Orthorexia Nervosa – how different is it from healthy eating?

We have been observing more and more focus on health and healthy eating over recent years. Many ‘health-promoting’ diets have been increasing in popularity and we have been paying more attention to a perfect, fit look. As a result, we became increasingly preoccupied with our diets and exercise regimens. Some of us went too far. They were preoccupied to such an extent that obsessing about diet and fitness started to affect all other areas of their lives. But how far is too far?


What is orthorexia?

The term orthorexia nervosa refers to an obsession with healthy or pure eating. It includes symptoms of obsessive behaviour in pursuit of a healthy diet. In oppose to anorexia or bulimia, a person with orthorexia will be obsessing about defining and maintaining the perfect diet, rather than a perfect weight. People suffering from orthorexia often show symptoms of anxiety disorders and have obsessive-compulsive disorder.

Commitment and following of a healthy diet only become a disorder when it starts to negatively affect the social, physical and psychological aspects of our lives.


What are the symptoms of orthorexia?

  • Compulsive checking of food labels and concern about the health of certain food ingredients
  • Spending numerous hours every day thinking about food and planning meals and shopping in advance
  • Thinking about what food might be served at upcoming events
  • Obsessive concern over the effect that certain food has on health
  • Narrowing our diet only to foods that we perceive as healthy or pure
  • Cutting out numerous ingredients (sugar, fat, salt) and whole-food groups (meat, dairy, animal products, carbohydrates)
  • Avoiding additives such as artificial colours, flavours, preservatives, or pesticides
  • Significant increase in the consumption of supplements
  • Increased interest in other people’s food choices, experiencing critical thoughts about others who do not follow rigorous diets
  • Showing high levels of distress when healthy foods are not available
  • Giving up the food that we used to enjoy in order to eat the ‘right’ foods
  • Feeling at peace with yourself, confident and in control when eating healthily
  • Feeling guilty when breaking the rules of healthy eating
  • Avoiding eating food bought or prepared by others or withdrawing from friends and family who do not have similar views about food
  • Worsening depression, mood swings or anxiety

What can happen if you are orthorexic?

Because people suffering from orthorexia restrict the amount and variety of foods they eat, their risk of malnutrition and anaemia can increase. Consuming fewer calories than you need may lead to your body breaking down its own tissue to obtain energy. Oftentimes this breakdown affects muscles first, including the heart, and increasing the risk of heart failure. Less severe energy deficit can result at least in fatigue and weakness.

Other consequences include symptoms from the digestive system such as slowed digestion or constipation. These may also include stomach pain and bloating, nausea, vomiting and blood sugar imbalance.

Some neurological problems can also be observed. Reduced intake may mean that our brain does not get enough calories to function properly.

We can also experience problems with sleep, muscle cramps or even seizures due to deficiencies in nutrients such as potassium, sodium, chloride, and calcium as well as dehydration and electrolyte imbalance.

Additionally, reduced fat intake can disturb the production of certain hormones and mineral deficiencies can affect our bone health.

Orthorexia has also social and psychological consequences. It can lead to withdrawal from social life, decreased quality of life, or lead to anxiety and depression.


When does healthy eating turns into obsession?

Obsession with clean food can develop and affect other activities and interests, relationships and impair health. When this happens, we can view orthorexia as one of the eating disorders.

The exact causes of orthorexia are not entirely known but research shows that obsessive-compulsive tendencies and previous or current eating disorders may be risk factors. The risk may also increase in people with the inclination to perfectionism or anxiety. Further, people who are preoccupied with health and appearance in view of their career, such as athletes, dancers, public figures, may be at a higher risk of developing orthorexia.


How can you treat orthorexia?

There are currently no clinical treatments designed specifically to manage orthorexia. However, as it can be perceived as one of the eating disorders, treatment is usually similar and involves psychotherapy. This should be helpful in, not only recognising the problem but also in releasing some of the dietary restrictions, increasing the variety of foods as well as managing anxiety. Therapies can also support weight restoration as needed.

In conclusion, orthorexia is a serious condition that can affect physical, social and psychological wellbeing and the general quality of life. However, when recognised and properly diagnosed by a healthcare professional, it can be managed and alleviated through appropriate therapies.


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