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Orthorexia

Meredith Hawk MS,RDN, LD


In a health obsessed culture it is easy to get carried away with the latest diet trends. Is it best to

be following paleo, vegan, or vegetarian diets? Should I do a weekly cleanse? Is food safe to

consume if it’s not GMO-free? It’s confusing, to say the least. The bigger question, can it all be

taken too far?



Orthorexia comes from the Greek words: (1) ortho, meaning correct or right and (2) orexia

meaning appetite or hunger (1,2,3). It is more simply put by Hanganu-Bresch, “a fixation on

eating proper food” (1). It is not officially recognized in the DSM-5 as an eating disorder, which

leaves it in the gray zone. Most research conducted has categorized it as having similarities to

both Anorexia Nervosa (AN) and Obsessive Compulsive Disorder (OCD) (2).


The current proposed diagnostic criteria for Orthorexia Nervosa (ON) include but are not

limited to (2):


  • Obsessive focus on healthy eating (a mental pre-occupation with foods consumed)

  • Violation of self-imposed dietary rules due to fear of disease; negative physical sensations that leave one feeling impure

  • Dietary restrictions that escalate over time leading an individual to eliminate entire food groups




One of the primary differences between people who suffer from AN versus ON is that

individuals with orthorexia perceive their dietary restrictions as health beneficial. There is no

actual desire to lose weight, however, these dietary practices can lead to physical

deconditioning such as weight loss, malnutrition and/or further medical complications. Not only

can it lead to physical deficiencies, but also to social deficiencies (2). People who suffer with

orthorexia may choose to avoid social interactions around food, which can take a toll on the

psyche.


While the research remains limited and unclear as to how to categorize orthorexia, there are

similarities in that regulation of emotions plays an integral role in the onset of the behavior (3).

It is best to seek a multi-disciplinary approach that includes a physician, psychotherapist and a

Registered Dietitian for treatment (2).



Social media is everywhere and it is so easy to follow the latest trend. While being “healthy” is a

positive thing, it is important to be aware that there can be a time where it is taken too far.

While more research is needed on Orthorexia, it appears it does serve a rightful place in today’s

culture with the influence of health blogs, Instagram accounts, etc. (1). A good rule of thumb is

listening to your body as it may be advising-you need additional nutrients to help sustain or

fulfill you. While social media certainly has its place and can be beneficial, we have to keep in

mind that most people giving the advice are not professionals. What may work for some will not necessarily work for others. Keep in mind, it’s always best to seek advice and guidance from a professional.



References


1. Hanganu-Bresch, C. (2020). Orthorexia: eating right in the context of healthism. Med Humanit,

46:311-322. <doi:10.11.1136/medhum-2019-011681>.


2. Scarff, J.S. (2017). Orthorexia Nervosa: An Obsession With Healthy Eating. Federal Practitioner,

36-39.


3. Vullier, L., Robertson, S. & Greville-Harris, M. (2020). Orthorexic tendencies are linked with

difficulties with emotion identification and regulation. Journal of Eating Disorders, 1-10.

<http://doi.org/10.1186/s40337-020-00291-7>.

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