Orthorexia refers to obsessive thoughts and behaviors regarding eating healthful or “clean” food.
While the Diagnostic
and Statistical Manual of Mental Disorders
(DSM-5) does not classify orthorexia as a separate eating
disorder, such as anorexia nervosa, some argue that it is a subtype of
avoidant/restrictive food intake disorder (ARFID).
A person with orthorexia may follow a strict diet comprising
only “clean” or “pure” foods, such as organically grown fruits and vegetables.
The obsession with clean eating can be all-consuming for the individual.
These strict rules for eating can lead to social isolation,
malnutrition, and mental distress.
Continue reading to learn more about orthorexia, including the
warning signs, treatment options, and how to cope.
What is it?
Currently, doctors do not recognize orthorexia as a
specific disorder, but some consider it to be a form of ARFID. Others argue
that it shares similarities with anorexia nervosa.
However, although orthorexia may lead to anorexia, there are subtle
differences between the two.
A person with anorexia typically focuses on the number of
calories in foods, while someone with orthorexia focuses on the quality or
purity of foods.
Orthorexia can result in people severely restricting the foods
that they allow themselves to eat.
Examples of restricted foods and ingredients may include:
- nonorganic
foods
- foods
containing artificial colors, flavors, or preservatives
- all
refined sugar
- any
processed or packaged foods
- high
carb foods
- meat
and other animal products
- food
that anyone other than themselves has prepared
Research on orthorexia is limited, and, as the condition is not
a standalone diagnosis, it is difficult for researchers to determine how many
people it affects.
Data from a small 2017 study of college students suggest that
the prevalence of orthorexia is less than 1% overall, although it may
be higher in healthcare professionals and performance artists.
However, other research in students in Europe has found that 17% of
people may be at risk of orthorexia.
It is important to note that many people avoid certain food
groups for other reasons.
For example, vegetarians and vegans may avoid animal products
for ethical reasons, and people with celiac disease or a gluten intolerance
avoid foods that contain gluten to prevent health issues. People with certain
religious beliefs may also abstain from particular foods, such as pork or beef.
The difference between regular dietary restrictions and
orthorexia is that the latter has a mental health impact because a person may
have intrusive thoughts about their eating habits.
Signs and symptoms
Orthorexia tends to start with a person cutting down on foods
such as red meat or processed products to make their diet more healthful.
The individual may continue to restrict their diet by cutting
out major food groups.
Eventually, they end up eating a limited number of
foods that they consider pure. The healthful eating practice soon becomes the
center of a person’s life.
Signs and symptoms of orthorexia include:
- spending
more than 3 hours a day researching, acquiring, and preparing
specific types of foods (not in relation to a job)
- avoiding
restaurants or social gatherings because of the food on offer
- having
judgmental thoughts about others who do not eat “clean”
- blaming
unhealthful eating for physical or mental illnesses
- experiencing
feelings of guilt after eating restricted foods
- feeling
that adherence to food restrictions determines self-worth
- having
obsessive thoughts about food that interfere with sleep, work, or school
- having
problems with relationships, as food becomes the primary source of
happiness and meaning
- using
frequent cleanses or fasts to “detox”
- experiencing malnutrition and
weight loss
The exact cause of orthorexia is unknown. The widespread
focus on healthful eating trends across social media could have
contributed to the development of orthorexia in some individuals.
Many other factors increase a person’s chances of developing
orthorexia or an eating disorder.
These include:
- an
imbalance in brain chemicals
- low
interest in eating, or being a picky eater
- low
self-esteem
- strong
need for structure
- perfectionism
- difficulty
controlling emotions
- impulsive
behavior
- troubled
relationships
- altered
body image
- mood
disorders
Diagnosis
Experts do not recognize orthorexia nervosa as an official
psychiatric diagnosis, although some consider it to fall under the ARFID
classification.
Orthorexia has features similar to those of obsessive-compulsive
disorder (OCD), anxiety, and anorexia, so others may consider it
a subset of these mental health disorders.
A doctor, therapist, or dietitian can diagnose an eating
disorder by interviewing a person and reviewing their symptoms and eating
habits.
A doctor may follow up with a routine physical exam and blood
work to check for nutritional deficiencies and other complications.
Treatment
The treatment for orthorexia is similar to the treatment for
other eating disorders.
It involves some form of therapy to address both the eating
disorder and any underlying mental health conditions, such as depression and
anxiety disorders.
Types of therapy that a doctor may recommend include:
Cognitive behavioral therapy (CBT)
CBT helps a person recognize that their thoughts and
beliefs directly affect their emotions and behaviors.
By challenging and changing their negative thinking about food
and self-esteem, CBT can help people with orthorexia.
Dialectical behavioral therapy (DBT)
DBT combines behavioral and cognitive therapy with some
form of meditation.
The idea behind DBT is to help individuals come to terms with
their uncomfortable thoughts, feelings, and behaviors instead of avoiding them.
Nutritional counseling
Treatment for orthorexia should include education on the
different nutrients that a person needs in their diet to maintain good health.
A registered dietitian can help with this part of a person’s treatment plan.
Medication
A doctor may prescribe an anti-anxiety or
antidepressant medication if the individual has an untreated underlying mental
health disorder.
Correcting nutritional deficiencies
Individuals with orthorexia may be deficient in multiple
vitamins and minerals, such as vitamin D, calcium, folate, and B vitamins.
Replacement of these and other nutrients is an important part of treatment.
Hospitalization may be necessary if a person is significantly
underweight or malnourished.
Source: Medical News Today
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