If you understand what it means to be healthy, then you are also fully aware that being healthy starts with the correct diet. Most people choose healthier foods, organic ingredients, and avoid foods they might be sensitive to because they want to be healthier.

However, some can take this desire to become healthier too far. These people develop an eating disorder which stems from their need to eat healthier but eventually spirals into an obsession and turns into Orthorexia. This disorder can lead to serious physical complications and mental instability.

What is Orthorexia?

The term orthorexia nervosa was coined by American physician Dr. Steven Bratman in 1997. He suggested that some people who are susceptible can develop a condition which is determined by their need for healthy nutrition and paradoxically leads to serious unhealthy complications. These people who become extremely focused on regulating foods and cutting out what they deem as unhealthy develop anxiety, social isolation, and reduced importance in doing other healthy human activities. In some cases, the outcome of orthorexia can be severe malnutrition and even death.

Those who suffer from this eating disorder do not focus on losing weight most of the time. Their primary doctrine is only consuming foods which they have determined to be healthy and pure. This determination is based on their understanding of what healthy food is, and most of the time it is an extremely over exaggerate definition of a healthy diet.

Unlike other eating disorders, there is no focus on the quantity of food being eaten. Instead, the primary focus is on the quality of the food and the “healthy” benefits that the specific food offers. Those foods which are deemed unhealthy are avoided at all costs and even the sight of the forbidden food can cause discomfort.

At the given moment, the American Psychiatric Association does not recognize orthorexia as an official disorder. Likewise, this disorder is not listed in the Diagnostic and Statistical Manual of Mental Disorders. However, the awareness of orthorexia is quickly gaining ground.

What are the factors associated with Orthorexia development?

Since there has not been much research done regarding orthorexia, there isn’t much information regarding the development of this disorder. Speculations state that those with obsessive compulsive tendencies and those who suffer from or were formerly affected by other eating disorders are more susceptible to developing orthorexia.

Generally, orthorexia starts with a simple desire to be healthier and a decision to change one’s diet. Over time, this focus becomes extreme and develops into a strict determination to exclude certain foods from your diet. Food supplements can also play a big role amongst those who have developed this eating disorder, due to an attempt to gain that optimal healthy body.

Fear of disease or sickness is associated with the foods which are deemed unhealthy. Breaking the self-imposed strict dietary rules results in anxiety and shame. As time progresses, more severe restrictions surface, whole food groups are eliminated, and body detoxifications and cleanses start to occur more frequently. Fasting also becomes part of the disorder. Weight loss is a direct effect of this behavior but there is no desire for weight loss or it is less important than the idea of eating “healthy” foods.

Some research points to those who focus on their health due to career choices as more likely to develop orthorexia. Athletes, ballet dancers, actors, and healthcare workers are all at a higher risk of developing this disorder. There are many other factors which influence the chances of developing orthorexia nervosa but, due to lack of research, these factors have yet to be defined and confirmed.

How often do cases of Orthorexia surface?

In most situations, it can be very difficult to determine if a person is simply hard pressed on following their diet or if they are suffering from orthorexia. The main reason for this is the inability to assess properly whether the person is influenced negatively by their strict regimen on a social, physical, or mental scale. So properly diagnosing orthorexia cases can be nearly impossible.

Furthermore, since the disorder is not recognized by the American Psychiatric Association, there is no clear diagnostic criterion which has been universally set for determining if the patient is suffering from orthorexia nervosa.

The only time that enthusiastic healthy eating becomes orthorexia is when it starts to affect your daily life, either because of your mental state or physical state. A clear example of this would be severe weight loss or choosing to avoid going to restaurants or eateries with your friends because of fear and anxiety.

If all of these determining factors are applied to orthorexia, then the cases for its development are at about 1% of the population, which is at the same level of other eating disorders.

What is the best way to diagnose Orthorexia?

Dr. Thom Dunn of the University of Northern Colorado and Dr. Steven Bratman proposed a two-step criteria to determine the difference between healthy eating and orthorexia.

These criteria were published in the journal Eating Behaviors:

Criterion 1

Highly exaggerated emotional distress in relationship to food choice is clearly noted in the person suspected of having orthorexia. Weight loss is seen as a part of ideal health rather than the main goal.

This behavior can be evidenced by the following:

  • Compulsive behaviors or mental preoccupations with dietary choices believed to promote optimal health.
  • Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
  • Dietary restrictions escalate over time and may include the elimination of entire food groups and involve more frequent and/or severe “cleanses” regarded as purifying or detoxifying.

Criterion 2

The compulsive behavior and mental state become so severe that daily life becomes clinically impaired by any of the following:

  • Malnutrition, severe weight loss, or other medical complications from the restricted diet.
  • Intrapersonal distress or impairment of social, academic, or vocational functioning secondary to beliefs or behaviors about a healthy diet.
  • Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined “healthy” eating behavior.

Although there has been a questionnaire which was developed for the purpose of identifying those who suffer from orthorexia, Dunn and Bratman deemed the tool to be lacking in internal and external support.

What are some effects of Orthorexia?

There are three primary ways that a person who suffers from orthorexia can be affected: physically, psychologically, and socially.

During the early stages of orthorexia development, the effects are usually limited to being social and psychological. It is common to see individuals frustrated and uneasy when their diet-related habits are broken or disrupted. The person can develop the feeling of guilt and self-loathing if they break their own rules regarding healthy eating. Compulsive tendencies might develop to cleansing or fasting if the diet is disrupted. Excess time will usually be spent doing research or meticulously measuring the right amounts of food during meal planning.

All this mental focus on food and healthy eating also affects memory and the person’s ability to recall moments in the past. Tasks which require higher levels of concentration or multi-tasking become very difficult and nearly impossible.

In social situations, being forced to give up control over food types or dietary needs becomes an impossibility. Because of strict regimens, going out with friends to eat or spending time at a restaurant isn’t an option. Other social life aspects become impossible due to adverse reactions from even being around food which is deemed unhealthy. Sharing a living environment with another person is pretty much out of the question. More often than not, solitude and social isolation become the leading lifestyle choice of an individual with orthorexia.

Since there hasn’t been much research and very few studies conducted regarding orthorexia, the only physical complications which can be associated with this eating disorder are very similar to the physical issues which are caused by other eating disorders. Severe weight loss will cause lack of proper nutrients and minerals resulting in malnutrition. Slow heart rate and anemia are also a very high possibility. Development of digestive issues can occur, which can lead to an inability to absorb electrolytes properly. Hormonal imbalance can also occur, as well as metabolic issues.

All of these physical complications can become life threatening and have to be taken seriously. Although unlikely, death is a vivid possibility if these problems are not addressed in time.

Orthorexia Review – Final Words

Orthorexia is a serious eating disorder. It is slowly becoming recognized throughout the medical world and it can be treated as long as help is sought after. The first step to overcoming orthorexia is determining that you have a problem. We know this can be difficult, but it can be done.

Once this is identified, one should seek help from medical professionals. Your doctor, physician, and dietitian should be involved in your recovery. Different treatments can help overcome the behaviors associated with this disorder. Exposure and response prevention techniques can be adopted to help you overcome the uneasiness associated with the need to follow a strict “healthy” diet. Lastly, education about the correct nutritional values of different food types can also help dissolve false food practices.

This disorder can be dealt with and there are people who can help. The first step is to admit that you need help.