Orthorexia Nervosa is an obsession with healthy eating and the purity or quality of food. The term was coined in 1998 and translates to “fixation on righteous eating.” Orthorexia is not recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it is becoming an increasingly widespread eating disorder. Being preoccupied by the nutritional quality of food and so-called “healthy eating” can be seriously damaging to one’s physical and mental health.

By: Nicole Guzman

In recent years, an emphasis on clean eating has been on the rise. Clean eating refers to choosing more whole foods and limiting consumption of processed foods with added sugar, fat, and preservatives. While being aware of the nutritional quality of food may not be a problem in and of itself, it can become damaging when someone becomes so fixated on it and tries to eat the “perfect” diet. Individuals with orthorexia become so rigid and extreme in this way of eating that it often leads to negative health outcomes, such as extreme weight loss, vitamin and mineral deficiencies, or malnutrition.

Signs and Symptoms

Orthorexia is easily overlooked, as eating healthy is usually considered an admirable goal. Typical warning signs and symptoms of orthorexia may include:

Cutting out entire food groups or being overly restrictive
Compulsive checking of ingredient or nutritional labels
An inability to eat anything but foods deemed “healthy”
Experiencing high levels of distress when “healthy” foods are not available
Feeling extreme guilt after eating “bad” foods
Going out less with family and friends in an effort to avoid “bad” foods
Devoting a lot of time planning meals or researching nutritional components of food
Judging other people’s eating habits
Orthorexia may also be accompanied by over-exercise

Health Complications

Health outcomes of orthorexia go beyond just physical complications. Aside from excess weight loss and malnutrition, orthorexia can disrupt daily functioning, negatively impact social activities, interfere with relationships, and cause extreme emotional distress.

Causes of Orthorexia

The underlying causes of orthorexia are complicated and multifaceted. On the surface, orthorexia is caused by the desire to better one’s health. However, eating only pure foods while restricting others may become a way to deal with other issues or emotions. Some of these include a fear of illness, a desire for control in other areas of life, perfectionism, or creating an identity. It is important to recognize that each person will require individualized care to determine and address the root causes.

Is it Orthorexia or Anorexia?

It is helpful to make the distinction between orthorexia and anorexia, as the two share many of the same signs, symptoms, and health complications. While restriction of food is characteristic of both orthorexia and anorexia, there are differences between the two. Orthorexia is characterized by an obsession with the quality of food, while anorexia is characterized by an obsession with the quantity of food. Individuals with orthorexia may restrict foods they consider to be “unhealthy,” while those with anorexia may restrict all foods, regardless of their nutritional quality. Additionally, those with orthorexia typically wear their diet as a badge of honor, while those with anorexia may feel ashamed and try to hide their eating habits. Orthorexia can be further characterized by a focus on how food will impact overall health, while anorexia is characterized by a focus on how food will impact body appearance and weight.

Treatment for Orthorexia

Treatment for orthorexia is similar to treatment for anorexia and obsessive-compulsive disorder. It typically involves psychotherapy to increase the variety of foods consumed and exposure to fear-foods or foods that are anxiety-producing. Weight restoration may also be warranted for some individuals with orthorexia. However, each case will be highly individualized and focus on the whole person.

Do You Think You or a Loved One Might Be Living With Orthorexia Nervosa?

At BALANCE eating disorder treatment center, we are dedicated to treating the spectrum of eating disorders, including orthorexia and other less-recognized disorders, anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We understand that each client is unique and requires a customized treatment program.

Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below or read more about our philosophy here.

This post was written by BALANCE intern, Nicole Guzman.

Nicole is a second-year graduate student at Hunter College pursuing her Masters in Nutrition and Dietetics. Nicole graduated from Fordham University where she received a Bachelor of Science in Psychology. After struggling with disordered eating behaviors, Nicole became passionate about sustainable wellness and debunking common nutrition myths. In the future, Nicole hopes to help individuals cultivate positive relationships with food, confidence, and wellbeing.

Resources

Orthorexia. (2017, February 26). National Eating Disorders Association. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

Orthorexia Nervosa—HelpGuide.org. (n.d.). Https://Www.Helpguide.Org. Retrieved September 28, 2020, from https://www.helpguide.org/articles/eating-disorders/orthorexia-nervosa.htm

The Difference Between Anorexia Nervosa and Orthorexia Nervosa. (2019, April 25). Center For Discovery. https://centerfordiscovery.com/blog/anorexia-nervosa-orthorexia-nervosa/

What is Orthorexia?