Orthorexia belongs to the eating disorders, but it is neither known nor frequently diagnosed as such. Affected individuals have a pronounced desire to always eat as healthy as possible.
What is orthorexia?
The term orthorexia is derived from the Greek words “orthos” and “orexis” for “right” and “appetite.” Unlike other eating disorders, orthorexia does not focus on the quantity of food, but rather on its quality. Affected individuals reach exclusively for the foods they consider healthy. A pronounced preoccupation with food and the study of nutritional values are also part of the clinical picture. All these behavior patterns of orthorexia have a compulsive character.
Causes
Similar to anorexia nervosa, the main cause of orthorexia is considered to be a pronounced need for control. Affected are mostly young women from higher educated classes, who are not infrequently perfectionistically inclined. Many sufferers of orthorexia compensate for a perceived loss of control in another area of life by taking strong control over their diet. This increases their self-esteem and relieves them of many everyday anxieties. Often, a strict diet with the goal of weight loss is the entry point into orthorexia, because during it, sufferers find pleasure in being able to control and shape their bodies.
Symptoms, complaints and signs
Sufferers of orthorexia are obsessively fixated on good quality food. Unhealthy foods are completely avoided whenever possible. As a result, the thoughts of affected individuals revolve for several hours a day not only around various foods and planning their meals, but also around how to avoid eating foods that are supposedly unhealthy. For their food choices, sufferers usually study nutritional tables or check the vitamin and mineral content of the same using tables from books or the Internet. They are always on the lookout for new, nutritionally even more valuable foods and do everything they can to obtain these foods. This can take absurd forms such as ordering from selected sources, for example from special online stores. Not only the calorie content as well as the distribution of macronutrients play a role. Also with the micro nutrients of the food is not yet an end for the concerning. In particular if food is present in the media, since they were classified for example as krebserregend or above average with pollutants such as pesticides loaded, they are avoided consistently by Orthorexie patients. While eating, those affected always think carefully about the nutritional values of the chosen foods and often also about how they can make their meals even healthier. Thus, they can no longer enjoy food in a relaxed manner.
Diagnosis and course of the disease
Orthorexia often goes unrecognized because many doctors dismiss the particularly pronounced tendency to eat healthy as a passing fad. Moreover, some physicians do not consider orthorexia to be an eating disorder in its own right, but rather a common obsessive-compulsive disorder. Also, since the classification of orthorexia does not yet follow any established criteria, its diagnosis is thus difficult. The consequences of orthorexia occur on both a physical and psychological level. Due to the severe restriction of “allowed” foods, it is not uncommon to experience significant malnutrition as well as underweight. This can be accompanied by various complaints such as listlessness, sleep disorders, concentration problems or a reduced ability to perform and work under pressure. The psyche can also suffer greatly from orthorexia. In addition to the lack of pleasure in eating in general, those affected often isolate themselves from their environment. Thoughts can revolve around food intake for several hours a day. A casual meal together can no longer take place in severely pronounced forms of orthorexia, unless those affected have previously extensively examined the food options offered or even brought their own food. Often people suffering from orthorexia also try to convert their fellow human beings to their supposedly healthier diet. The insight for the fact that their eating behavior is already pathological is missing thereby. Such behavior patterns can lead to self-induced isolation of the patients.
Complications
Orthorexia negatively affects the psyche and also the body. Usually, patients suffer from an eating disorder due to orthorexia. This eating disorder has a very negative impact on the patient’s quality of life and can also lead to significant social discomfort. In most cases, this leads to malnutrition and further also to deficiency symptoms. These can lead to other symptoms. Likewise, orthorexia not infrequently leads to severe weight loss. In severe cases, those affected can also lose consciousness. The psychological symptoms sometimes lead to personality disorders or obsessive-compulsive disorder. Depression or other psychological upsets can also occur as a result of this disease. In severe cases, the affected persons are dependent on treatment in a closed clinic. Concentration disorders or anxiety can also occur due to orthorexia. Treatment usually takes place with a psychologist. In outpatient cases, however, inpatient treatment is necessary. Complications do not occur. However, not every treatment leads to success. In many cases, the treatment also strikes only after a very long period of time.
When should you go to the doctor?
Normal interest in healthy food has no disease value. Neither does a strong, one-sided interest that is to be exploited professionally. Where it becomes difficult is when sufferers obsessively focus on the health value of food. Many orthorexics impose strict rules on themselves about what is eaten and what is not. The distinguishing factor between orthorexia and mildly disordered behavior is the pathologization of interests. In the case of pathological traits and an obsession, the affected person belongs to a doctor because of his eating disorder. Alternatively, he could go to a drop-in center specialized in eating disorders, where eating disordered individuals receive psychological care. The discussions about orthorexia nervosa are controversial because the transitions between a strong interest and pathological traits are often fluid. Vegans or Paleo fans also show a certain consistency in eating behavior. Some develop thereby strong missionary readiness to fight. A disease value does not have to have this however. The disease value is given however, if the concerning under its own behavior suffers and it nevertheless not to stop can. In this case it is to be assumed that the excessive interest for healthy food superimposes other mental problems. Whether orthorexia is actually an eating disorder or a compulsive or addictive strategy to distract oneself from other problems must be assessed individually by a medical professional.
Treatment and therapy
The goal of therapy for orthorexia is to help sufferers regain a normal and relaxed relationship with food. During psychotherapy, those affected learn to reintegrate supposedly unhealthy foods into their daily lives, which they have avoided in the course of the eating disorder. The food should no longer be selected exclusively according to its nutritional value or other health aspects. Accompanying this, the sometimes hours-long fixation of thoughts around food and food intake should be loosened. If malnutrition and the accompanying underweight have occurred in the course of orthorexia, another goal is to gain weight into the range of normal weight. In some cases, it is also necessary to reintroduce sufferers to carefree eating in company.
Outlook and prognosis
The condition known as “orthorexia nervosa” has not yet been officially recognized as an eating disorder. In the U.S., however, experts consider those obsessed with healthy eating to be disturbed and mentally ill. They have abandoned a healthy relationship with food in favor of an obsessively unhealthy relationship with its presumed health benefits. Whether orthorexia is an obsessive-compulsive disorder or an eating disorder is not entirely clear. After all, sufferers eat only healthy foods. Only the obsessive preoccupation with it for hours is not healthy. In many cases, the food is selected according to strict criteria that are not comprehensible to others. However, it is problematic that the lack of classification of orthorexia in eating or obsessive-compulsive disorders also limits the treatment options.Neither the therapeutic approaches for eating disorders nor those for obsessive-compulsive disorders are fully applicable. Orthorexia may also be combined with other eating disorders. An orthorexic may also suffer from bulimia nervosa or anorexia nervosa. In this case, treatment options are somewhat greater. However, the chances of recovery depend on the cooperation of the sufferer. In the case of anorexics or bulimics, the level of insight into the illness is often very low. Therefore, only a portion of those affected can be helped. As long as the affected persons understand the causes and the disease value of orthorexia, the prognosis for recovery is uncertain.
Prevention
Not only because it is often insidious and still has little recognition as a medical condition, prevention of orthorexia is difficult. It is important to be aware that a balanced diet does not consist exclusively of healthy foods and that enjoyment also plays a role. A healthy self-awareness not only regarding eating behavior, as well as critically questioning health-related messages about various foods, can help in the prevention of orthorexia.
Follow-up
In most cases, the person affected by orthorexia has only a few and also limited measures or options for aftercare, so that in the first place a quick diagnosis with subsequent treatment must take place for this disease. It is also not possible to cure the disease on one’s own, so that the affected person is usually always dependent on a visit to a doctor for this disease. As a rule, psychotherapy is necessary in the case of orthorexia. Especially parents, relatives and friends of the patient must support the patient during the treatment and point out the symptoms and complaints of the disease. The triggers of the disease should also be avoided as much as possible, so that there is no relapse even after a complete cure. In general, a doctor can also prescribe a diet plan for the patient, which should be followed in any case. It is also very important to have loving and intensive conversations with one’s own family in order to prevent depression or other psychological complaints. Often, contact with other sufferers of orthorexia is also very useful, as it comes to an exchange of information, which can facilitate the everyday life of the affected person.
This is what you can do yourself
If there is a suspicion that a person suffers from orthorexia nervosa, a visit to the doctor is recommended. Since the clinical picture is not precisely defined, a specialist must assess whether the affected person is actually suffering from an eating disorder. If an eating disorder is present, the obsessive behavior must be reduced. This can be achieved through behavioral therapy and a change in habitual routines. For example, the patient can use notes to catch himself or herself overindulging in food. Friends and family members can also play this role. In addition, literature, documentation, and other material that tempts obsessive behavior should be discarded. Meanwhile, it is important to find the cause of orthorexia nervosa. Inferiority complexes often underlie the pathological condition. These must be worked through in the course of therapy. In any case, the patient should consult a psychologist and talk to him about his problem. Initially, those affected can seek advice in forums or in self-help groups. The most important step is to recognize the excessive preoccupation with the quality of food. Then, the decision can be made to specifically break the behavioral patterns.
