Orthorexia Nervosa: The Obsession with ‘Healthy’ Eating

Eating healthy is a goal that most of us would like to achieve, it’s a pathway to a better lifestyle and an answer to many of our health-related problems. A healthy diet is often synonymous with a healthier and happier life. But there is a downside to everything, and this is not an exception.  

What is Orthorexia Nervosa? 

Orthorexia Nervosa is an eating disorder that involves an unhealthy obsession with healthy eating. Unlike anorexia nervosa, which involves losing weight, orthorexia is a behaviour and  obsession motored by an unbending dieting regime perceived as “pure.” It creates conditions for social isolation, nutritional deficiencies, and finally physical health impairments. 

Key Symptoms of Orthorexia Nervosa

• Nutritional deficiency: Malnutrition arises because of poor variety in the foods consumed.
• Intense fear of illness: A person is highly anxious about food “purity” and its consequences on health. 
• Excessive food research: People spend a great deal of time researching food, planning meals, and reviewing ingredients.
• Excessive concern about food quality: Individuals with orthorexia tend to have an extreme interest in the quality and origin of their food, which often creates a great deal of anxiety.
• Food avoidance from outside: The individuals may avoid eating out or consuming food prepared by others, as they may be afraid of contamination or the inability to maintain their strict diet standards. 

The psychological effects of Orthorexia Nervosa

One feels compelled to be in control of one’s diet and dreads the potential consequences of breaking one’s strict rules. Individuals with orthorexia are very critical of their friends regarding food selection, and they can never justify themselves. Food fixation is a vicious cycle of guilt and self-love that keeps the diet from ever-changing or getting too strict. 

Factors Contributing to Orthorexia Nervosa

• Food preferences: It is the like or dislike of certain foods that can be a contributing factor. 
• Taste perception: Everyone perceives taste differently, and people are sensitive to some tastes.  
• Food neophobia: It is a sort of eating disorder whereby one fears trying different foods, thus limiting one’s diet.  
• Personality characteristics: Perfectionism, concern with appearance and a history of being overweight are at risk. 
• Family history of eating disorders: You may tend to develop an eating disorder if one member of your family has it.
• Parental feeding practices: The way parents fed their children when they were young can affect their eating behaviour. 
• Weight history: Those people who have a history of overweight or obesity before the condition developed might be more prone to orthorexia. 

All these factors contribute to the development of orthorexia; however, we must remember that these factors do not mean that every individual will eventually develop the disorder.

Treatment Approach 

Unlike Anorexia Nervosa patients, Orthorexia Nervosa patients may be relatively easier to treat because of their interest in health and well-being. We should recommend a multidisciplinary team of doctors, therapists, and dieticians for treatment.

• Relaxation Therapy: This may reduce anxiety around mealtimes. 
• Cognitive Behavioural Therapy (CBT): Modifies perfectionism and irrational thinking patterns. 
• Psychoeducation: There is a need to inform patients about the reality of food and nutrition. This may help alter false beliefs, but will also be emotionally stressful for the sufferer. 
• Exposure and Response Prevention: This is probably effective for obsessive-compulsive behaviours since it gradually exposes the patients to their fears and teaches them not to respond. 
• Outpatient versus Hospitalization: The treatment can usually be conducted outside the hospital setting, but if there is severe weight loss or malnutrition, then hospitalization may be necessary with nutritional support. 
• Drugs: Serotonin reuptake inhibitors can be prescribed to patients with ON, which works just like antidepressants in treating anxiety and obsessive-compulsive behaviours. However,  there is a tendency for patients with ON to avoid medications such as these because they are unnatural. 
• Medical Tests: Physical check-ups and laboratory analyses are needed also because, just like in AN, overly strict diets in ON may lead to health risks, such as brittle bones, anaemia, low sodium, low blood cells, slow pulse, and even cessation of breathing. There is no research about treatments intended particularly for ON; however, some treatments are suggested using similarities with AN. 

Orthorexia nervosa is a new kind of eating disorder; thus, it is an excessive preoccupation with healthy eating. The obsession may then convert into an inflexible adherence to what the person views as a “pure” diet. This can lead to a tendency to experience nutritional deficiencies and even problems with physical health. Recognizing signs and symptoms is  important in this respect so one knows whether he or she needs to seek professional help or whether someone you know needs professional help. To help patients overcome compulsive beliefs and behaviours and learn how to make healthy food choices, orthorexia treatment typically consists of a combination of therapy and nutrition counselling.