Do you have friends or family members who seem to be constantly obsessed with their food choices? Are they always following strict diets and controlling every aspect of their meals? Have you been told that you’re “too strict” with your own diet?

If so, you may be dealing with a condition called orthorexia nervosa. While anorexia nervosa and bulimia nervosa are more focused on the quantity of food consumed, orthorexia nervosa is an obsession with the quality of the food eaten. Although it is not an official psychiatric diagnosis in the DSM-5, the term is becoming more widely recognized and studied.

Orthorexia often starts with a desire to become healthier, but this drive can quickly spin out of control. It’s more than just eating healthily or wanting to lose weight – it’s an obsessive and pathological behavior. In many cases, orthorexia co-occurs with other mental health conditions such as OCD, and it often starts as a coping mechanism for those who feel the need for control.

The hallmark of orthorexia is a fixation on eating only biologically pure foods that are free of pesticides, herbicides, and anything artificial. This can lead to a restrictive and rigid avoidance of certain foods, paired with ritualized patterns of eating that can be red flags for health practitioners. What’s more, many people who are applauded for their dedication to a healthy lifestyle may actually be hiding this unhealthy behavior, fueling their psychiatric problem.

Orthorexia can be seen in a variety of populations, including athletes, dietitians, opera singers, ballet dancers, symphony orchestra musicians, and medical students. Perhaps the most recognizable is the body builder or figure show competitor, whose ritualistic weighing, measuring, and timing of specific foods may be a sign of a hidden eating disorder. Unfortunately, like all eating disorders, long-term health risks and damage can occur, including malnutrition, poor dental health, nutrient deficiencies, and hormonal damage.

In addition to the physical risks, there is also a significant mental toll associated with orthorexia. Those who suffer from this condition may become intolerant of others’ eating patterns, and obsessive thoughts and behaviors can consume them. While some medical diagnoses, such as Crohn’s disease, Celiac, EDS/POTS, Mast Cell Activation Syndrome, and Diabetes, may require strict dietary restrictions, it is the mental attitude towards food that distinguishes orthorexia from these conditions.

Currently, there are no clear diagnostic criteria for orthorexia nervosa, but experts caution that enthusiasm for healthy eating only becomes a problem when it turns into an obsession that negatively affects everyday life. This may manifest as extreme weight loss, a refusal to eat out with friends, or other restrictive eating behaviors.

If you or someone you know is struggling with orthorexia, it’s essential to seek professional help. With the right treatment, including therapy and possibly medication, recovery is possible. Remember that health and well-being should always be the primary goal of any dietary choices, and it’s important to find a balance that works for you.

References:

Orthorexia: When Healthy Eating Becomes a Disorder

Evidence and gaps in the literature on orthorexia nervosa

Orthorexia nervosa and adaptation of ORTO-11 into Turkish

The clinical basis of orthorexia nervosa: emerging perspectives

Orthorexia Nervosa in Dieticians

Orthorexia nervosa: a frequent eating disordered behavior in athletes

The prevalence of orthorexia nervosa among eating disorder patients after treatment