What Is Orthorexia: Causes, Symptoms, Consequences And Treatment

The term orthorexia, coined in 1997 by the American doctor Steven Bratman, is a neologism that comes from the Greek orthos or correct and orexis, which means appetite. Orthorexia is a pathological attitude towards food, which is why it is conceptualized as a obsession with healthy food an eating pattern that meets a series of strict and restrictive requirements.

It is important to note that the fixation that a person develops with food that they consider healthy does not imply that it is actually healthy, of quality and beneficial. This is because the criteria that the person with orthorexia nervosa establishes are based on their own belief system and on various sources that are not necessarily scientifically proven.

This pathology, despite not being included in any manual of mental disorders such as, for example, the DSM-5, is included within eating disorders, since diet is the central element in this disease. Likewise, orthorexia is also related to obsessive-compulsive disorder due to the development of rigid and inflexible eating rituals. However, it differs from other eating disorders such as anorexia and bulimia in that in the latter there is concern about the quantity of food, while in orthorexia the obsession is with quality, and on the other hand, there is no distortion of body image.

How does orthorexia originate? Regarding the etiology of orthorexia nervosa, its origin has various causes or factors that could predispose this pathology:

• Although it can affect anyone, be a woman and young are risk factors for this disease, as well as having a medium-high purchasing power, which allows access to a certain type of diet.
• The sporty people They also constitute a population sector vulnerable to this disorder, since they develop a high awareness of nutrition and its effects on their physique and performance.
• He increasing the relevance of nutrition Nowadays, the dissemination of information on social networks and in the media can lead to excessive concern about nutrition in the population.
• The dietary and nutritional information that does not come from scientific studies nor empirical evidence favors the spread of dangerous practices. Likewise, there are economic interests on the part of the food industry to promulgate diets that favor them and that do not really care about people’s health.
• He cult for image and thinness In today’s society, as synonyms for success, they promote aesthetic pressure based on beauty canons that can lead to the development of inflexible and severe diets based on supposedly healthy criteria to achieve a certain physique socially associated with health.
• Some Personality traits such as rigidity and lack of mental flexibility, perfectionism or excess self-control are predisposing factors for orthorexia.
• The presence of a obsessive compulsive disorder It is related in some cases to the origin and development of orthorexic-type behaviors.
• Sometimes people who have suffered anorexy They adopt a series of eating patterns and rituals in their recovery process that lead to orthorexia.

Due to the recent appearance of orthorexia as a pathology, there are currently no series of official diagnostic criteria shared by experts. Despite the debate about this disorder, there are two psychometric instruments that would be used to explore the thoughts, attitudes and behaviors of orthorexia: the ORTO-15 and the Orthorexia Self Test.

Likewise, a series of symptoms have been identified that are characteristic of orthorexia nervosa:

• Limitation and severe restriction of a large number of foods that the person does not consider healthy.
• Dedication of more than three hours a day to diet planning and feeding that same day.
• Recurring thoughts about purchasing, preparing, and consuming the foods in your diet.
• Absence of enjoyment or gratification through food, the source of satisfaction is compliance with strict established criteria.
• Impact on quality of life and neglect of other vital areas of the person as a consequence of excessive dedication to food.
• Development of obsessive behavioral rituals in the preparation of food, such as the way it is cut or peeled, for example, and in the use of certain culinary instruments, for example, avoiding metal ones.
• Feelings of guilt if the person skips any of the inflexible parameters. These emotions can lead to self-punishment, which sometimes consists of fasting.
• Perception of control over the circumstances and aspects of your life by eating the way you consider correct.
• Social isolation because they avoid those events in which there is food or drink, since they do not trust the preparation of food by people other than themselves.
• Identity and personal satisfaction based on compliance with food and health standards.
• Avoidance and phobic rejection of foods that are not considered suitable.

What are the consequences of orthorexia? Orthorexia nervosa can lead to a series of problems or conditions:

• Physical consequences: anemia, both excess and deficiency of vitamins depending on the diet adopted, hypotension, osteoporosis, thyroid problems, cardiovascular problems, weight loss, weakening of the immune system, infertility, nutritional deficiencies or malnutrition, etc.
• Psychological consequences: development of low self-esteem and self-concept, anxiety, stress, depression, obsessive disorders, irritability, difficulties with concentration and attention, anhedonia or inability to experience pleasure or enjoyment…
• Social consequences: social isolation, loss of friendships and significant ties due to dedicating most of the time to food, neglect of social, family, personal and even work responsibilities, which can lead to loss of employment.

The goals of treatment for orthorexia are restoration of nutritional levels of the person, the establishment and internalization of truly healthy dietary guidelines and patterns, and the addressing of complications associated with orthorexia. Intervention with a person with orthorexia nervosa requires interdisciplinary work between psychology, nutrition and psychiatry professionals, if necessary:

Psychological intervention

Includes psychoeducation or explanation about the disorder, its symptoms and consequences, also an exploration and approach to possible associated disorders such as depression or anxiety, cognitive restructuring with the aim of increasing the flexibility of thinking and work on the person’s self-esteem and social skills to avoid social isolation . In the event that orthorexia is the result of obsessive-compulsive disorder, it is recommended to apply treatment for this latter pathology.

Nutritional intervention

First of all, use will be made of Food supplements to improve nutritional status and address potential medical complications. Subsequently, education and reintroduction of eating habits is carried out, as well as teaching the person to develop a healthy and balanced relationship with food.

Psychiatric intervention

Psychiatric intervention is not always necessary, however, in more complicated cases it may be advisable to medication use. SSRI and tricyclic antidepressants, as well as atypical antipsychotics, are normally used.

It is worth mentioning that it is very important to prevent orthorexia through science-based nutritional education, in addition to emotional education, self-concept work, and self-acceptance.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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