Orthorexia nervosa (orthorexia) is characterized by an individual’s obsession to eat only foods they believe to be healthy and pure. People with orthorexia also tend to be hyper-focused on food preparation, and often exhibit rigid eating patterns. The National Eating Disorder Association (NEDA) states, “people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.” In 1997, American physician Steven Bratman, M.D. named the obsessive behavior “orthorexia,” which translates to “correct diet.”
While the Diagnostic and Statistical Manual (DSM), used by clinicians and psychiatrists to diagnose psychiatric illnesses, does not yet recognize orthorexia as a diagnosable eating disorder, many physicians agree that it can be a serious medical condition. Whenever people strictly limit the variety or amount of food they eat, they run the risk of consuming insufficient nutrients or calories, which can lead to malnutrition and other health problems. Even though the DSM does not contain any diagnostic criteria for orthorexia, doctors are still diagnosing the condition as it has become increasingly common.
Signs and symptoms of orthorexia
While a healthy diet is rich in lean proteins, healthy fats, complex carbohydrates, and vegetables, those with orthorexia take their dietary choices to an extreme. Their strict eating requirements may exclude certain foods and food groups they feel to be unhealthy or impure, including fats, sugar, salt, food dyes, pesticides, preservatives, hormones, antibiotics, animal products including dairy, and genetically modified foods. Those with orthorexia commonly display ritualized patterns of eating.
Signs that an individual may be suffering from orthorexia include:
- Severely restricting what they’ll eat, often eliminating entire food groups from their diet
- Spending abnormal amount of time checking labels and ingredients and planning meals
- Claiming food allergies to certain foods or food groups, although allergy was not diagnosed
- Abnormal concern about effects of foods on body and health
- Taking wide variety of vitamins, herbs and probiotics
- Fear of eating out or eating any food prepared by others due to concerns about food purity, food preparation and food handling practices
- Feeling disgusted with themselves if they eat any “unhealthy” food
- Social isolation, as they don’t want to eat with anyone who doesn’t share their beliefs
Many of those with orthorexia also suffer from co-occurring mental disorders. According to NEDA, “Anxiety, depression, and obsessive-compulsive disorder (OCD) are just a few additional mental health diagnoses that frequently co-occur with eating disorders.”
If you think you may be suffering from orthorexia, take the self-test written and authorized by Dr. Bratman.
Is orthorexia similar to anorexia?
A study published by the National Institutes of Health (NIH), The clinical basis of orthorexia nervosa: emerging perspectives states, “An examination of diagnostic boundaries reveals important points of symptom overlap between orthorexia and anorexia nervosa, obsessive-compulsive disorder (OCD), obsessive-compulsive personality disorder (OCPD), somatic symptom disorder, illness anxiety disorder, and psychotic spectrum disorders.”
Those with anorexia and orthorexia both exhibit disturbed eating patterns and an unhealthy obsession with food. While those with anorexia are more focused on the quantity of food, those with orthorexia are obsessed with the quality and purity of the food. People with these eating disorders often exhibit similar personality traits, including low self-esteem, poor body image, rigid thinking, a need to feel in control and perfectionism.
Even though the food obsession and motivation are different for those with orthorexia versus anorexia, the result is often the same: malnutrition caused by severe food restriction. Health consequences can include bone loss, anemia, dangerously slow heart rate, and metabolic acidosis. As with anorexia, orthorexia can have life-threatening implications. For more in-depth information on how orthorexia and other eating disorders affect the various body systems, visit the NEDA website.
While there are many similarities between orthorexia and anorexia, there are also significant differences. As stated in the earlier study, “the most significant difference between orthorexia and anorexia is the motivation for disordered eating. In anorexia, individuals are preoccupied with body image and fear of obesity, altering their eating patterns in order to lose weight. In orthorexia, individuals adopt eating habits given a desire to be healthy, natural or pure, entertaining unrealistic, if not magical, beliefs about certain foods.” The study also notes that while those with anorexia often hide their behavior from others, those with orthorexia may flaunt or brag about their “healthy” behavior.
Orthorexia and OCD
To date, there is no definitive answer as to whether orthorexia is a form of anorexia, obsessive-compulsive disorder or a stand-alone eating disorder. According to NEDA, “studies have shown that many individuals with orthorexia also have obsessive-compulsive disorder.”
Regardless of the label, the behavior is compulsive and extreme, and can dangerously affect an individual’s health. It is important that individuals with symptoms of orthorexia, or any eating disorder, receive professional treatment. Early intervention has the highest success rate and can prevent dangerous health consequences. It is important to recognize and treat any co-occurring disorders simultaneously.
Turning Point of Tampa
At Turning Point of Tampa, we are committed to treating the individual as a whole. This includes understanding the impact of co-occurring disorders and how they are interconnected with eating disorders.
In 1989, we developed our nationally recognized Eating Disorders/Food Addiction Program. This comprehensive program uses a 12-Step based treatment approach to focus on and treat food as an addiction.
At Turning Point of Tampa, our food addiction treatment plan includes:
- Individualized food plans
- Individual and group counseling
- Body image groups
- Meal planning, food shopping, and meal preparation
- Nutritional education
- Balanced exercise
- Development of assertive communication skills
We provide a safe food environment where meals are planned ahead, prepared by the client, and weighed and measured. Meals are eaten together and monitored by staff for added support. At Turning Point of Tampa, clients live with their food, which strengthens the development of daily behaviors and life skills needed to maintain recovery.
Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups. We have been offering Licensed Residential Treatment for Substance Abuse, Eating Disorders and Dual Diagnosis in Tampa since 1987.
