has gained significant popularity over the past 10-20 years, and while it is not officially recognized as an eating disorder in the DSM-5, it is often confused with anorexia nervosa. Some aspects of these disorders overlap, but each presents differently, and it is crucial to distinguish between the two.
By: Marlee Dannenbaum
What is Orthorexia?
Orthorexia Nervosa (ON) is a term that means “fixation on righteous eating.” It typically manifests through an obsession with eating foods that are “pure” and “perfect” and presents as an obsession with “healthy eating.”This pursuit of perfection through “healthy eating” infiltrates an individual’s thoughts and feelings. When taken to an extreme, it can lead to a nutritionally unbalanced diet, rigid food rules, social isolation, interference with activities/interests, and health problems. While not formally recognized as a clinical diagnosis according to the DSM-5, ON is incredibly common among the general population as trends such as “clean eating” continue to gain popularity.
What is Anorexia?
Anorexia Nervosa (AN) is characterized by extreme restriction of food intake, resulting in weight loss (or absence of weight gain in growing children), and is accompanied by a distorted body image and intense fear of gaining weight. Common signs of AN include cutting out or severely limiting specific foods or food groups, cooking for others without eating, gastrointestinal complaints, preoccupation with weight, food, and dieting, sleep disruption, feeling cold often, loss of menstrual period, muscle weakness, inflexibility in daily life, and social isolation. Unlike ON, anorexia is a mental health disorder included in the DSM-5.
How are Anorexia and Othorexia Similar?
There is a great deal of overlap in the signs/symptoms of these disorders. Both disorders present with black-and-white thinking, categorizing foods as good or bad, hyper-fixation of foods, intrusive thoughts regarding food, rigid food rules, and overwhelm when thinking about deviating from their plan/self-imposed rules. Other common signs/symptoms include the inability to maintain appropriate body weight, strong interest in what others are eating, elimination of entire food groups, and general health problems associated with restricted intake.
How Do Anorexia and Orthorexia Differ?
The primary difference between these two disorders is what/where fixation stems from. Weight seems to be the sole driver for anorexia, whereas pursuing “health” and focusing on health implications associated with dietary choices is mainly associated with orthorexia. Individuals that suffer from anorexia restrict food intake to control their weight/body, while those with orthorexia focus on how “pure” or “healthy” food is. With orthorexia, there is a strong focus on food quality, but with anorexia, the focus is on the quantity of food.
Treatment Approaches
Treatment for orthorexia and anorexia are the same and typically involve behavioral, psychological, and nutritional counseling. There are different levels of care depending on what you or your loved one need.
At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained to diagnose and treat the spectrum of eating disorders, including orthorexia, anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating and body image issues.
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This post was written by BALANCE Dietetic Intern, Marlee Dannenbaum (she/her).
Marlee is a Dietetic Intern currently pursuing her M.S. in Clinical Nutrition and Dietetics at New York University. She is originally from South Jersey, but has lived in NYC for the past 2 years. Marlee earned her undergraduate degree in Human Development and Family Studies from the University of Wisconsin-Madison. Marlee is a supporter of intuitive eating, HAES, and is excited to work in the eating disorder space as a future dietitian. In her free time, you can find her eating french fries, snowboarding, and watching reality TV.
References
Orthorexia nervosa - national eating disorders. (n.d.). Retrieved February 2, 2023, from https://www.nationaleatingdisorders.org/
Anorexia nervosa. National Eating Disorders Association. (2018, February 28). Retrieved February 1, 2023, from https://www.nationaleatingdisorders.org/
Substance Abuse and Mental Health Services Administration. (2016). DSM-5 Changes: Implications for Child Serious Emotional Disturbance. Substance Abuse and Mental Health Services Administration (US).
Gramaglia, C., Brytek-Matera, A., Rogoza, R., & Zeppegno, P. (2017). Orthorexia and Anorexia Nervosa: Two Distinct Phenomena? A Cross-Cultural Comparison of Orthorexic Behaviors in Clinical and Non-clinical Samples. BMC Psychiatry, 17(1), 75. https://doi.org/10.1186/s12888-017-1241-2