Orthorexia Nervosa – An obsession with healthy eating

“Orthorexia” is a term to denote an excessive obsession over healthy eating. Who would have thought that eating healthy could be a disorder too? Well, to be precise, “eating a healthy diet” is perfectly normal, but an obsession with ensuring that it is “healthy” or “of good quality” or “pure and unadulterated” – is not. 

We are familiar with other eating disorders such as “anorexia” and “bulimia,” which result from under-eating and over-eating, respectively. These are associated with the “quantity” of food eaten. But unlike them, “orthorexia” is a fixation with the “quality” of food eaten (‘ortho’ comes from the Greek word meaning “right”).

Orthorexia Nervosa – Who is impacted the most?

Like other eating disorders, Orthorexia affects about 1-2% of the population. It is worth taking a note here that there is a greater part of the community (mostly in the economically advanced section of the populace) who are ‘concerned’ about what they eat, how much of it is good for the body, is it nutritious, does it comprise a balanced diet, is the food organically prepared, etc. But these “concerns” stem from general awareness and positivity about one’s own health. 

However, in the case of Orthorexia, it is not merely a “concern” but an obsessive compulsion that negatively affects and disturbs the social, physiological, and mental equilibrium of a person. It is not easy to determine who is impacted more or less as compared to others. The American Psychiatric Association hasn’t declared “orthorexia” as a disorder yet, ever since the term was coined by American physician Steven Bratman in the year 1997.

It has been seen that those who are already exposed to or have been focussed on healthy eating are more susceptible to ‘developing’ Orthorexia as compared to others who are less focussed. Thus, career and lifestyle play a big role in the development of this condition.

Health workers, those involved in the entertainment business, fitness freaks, and even sportspersons, are more prone to developing “orthorexia Nervosa.” But it would be incorrect to say that anyone else, other than the above, cannot develop this.

What causes Orthorexia?

There is only one thing that causes “Orthorexia” – an obsessive desire to eat healthy. However, with advancement and awareness of science and nutrition, many people have this desire… When in the supermarket or grocery store, more and more people are seen reading the labels to determine whether the ingredients are safe for consumption, the Nutri score, the date of packaging. In addition to this, people are also concerned about things such as – the percentage of fat, the usage of preservatives, the residue of pesticides, and even the country of origin.

Are all these people going to develop “orthorexia”? 

The answer is No. Although full-blown research is yet to be carried out to determine which age, gender, socio-economic status, educational background, geographic distribution are more prone to this disorder, it is often seen that people with certain pre-existing attributes along with mental disposition are more susceptible. Such as those with a need for control, need for perfection, or with higher anxiety levels. 

Also, most people who develop “orthorexia Nervosa” have been found to have been already suffering from obsessive compulsions (as in OCDs or other eating disorders. As already mentioned, those in careers where there is a necessity to maintain a good image of one’s looks, are more vulnerable than others to develop the fetish into a fixation.

The four symptoms of Orthorexia

It is a thin line that can differentiate a preoccupation from an obsession. 

1/4. An excessive fear or anxiety caused due to the slightest deviation from any self-imposed restrictions on food. Visible distress during any such violation. 

2/4. A gradual increase in the number of restrictions about food, which eventually results in the complete elimination of food categories. “Fasting” and other forms of abstaining with the motive of detoxification or purification.

3/4. Malnutrition or rapid loss of body weight even though the dietary restrictions are not about weight loss.

4/4. Social life gets impaired due to distancing one’s self from others who do not comply with the same beliefs about “purity” or “toxicity” of particular food items.

It is clinically very difficult to identify these symptoms as the disorder manifests itself in these behavioural changes only. However, eventually, the behavioural modifications start to reflect in physical aspects as well.

Any treatment for this obsession with healthy eating?

There is no specific treatment available for Orthorexia. However, it is often diagnosed and treated as a type of anorexia or OCD. Psychotherapy is the first procedure towards treating the ‘anxiety’ or ‘distress,’ followed by dietary corrections through diet experts. In most cases of Orthorexia Nervosa, a weight correction method is also required to replenish the lost body weight and nutrition.

Mindful awareness guidance, aided by a mindfulness expert, can help people who are still not too deep into this disorder.

Self-detection for those suffering from Orthorexia Nervosa

Given that, Orthorexia does not cause any immediate response in the body, it may go unnoticed for a long time, until one of the physical symptoms may start to show up. And in that situation, the disorder is often too advanced for the sufferer to consciously seek medical help. 

However, those who feel a certain amount of restlessness or distress related to the quality of food they intake can subject themselves to this basic questionnaire and find out if they need to “stop” before it’s too late. 

1. Are you continuously and uncontrollably checking the ingredient list before buying any product off the shelves?

2. Do you find yourself in a situation where a knowing but unavoidable dispensation from your choice of food causes a level of stress for you?

3. Do you continually worry about the health of others and how the food they eat may directly be responsible for their health?

4. Do you eat only because it is “healthy” to do so and not because you “enjoy” or that you are “hungry”?

5. Are you a voracious reader of literature available on the internet about health benefits or negative impact of food and compulsively subscribe to any channel on YouTube that promises to enhance the quality of your diet?

6. Do you compulsively want to shame others for their food choices and the consequences on their health?

If more than three of the questions are “yes” for you, you may be running a risk of developing orthorexia nervosa later in your life if not already present. Consider taking medical help or talk to a health practitioner about your concerns.

The disorder, excessive obsession over health eating, develops gradually, and unlike anorexia nervosa, Orthorexia can affect both genders equally. Besides the medical intervention, regular sessions of mindfulness self talk, guided by a mindfulness guide, can work wonders in curing oneself off Orthorexia.