What is orthorexia Nervosa?

Orthorexia, also known as orthorexia nervosa, is a harmful obsession with healthy eating. Those with orthorexia are often preoccupied with the cleanliness and purity of the food in their diet. This term, coined by American physician Steven Bratman in 1996, means fixation on healthful consumption. Individuals with orthorexia often find themselves scrutinizing every element in their diet, severely limiting the kinds of food that they eat. This focus to eat “a perfectly healthy” diet can take a serious toll on the bodily and mental health of the person.

This is a kind of diet that aims to limit eating of processed foods and those that have high quantities of sugar, unhealthy body fat, and other preservatives. It also includes selecting entire foods in their most natural state. For example, sticking to a vegan, dairy-free, raw nutrition, gluten-free, etc. could all fall under efforts to eat healthfully. Though, orthorexia can grow out of any specific method consumption and can develop from a genuine place of wanting to be healthier.

What are the signs and symptoms of orthorexia nervosa?

Symptoms of this disease can be visible because it can make changes in the human body that can be easily identified. Like other eating disorders, many signs surround the individual’s concept and actions regarding food intake. Also similarly, there are emotional symptoms that might be difficult to see, but the individual certainly feels. Some examples of symptoms are as follows:

Ø  Fixation over the quality of food

This is really at the root of orthorexia. Individuals living with orthorexia are very attentive and compulsive over the type of their food they eat. People with this disorder often limit their nourishment to those that they deem “healthy”. The quantity of nourishment is characteristically less significant than that quality. Individuals might also compulsively follow food and healthy lifestyle blogs and social media accounts.

Ø  Uncompromising eating patterns

Somebody with orthorexia is often very rigid with their food intake. Whatever measured by the individual to be unhealthy or bad for the body will be avoided. They typically check all food labels and ingredient lists extensively, as well as develop an unusual interest in what other people eat. They might even become extremely critical about what their friends and family are eating, without having rationale for their opinions regarding what is or is not healthy. The research that they might find themselves diving about what food has what ingredients, etc. becomes all-consuming and an obsession.

Ø  Cutting out entire food groups

This surely expresses you how unbending these orthorexia-fuelled rule-based foods can become. Removal of entirefood groups is a common incidence for this population of people. For example, some groups of food could be processed foods, sugar, meat, carbohydrates, gluten and dairy products.

Ø  Anxiety  

There could be increased anxiety surrounding what food options might be available at an event. An individual with orthorexia would find themselves obsessed with thinking about their future food intake and become anxious and/or distressed if food they eat is not available to them. As a part of this, there could also be a fear of losing control. In other words, someone might feel that eating one piece of food that is not the quality they deem healthy could be disastrous.

Ø  Physical weakness

Those with orthorexia would likely find themselves feeling weak, tired, low energy, and/or cold consistently. The changes in diet and depending on what the individual continues eating can severely impact the body’s ability to maintain day to day activities. In fact, it can also impact the body’s ability to fight off sickness and these individuals might find themselves taking a long time to recover from illness.

Ø  Loss of weight

Though weight is not essentially a clinical indicator of orthorexia, some cases do include weight loss. An orthorexia diet is an unstable diet that often results in undernourishment. While someone with orthorexia may sense as though removing certain foods will bring positive body goals, they are frequently doing quite the opposite by depleting their own nourishment in decreasing food variety. Intentional weight loss and body image concerns may play a role in orthorexia, but not necessarily.

Treatment

There is no treatment created specifically for orthorexia, but it is typically treated as other eating disorders and obsessive compulsive disorders are. Commonly, it is treated with psychotherapy and/or medication. Following are the most effective treatments of orthorexia given:

  1. Acceptance and Commitment Therapy (ACT)

The goal of Acceptance and Commitment Therapy is to focus on changing actions rather than thoughts and emotions. ACT also encourages clients to distance themselves from their feelings and learn that pain and anxiety are a normal part of life. The goal is not to feel good, but to live an authentic life.

  1. Cognitive Behavioral Therapy (CBT)

A kind of psychotherapy known as cognitive behavioral therapy is particularly valuable for treating Obsessive Compulsive Disorder and eating disorders because it aims to modify distorted beliefs and attitudes. In regards to eating disorders, it can target the meaning of food intake, weight, and appearance, all of which are correlated to the progression of the eating disorder.

  1. Cognitive Remediation Therapy (CRT)

Cognitive Remediation Therapy aims to develop an individual’s ability to focus on more than one thing. For example, when working with a client with orthorexia, encouraging the client to think beyond the integrity of the food. CRT targets rigid thinking processes, which is considered a core component of many eating disorders through simple exercises, reflection, and guided supervision. 

  1. Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy is used often in treatment of Borderline Personality Disorder and Obsessive Compulsive Disorder. Dialectical Behavioral Therapy combines behavioral, reasoning, and contemplative skills to support an individual in their healing process. The skills also have an emphasis on mindfulness, interpersonal relationships, emotion regulation, and distress tolerance.

  1. Family-Based Treatment (FBT)

Also known as the Maudsley Method or Maudsley Approach, Family-Based Treatment is a home-based treatment approach that has been shown to be effective for adolescents, specifically, with eating disorders. FBT doesn’t focus on the cause of the eating disorder, but instead focuses on refeeding and full weight restoration to promote recovery from the beginning. All family members are considered an essential part of the treatment, which consists of re-establishing healthy eating, restoring weight, and interrupting compensatory behaviors, thus returning control of eating back to the adolescent.

  1. Interpersonal Psychotherapy (IPT)

Interpersonal psychotherapy is an evidence-based treatment for eating disorders as it contextualizes eating disorder symptoms as occurring and being maintained within a social and interpersonal context. IPT is associated with specific tasks and strategies linked to the resolution of a specified problem area. IPT can help clients improve relationships and communication, as well as resolve interpersonal issues in the identified problem area(s). With all of those areas addressed, there is typically a reduction of eating disorder symptoms

  1. Medication

Doctors also may recommend medicines to treat orthorexia. The most generally given medications for orthorexia are antianxiety and antidepressant medications. If given medication, psychotherapy is still strongly suggested.

  1. Developing a healthier relationship with food

With so much information on diet and food out there, it can be tough to differentiate the good from the bad. Normally, we all want a balance of protein, carbohydrates, fiber, fats, vitamins, and natural resources to give us the best energy and fitness. In aiming for the ideal, look to comprise some of each food group in every meal. Swapping processed foods with fresh constitutes when possible is a decent place to start. Likewise, homebased cooking rather than take-out is also helpful in keeping a well balanced diet. Emphasis should always be caring for yourself.

Following table helps us to understand the differences between healthy eating and orthorexia.

Healthy EatingOrthorexia
1.     You do your finest to make nutritious diet selections most of the time, but make exceptions when you want to.1.     You stick strictly to your food and may waste food or become nervous if you do not have access to the food that meets your stipulations.
2.     You cut out certain foods for health reasons or when you physically feel healthier when you avoid them.2.     You cut out some nourishments or even entire food groups because you view them as impure or not good for your health.
3.     Your uniqueness is founded on numerous interests, groups, work, and hobbies.3.     Your identity is based mainly on the cleanliness and excellence of your diet.

Frequently Asked Questions

  1. What does orthorexia do to your body?

Orthorexia can cause one’s body to develop malnutrition and medical complications. Similar to other eating disorders, some possible conditions are heart disease, problems with cognition, lowered immune system, nutritional deficiencies, osteoporosis, kidney failure, and infertility.

  1. How does orthorexia start?

It can often begin as a desire to eat healthier to improve health. Orthorexia is manifested when the desire to eat healthy becomes an obsession. 

  1. Can orthorexia kill you?

Orthorexia can lead to malnutrition if the individual cuts out entire food groups. Malnutrition can lead to many other complications and can be fatal.

  1. Are vegans orthorexic?

Vegans are not orthorexic, though individuals who follow vegan diets could become orthorexic. Orthorexia is an extreme obsession with healthy eating, whereas veganism is a specific set of guidelines for one’s diet.

  1. How prevalent is orthorexia nervosa?

There is limited research on orthorexia nervosa, but the few studies that have been conducted suggest that 1%-7% of the general population. Like other eating disorders, research suggests that more women than men are affected by orthorexia. 

For more information, check out these recommended readings:

Orthorexia: When Healthy Eating Goes Bad

This book compassionately and expertly explains to the reader how to recognise potential issues, break free from the condition, and discover how to get back to a balanced, truly healthy way of eating and overall enjoying life again.

Health Food Junkies: Orthorexia Nervosa – the Health Food Eating Disorder

Health Food Junkies is the first book to identify orthorexia nervosa. Being a newly identified eating disorder, orthorexia nervosa there is not much information on the disorder in the world. This book offers detailed, practical advice on how to cope with and overcome it. 

Beating Orthorexia and the Memoirs of Health Freak: Take Back the control of your life which your obsession with health took away 

In Beating Orthorexia, the author shares his experiences and thoughts about what it means to be Orthorexic, how it can impact your life, and practical suggestions about how to alter your fundamental views about health and food around in order to overcome this condition in an incredibly honest and open way. 

REFERENCES

Help and Treatment, Beat Eating Disorders

Orthorexia, National Eating Disorder AssociationOrthorexia Nervosa: Signs and Treatment, WebMD

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