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Orthorexia Nervosa is When Healthy Eating Becomes a Disorder


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It's easy to get caught up in the swarm of health information, especially around New Year's. With every new fad diet and sensationalized nutrition study, the idea of a healthy lifestyle gets more muddled. It's one thing to take this information and adapt it to a balanced and healthy diet, but cutting out entire food groups may be disordered eating behavior. Orthorexia Nervosa is the unhealthy obsession with eating healthy. It's an eating disorder that can lead to malnourishment or impairment of daily functioning.

What is Orthorexia Nervosa?

As far as eating disorders go, orthorexia is fairly new. It's not in the diagnostic and statistical manual of mental disorders (DSM-5), so it can't be diagnosed yet.

Let's pull apart the word. The "-rexia" suffix means "appetite" in Greek. Anorexia, for example, literally means without appetite. "Ortho-" means "straight" or "right" (think orthodontist). So, orthorexia translates to "right appetite" or "righteous eating."

Dr. Steven Bratman, a functional medicine doctor, coined the term in 1997.  In 2005, Donini et al. proposed diagnostic criteria. Using a proposed diagnostic questionnaire, the ORTO-15, Dunn et al. found the prevalence of orthorexia to be less than 1%. However, the sample was limited to 275 college students.

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While weight loss is a goal of some people with orthorexia, orthorexia focuses more on the idea of clean eating. People with orthorexia will engage in specific eating patterns and eat restrictive diets. They have an obsessive focus on healthy eating to the point of perfection.

What Are the Symptoms of Orthorexia Nervosa?

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Even though a fixation with healthy eating might seem positive, it can cause a myriad of health conditions, including mental health issues.

These are some of the warning signs of orthorexia, according to The National Eating Disorders Association:

  • Feeling guilty when you don't eat healthy
  • Fear sickness
  • Worrying about the quality of food intake; compulsively check ingredients lists or nutrition facts
  • Cutting out an increasing number of food groups or ingredients (e.g., meat, carbs, sugar, fat, gluten, preservatives, pesticides)
  • Spending hours thinking about what food might be served at upcoming events
  • Feeling distressed when healthy food choices aren't available
  • Physical signs of malnutrition such as brain fog, gastrointestinal issues, a weakened immune system, kidney failure, or anemia
  • Overly critical of friends who don't eat the same way
  • Low self-esteem toward your body image

Risk factors of Orthorexia

It seems counterintuitive, but an obsession with healthy eating doesn't lead to better health. Orthorexia comes with several risks to your wellbeing, both mental and physical.

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Orthorexic eating habits can strain social relationships. Many special occasions are centered around food, but worrying about healthy foods at these events can cause significant distress. It might even cause some people to avoid special occasions and their loved ones altogether, potentially leading to social isolation.

Dietologist Doctor Holding Digital Tablet With Opened Diet Plan

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When entire food groups are cut out, a natural consequence may be nutritional deficiencies. Unfortunately, they're not easy to detect until they create a larger physical problem. The best way to detect deficiencies early is to get blood work.

Orthorexia may cause brain fog much like what you might see in a patient with anorexia nervosa or obsessive-compulsive disorder (OCD). Because of this similarity, researchers think these disorders may have similar causality.

If you cut out fat, your immune system may suffer. Immune cells rely on essential fatty acids for energy, signaling, and building cell membranes. Limiting dietary fatty acids can contribute to allergies, autoimmune diseases, and metabolic conditions.

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Dietary restrictions can throw your hormones and electrolytes off-kilter. In an effort to eat a healthy diet, people with orthorexia may cut out salt (sodium chloride) completely. Sodium, chloride, and potassium are all essential for regulating your body's fluid balance.

If you suspect orthorexia nervosa is something you're struggling with, consider contacting a health care professional specializing in psychiatry or psychotherapy. A dietitian can also help you establish healthy eating habits.

Crystal Gwizdala is a freelance science journalist based in mid-Michigan. When she's not writing, eating, or sleeping on the floor, you can find her trekking through the woods or rambling on about some hypothetical trip she has planned. Read Crystal's work in The Xylom, Woman&Home, and Catalyst Midland, or follow her on Twitter.

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