Orthorexia nervosa is a term coined by Dr. Steven Bratman from the Greek orthos, meaning “correct or right” and orexia, meaning “appetite.” Dr. Bratman uses the term to describe an eating disorder in which a person is obsessed with “eating right,” for instance, obsessed with “health foods.” While this diagnosis is not listed in the DSM-IV (the Diagnostic and Statistical Manual used by mental health practitioners to diagnosis mental health problems), it is becoming an accepted diagnosis in the mental health community.
A person with orthorexia nervosa is obsessed with what they believe is healthy eating. They may take a healthy diet to extremes. For instance, someone with orthorexia may begin following the Atkins diet, which restricts carbohydrates. They may then cut all carbs from their diet. While a diet of limited carbs may be healthy (and that’s debatable), a diet with no carbs is definitely not healthy.
Orthorexics often avoid processed foods, which are considered “artificial,” and preserved products, which are believed to be “dangerous.” Animal products are often avoided as well. The diet may be limited to only a few “safe” foods, for instance fresh fruits and vegetables.
The problem is that it’s impossible to live on only fruits and vegetables. People with orthorexia nervosa are often unhealthily thin. They are malnourished. They believe they are eating a healthy diet but in reality, they are not. Their diet is lacking in many key nutrients, such as protein, iron, and B vitamins. They suffer many of the health problems suffered by people with anorexia, and the condition can even be fatal.
Symptoms of Orthorexia
Symptoms of orthorexia nervosa include an obsession with “eating right.” People with orthorexia maintain a strict diet and are obsessive-compulsive about it. They rarely stray from their diet for any reason; for instance, they won’t eat a piece of birthday cake just because it’s a special occasion.
Orthorexics spend a great deal of time thinking about food. They obsess about how food was processed, prepared, etc. They devote a great deal of time to planning their meals and purchasing and preparing their food. Yet, they don’t enjoy their food.
People with orthorexia are often perfectionists and are self-critical. They may suffer from poor self-esteem.
People with orthorexia are often unhealthily thin. They may suffer from dizziness and fainting, weakness and fatigue, anemia, hypotension (low blood pressure), and more serious medical problems. In severe cases, heart problems can occur, which can be fatal.
Unlike other eating disorders such as anorexia and bulimia, orthorexia nervosa occurs more often in men than in women.
Treatment
Treatment for orthorexia nervosa must begin with stabilizing any medical problems, if existent.
Education about proper nutrition is an important part of treatment. People with orthorexia are often resistant to this part of treatment because they believe they know what a healthy diet is, and that their diet is healthy. They are proud of their dietary choices.
Counseling is also recommended. It can help orthorexics increase self-esteem and set more realistic expectations for themselves.
People with orthorexia are often socially isolated by their condition. Their obsession with food and their eating habits leave them little time to develop social relationships. Their eating habits prevent them from going out to dinner with friends. As this changes, increasing social support is an important component of treatment.
There is not much data available on the success rate of treatment of orthorexia. The treatment challenge is convincing people with the condition that they need help. Once orthorexics are willing to engage in treatment, it should have a high rate of success.
For more information on eating disorders and treatment, please see our home page.