Orthorexia

Two faces - River Centre Clinic

Orthorexia Nervosa versus Anorexia Nervosa?

Anorexia nervosa is a well-known eating disorder that afflicts both women and men. The disease creates an extreme fear of weight gain in people who suffer from it. Symptoms include not eating, binge eating and purging, also known as bulimia. However, there is a lesser known eating disorder that shares similarities to anorexia, but is still different. This disorder is known as orthorexia nervosa and was first described in 1998.

Orthorexia means an obsession with proper or healthy eating. Having a concern with the nutritional quality of the food is a healthy behavior, but problems occur when this concern becomes excessive, damaging and disruptive. Individuals with orthorexia become so fixated on what they perceive as healthy eating that they actually damage their own physical and emotional well-being.

Is Orthorexia Nervosa the same as Anorexia Nervosa?

Many of the symptoms and behaviors surrounding orthorexia tend to overlap with anorexia. Yet, in cases of anorexia, people tend to focus more on severely restricting the quantity of food (calorie count). There is a clear and forceful desire to not gain weight. This, in turn, creates behavior that focuses on excessive exercising in order to lose unwanted weight. However, these are separate inflictions.

Since orthorexia is a newer diagnosis, it still possesses varying levels of acceptance among eating disorder treatment professionals. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. There are reports that signs of orthorexia are perhaps increasing due to the use of social media to popularize extreme diets and other food-related behavior. Other health professionals, believe that patients with orthorexia symptoms are actually suffering from anorexia nervosa. The symptoms for orthorexia and anorexia have similarities such as:

  • A desire to maintain control of life by severely controlling daily food consumption.
  • Seeking self-esteem and fulfillment through controlling food intake.
  • Citing undiagnosed food allergies as a rationale for avoiding food.
  • Co-occurring disorders such as OCD or obsessive-compulsive personality disorder.
  • Elaborate rituals about food that may result in social isolation

What Is Orthorexia Nervosa?

There are still very few studies on the Orthorexia, but theories suggest that it is based on anxiety and/or depression much like other eating disorders. It is for this reason that the occurrence of orthorexia is typically accompanied by other eating disorders such as anorexia, bulimia, or binge eating disorder (BED). Which means a person’s orthorexia can co-exist with a bulimia disorder. This means an individual could binge on seemingly healthy foods (vegetables) and then purge the food in order to get rid of the calories.

Unlike bulimia though, people with orthorexia can hide their disease by displaying their symptoms in plain sight. At initial glance, people suffering from orthorexia appear to be simply taking care of their physical body. Individuals with orthorexia may even talk about how they are about their eating habits. But, this healthiness is an illusion. There is a difference between conscious, healthy eating and having orthorexia nervosa. Orthorexia is similar to obsessive-compulsive disorder (OCD), in the fact that people must create rules and engage in specific rituals around food.

Some trendy or extreme diets can trigger behavior that resembles orthorexia. However, simply adopting an alternative diet, whether based on science or pseudoscience, does not mean someone has orthorexia. For example, some people adopt a trendy diet that restricts certain food groups: Vegan, gluten-free, Paleo diets, etc. The adoption of these diets does not automatically create an orthorexia diagnosis.

Orthorexia turns eating into a pathological activity that becomes entangled with obsessive thinking, compulsive and ritualistic behavior and self-punishment. Individuals with orthorexia often use a diet to achieve a feeling of perfection, purity or superiority. They may feel judgmental towards people who do not follow their perfect, healthful diet. This means they often spend excessive amounts of time planning and researching “pure” foods, which interferes with participation in normal social activities and interactions. These symptoms are what turns a trendy diet into orthorexia nervosa.

How are Orthorexia Nervosa and Anorexia Nervosa Different?

Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders. But this is not a symptom of orthorexia. Instead, the focus for people with orthorexia is an excessive obsession with the health implications of their dietary choices.

People with anorexia will severely restrict their food intake in order to lose weight. People with orthorexia, however, strive to feel pure, healthy and natural. The focus is on quality of foods consumed instead of the quantity. In the end, it is critical that people with eating disorder signs and symptoms seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia as well as other conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be diagnosed and treated by a psychiatrist.

There are definite similarities as well as differences between anorexia and orthorexia. Both of these eating disorders tend to provide a sense of control and stability around the consumption of food. Again, both eating disorders are dangerous mental illnesses that require professional treatment from a skilled clinician.

For additional information or questions about anorexia and orthorexia, please contact the experienced staff at River Centre Clinic (RCC). Their Eating Disorders Programs provide a full range of treatment options for both adolescents and adults. The clinic is located in a modern, spacious and tranquil setting in Sylvania, Ohio.

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow on Twitter:  @River_Centre

Orthorexia Nervosa, Anorexia Nervosa,

Contributor: ABCS RCM

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Social Media and Orthorexia

Social media’s pervasiveness throughout society is well-established. Individuals from a variety of backgrounds read and actively use some type of social media channel. The mass adoption of this new communication form is starting to generate questions and concerns. One of these questions ask as to whether the use of social media makes people more susceptible to developing an eating disorder? A new study suggests that specific social media channels might actually lead to unhealthy obsessions with healthy eating.

Incidents of depression have been linked to heavy social media use. For example, there is an increasing amount of evidence that connects the amount of time spent on Facebook with the occurrence of depression. Other studies have also suggested that the extensive use of social media by young adults has a negative impact on body image, depression, social comparison, and disordered eating. Beyond these negatives, social media sites that offer the newest superfood or latest diet fad may be just as damaging. Studies are beginning to see a correlation between disordered eating – particularly orthorexia, or an obsession with eating healthy foods that can lead to unhealthy consequences like nutrient deficiencies, social isolation and anxiety.

Although not formally recognized in the Diagnostic and Statistical Manual, awareness about orthorexia is on the rise. Being concerned with the nutritional quality of the food is not a problem and is actually a good habit to develop. However, individuals with orthorexia become so fixated on what is considered healthy eating that they actually start to damage their own well-being. Studies have shown that many individuals with orthorexia also have obsessive-compulsive disorder. High orthorexia nervosa prevalence has been found in populations who take an active interest in their health and body and is frequently comorbid with anorexia nervosa. In particular, there seems to be a link between Instagram users and signs of orthorexia symptoms.

In 2017, a study in Eating and Weight Disorders found that out of the population studied, 49 percent of people who followed health food accounts on Instagram had symptoms of orthorexia. By contrast, less than 1 percent of the general population has the “condition,” which, by the way, isn’t an official diagnosis or classified eating disorder. The correlation between Instagram users and the increased symptoms of orthorexia nervosa is surprising. Especially, due to the fact that higher Instagram use was associated with a greater tendency towards orthorexia, but no other social media channels had this effect. Additional analysis indicated that Twitter showed a small positive association with orthorexia symptoms. Other features such as Body mass index (BMI) and age had no association with orthorexia. As a reminder, the prevalence of orthorexia nervosa among the study population was 49 percent, which is substantially higher than the general population which is less than 1 percent.

Understandably, people use social media to discover healthy eating tips or to stay accountable to a fitness plan. But the pursuit of nutritious eating can become an unhealthy preoccupation. The pursuit of the perfect diet can lead to self-punishment and interfere with social activities. Eating disorders and disordered eating behaviors do not discriminate; they can affect women, men, girls and boys. For some people, especially women, healthy eating becomes practically synonymous with deprivation. This means that the typical warning signs for eating disorders, distressing thoughts, compulsive behaviors and self-created rules around food, often go unnoticed or are even praised. This is despite the fact that restrictive diets are sometimes precursors to clinical eating disorders. According to the National Eating Disorders Association (NEDA), food inflexibility can lead to guilt or self-loathing if a “bad” food is consumed, as well as anxiety about food planning and isolation from social events with food and drinks.

The signs of orthorexia include compulsively checking nutrition labels, an inability to eat any food that is not designated pure, obsessively following healthy lifestyle bloggers or social media figures, and showing an unusual interest in what kind of food others are eating. Naturally, people can read nutrition labels and follow fitness experts on Instagram without being orthorexic. But, when the action becomes compulsive and obsessive, this may indicate something beyond following a healthy food plan is occurring. Does the individual feel required to check labels, perhaps even multiple times, even though they have purchased this item in the past and already know the nutritional content? When eating food, does the person feel anxious about eating in general? These are perhaps symptoms of an eating disorder like orthorexia. If untreated, orthorexia can lead to anorexia nervosa, since eating disorders are rooted in compulsivity and obsession surrounding food. According to NEDA, orthorexia is characterized by being consumed with good vs. bad or healthy vs. unhealthy food, while anorexia is characterized by obsessive caloric restriction and weight loss.

Orthorexia is not yet officially recognized by the DSM-5. However, Healthcare practitioners skilled at recognizing eating disorders will know the signs of orthorexia and can connect patients with the appropriate therapists and medical doctors. Doctors and therapists who specialize in eating disorders and mental health, such as those at the River Centre Clinic (RCC) in Ohio, are aware of orthorexia’s prevalence and risks. For additional questions about this topic or other behavioral health issues – please contact us.

 

Eating Attitudes Test (EAT-26)

The EAT-26 is the most widely cited standardized self-report screening measure that may be able to help you determine if you have an eating disorder that needs professional attention. Take the EAT-26 now and get immediate and anonymous feedback.

Follow us on Twitter:  @River_Centre

 

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