About Orthorexia
Orthorexia, or orthorexia nervosa, is an eating disorder characterized by an unhealthy obsession with healthy eating. Unlike other eating disorders, such as anorexia nervosa or bulimia nervosa, orthorexia focuses more on the quality of food rather than on weight loss or body image. Individuals with orthorexia have a strong fixation on the purity and cleanliness of their food choices, as well as an obsession with the perceived benefits of healthy eating.
This disorder can lead to nutritional imbalances and deficiencies if taken to extreme levels. It is important to note that while orthorexia is recognized by the medical community, it is not officially classified as an eating disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Treatment for orthorexia typically involves nutritional counseling, psychotherapy, and addressing any underlying psychiatric disorders.
The exact disease mechanism and causes of orthorexia are unclear, but it appears to be linked to other eating disorders and mental health issues like anxiety and obsessive-compulsive disorder (OCD).
Non-modifiable risk factors cannot be changed or controlled. These include:
- Need for control: Some individuals are naturally inclined toward needing strict control over their environment, especially food.
- Orientation towards appearance: A strong focus on appearance that drives individuals toward unhealthy eating patterns
Modifiable risk factors for orthorexia can be influenced or changed and are connected to individual habits and lifestyle choices. These factors can also be influenced by culture and society. Some of these include:
- Imbalanced brain chemicals and mood disorders: Issues like chemical imbalances in the brain or mood disorders can affect emotional health and eating habits.
- Low self-esteem and perfectionism: Feeling inadequate or striving for unrealistic standards can drive obsessive behaviors.
- Emotional challenges and impulsivity: Difficulty managing emotions or acting impulsively may increase the risk.
- Distorted body image and troubled relationships: Negative self-perception or unhealthy relationships can contribute to obsessive focus on diet.
- Social media influence: Exposure to posts about health and body image can strongly affect some individuals.
- Profession: Jobs that emphasize body image or health, like athletes or dieticians, can make people more prone to orthorexia.
It's important to remember that these risk factors are not definitive causes of orthorexia and further research is needed to fully understand the condition. If you suspect you or someone you know may have orthorexia, it is important to seek help from a healthcare professional who can provide appropriate guidance and support.
The most common early symptoms of orthorexia include:
- Cutting down on certain foods to make the diet healthier
- Restricting major food groups
- Eating a limited number of foods considered "pure"
- Spending excessive time researching, acquiring, and preparing specific types of foods
- Avoiding restaurants or social gatherings due to the food on offer
- Having judgmental thoughts about others who do not eat "clean"
- Feeling guilt or blame for eating restricted foods
As orthorexia progresses or becomes more severe, additional symptoms may occur, such as:
- Obsessive thoughts about food that interfere with sleep, work, or school
- 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
- Feeling excessive concern about what food might be served at social events
- Experiencing stress when the right food is not available
- Connecting self-esteem to healthy foods
It's important to note that orthorexia symptoms are primarily focused on food quality rather than body image. If you suspect you or someone you know may have orthorexia, it's essential to seek professional help for diagnosis and treatment.
There is currently no official diagnostic tool for orthorexia, but healthcare professionals may use several assessments to help diagnose the condition. The most commonly used diagnostic tools include:
- ORTO-15: A 15-question screening tool that identifies symptoms and behaviors related to orthorexia. A score of 40 is the cutoff for diagnosis, although this tool has limitations.
- ORTO-R: A newer version of ORTO-15 that includes six relevant questions related to orthorexia symptoms and behaviors.
- Bratman Orthorexia Test (BOT): A 10-question screening tool based on obsessive thinking about food, beliefs about nutrition and health, restriction, and other factors.
- Eating Habits Questionnaire (EHQ): A 21-item questionnaire that measures knowledge, positive vs. negative feelings, and problematic behaviors related to healthy eating.
Orthorexia does not have officially recognized stages or severity levels. Instead, healthcare professionals may rely on clinical interviews and assessments using the previously mentioned diagnostic tools to evaluate the individual's symptoms and behaviors associated with orthorexia.
Remember, it is essential to consult with a healthcare professional who can provide personalized advice based on your specific situation.
The goals of treatment for orthorexia are to address the physical and psychological aspects of the disorder and promote a healthier relationship with food. Here are the recommended treatments and how they work to achieve these goals:
- Nutritional counseling: This involves working with a dietitian to correct nutritional deficiencies and develop a balanced eating plan. The goal is to provide education about proper nutrition and help individuals understand that not all foods they perceive as "impure" or unhealthy carry health risks.
- Psychotherapy: Cognitive-behavioral therapy (CBT) is commonly used to treat orthorexia. It helps individuals identify and challenge distorted thoughts and beliefs about food and health, promoting more flexible thinking patterns. Therapy can also address underlying anxiety and control issues, helping individuals develop healthier coping mechanisms.
- Medication: While there are no specific medications approved for orthorexia, in some cases, medication may be prescribed to manage co-occurring conditions such as anxiety or depression. However, it's important to note that individuals with orthorexia may reject medications s due to considering them unnatural substances.
- Therapeutic procedures: Exposure response prevention therapy, often used for treating obsessive-compulsive disorder (OCD), may be employed to help individuals gradually confront anxiety-provoking situations related to their eating behaviors. By participating in feared activities, such as eating anxiety-provoking foods, individuals can learn that the outcome is not as bad as feared, reducing avoidance behaviors.
- Health behavior changes: Encouraging individuals to adopt a more balanced approach to food and health is crucial. This includes promoting intuitive eating, which involves listening to one's body cues and honoring hunger and fullness signals rather than strict rules or restrictions.
It's important to note that treatment for orthorexia is often multidisciplinary, involving medical doctors, dietitians, counselors, psychologists, and possibly even hospitalization for severe cases. Each treatment approach aims to address different aspects of the disorder and support individuals in achieving a healthier relationship with food. Remember, it's essential to consult with healthcare professionals for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.