From the Guidelines
Orthorexia nervosa is an eating disorder characterized by an unhealthy obsession with eating foods considered "pure" or "healthy," which can lead to malnutrition, social isolation, and psychological distress. Unlike anorexia nervosa, which focuses on quantity of food, orthorexia centers on food quality and purity. People with orthorexia become fixated on food rules, spend excessive time researching and planning meals, experience anxiety when "clean" foods aren't available, and may eliminate entire food groups.
Key Characteristics of Orthorexia Nervosa
- Unhealthy obsession with eating "pure" or "healthy" foods
- Fixation on food rules and planning meals
- Anxiety when "clean" foods are not available
- Elimination of entire food groups
- Potential for malnutrition, social isolation, and psychological distress
Treatment Approach
Treatment typically involves cognitive behavioral therapy to address rigid thinking patterns, exposure therapy to reduce anxiety around "forbidden" foods, and nutritional counseling to establish balanced eating habits. A multidisciplinary approach including a therapist, dietitian, and physician is most effective 1. Recovery focuses on developing a flexible relationship with food, challenging perfectionistic thinking, and addressing underlying anxiety or obsessive tendencies. If you suspect orthorexia, seek help from healthcare professionals experienced with eating disorders, as early intervention improves outcomes. Some key recommendations from the American Psychiatric Association practice guideline for the treatment of patients with eating disorders include:
- A comprehensive review of systems and laboratory assessment, including a complete blood count and comprehensive metabolic panel 1
- An electrocardiogram for patients with restrictive eating disorders or severe purging behavior 1
- A documented, comprehensive, culturally appropriate, and person-centered treatment plan that incorporates medical, psychiatric, psychological, and nutritional expertise 1
- Individualized goals for weekly weight gain and target weight for patients with anorexia nervosa who require nutritional rehabilitation and weight restoration 1
- Eating disorder-focused psychotherapy, such as cognitive-behavioral therapy, for adults with anorexia nervosa or bulimia nervosa 1
From the Research
Definition and Characteristics of Orthorexia Nervosa
- Orthorexia nervosa is characterized by a pathological obsession with proper nutrition, restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure 2.
- It is often prompted by a desire to achieve optimum health, but may lead to nutritional deficiencies, medical complications, and poor quality of life 2.
- Orthorexia nervosa involves obsessive thoughts about healthy eating and distress related to this obsession, and is closely related to eating disorder behaviors 3.
Symptoms and Diagnosis
- Symptoms of orthorexia nervosa include rigidity and control around food choices, routines, and preparation, as well as moral judgments around food 4.
- The condition is often associated with negative psychosocial and physical impacts, including eating disorder symptomology, obsessive-compulsive symptoms, anxiety, and depression 5.
- Despite its distinct behavioral pattern, orthorexia nervosa is not yet formally recognized as a psychiatric disorder, and there is ongoing debate about its classification and diagnosis 2, 6.
Risk Factors and Influences
- The development of orthorexia nervosa is influenced by a range of factors, including individual characteristics such as health concerns, past trauma, and personality traits 4.
- External influences, such as parents, partners, and social media, can also contribute to the development of orthorexia nervosa 4.
- Societal factors, including aestheticism, moral citizenship, and the emphasis on individual responsibility for health, can also play a role in the development of orthorexia nervosa 4.
Treatment and Intervention
- Orthorexia nervosa can be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication 2.
- However, there is a need for further research on the effectiveness of different treatments and interventions for orthorexia nervosa, as well as the development of reliable and valid assessment tools 2, 5.