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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.

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Orthorexia Nervosa, Anorexia Nervosa,

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Six Tips to Prevent Relapse

A residential treatment program can become a safe space for many patients. It may feel scary going back to your home, job, or school. While in treatment, you have invested time working on your recovery and hopefully whatever environment you are returning to can foster a pro-recovery environment. Despite the environment, many patients have a few slips during the recovery process post-treatment. River Centre Clinic’s hope is that you have learned strategies to prevent those slips from becoming a relapse. These five tips are not all-inclusive, but they are some of the best strategies to ensure recovery.

Meal plan.

While in treatment you have learned how to meal plan and it most likely began to feel like a normal process towards the end of your stay. However, directly after treatment, meal planning may feel inflexible. It may be tempting to not follow your plan precisely or to completely stop planning. Rest assured that you will not have to meal plan forever to maintain your recovery. While the timeline differs for each individual as to when they can stop meal planning, patients who stick to their meal plan as ordered are less likely to relapse. Be open and honest with your outpatient therapist regarding your concerns with meal planning and create a strategy that works for both of you.

Connect with your outpatient treatment team regularly.

Before you leave residential treatment, you will have hopefully connected with an outpatient therapist and set up your first appointment post-treatment. Talk to your therapist to determine who else you should connect with to create a team of health professionals that advocate for your recovery. Often a team including a therapist, dietitian and primary care physician, all skilled in treating eating disorders, are highly beneficial for post-treatment care.

Utilize your team.

Connecting with a team of skilled health care professionals post-treatment is a vital part of recovery. Just as important, is connecting with a team of friends and family. Your tribe should include people that you feel comfortable talking to about your eating disorder, meal plan and urges. Take time to talk to these special individuals about the type of support you need. Ask your therapist if you can schedule a designated appointment for your tribe to help them understand your recovery
process and how they can help.

Define one self-care ritual and stick to it!

Stress is inevitable and it can make recovery more difficult. But you can combat stress by taking care of yourself and incorporating self-care into your daily routine. Self-care can look different depending on the individual. Do you enjoy reading, a nice hot bath, journaling, listening to music, meditation? These types of activities can be incorporated into your routine to help manage stress.

Know the difference between a slip and relapse.

A slip usually happens suddenly and may take you by surprise. Maybe you were having a particularly busy day and realized at 4:00 p.m. that you missed your afternoon snack. If you’re able to get right back to your planned meals and squeeze in the missed calories, consider that a slip. While a slip is still a setback, it’s much more minor than relapse. Relapse is when a slip turns into consistent eating disorder behaviors. To prevent this from happening, acknowledge a slip if it occurs. Call someone in your tribe or your therapist, if you are able to, so that they can help prevent guilt and shame that you may feel from your slip. These feelings will only exacerbate the problem. Focus on the progress you have made and brainstorm
solutions to prevent a future slip.

Make your own stoplight list.

How will you know when you are falling back into old eating disordered habits? By creating a personalized red, yellow and green flag list with the help of your therapist, you will have a written set of guidelines which will help you to recognize when you need to reach out for assistance. Look specifically at your own personal relapse cues and recovery behaviors and create a comprehensive list. Being sure to identify high-risk indicators that you are doing poorly (red flags), warning signs that you are slipping back into old habits (yellow flags), and signs that you are living a recovered lifestyle (green flags) is integral to keeping on track. Be sure to include both physical and emotional indicators of each.

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