Orthorexia: when fear of 'unhealthy' food takes over your life

Last update: February 21, 2024
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Reading time: 3 minutes
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By Brain Matters

Nowadays, social media is full of ‘fitgirls or boys’. At first glance, this seems of no harm, especially with obesity being a worldwide problem among the youth. However, this promotion of a healthy lifestyle has its dark sides as well, since the prevalence of an eating disorder called ‘Orthorexia Nervosa’ has increased over the past years. Orthorexia can best be described as the unhealthy obsession to eat and live healthily. A patient suffering from orthorexia explains; “it is literally as if a parrot is screaming in my head that after eating this piece of cake, I am getting fat and I have to run 10 kilometers to make up for it”.

What is then the difference with other eating disorders (Anorexia nervosa or Bulimia nervosa) you may wonder? Well, in contrast to these eating disorders, Orthorexia has not yet been included in the DSM (the handbook used by psychologists to diagnose patients with various psychological disorders). 

Besides that, a lot of debate is going on if Orthorexia could be seen as an eating disorder or as an Obsessive Compulsive Disorder (OCD). OCD is a disorder where people experience severe obsessions, for example the fear of catching a contagious disease, combined with a certain compulsion to decrease this fear, like washing your hands a hundred times a day.   Just as with OCD, patients suffering from Orthorexia have an immense phobia, however in the case of Orthorexia this is the fear of eating “non-pure” food. When they do not stick to their strict eating regime, they compensate with excessive exercise. 

Actually, this comparison with OCD is not strange since research has shown that individuals that scored higher on OCD symptoms, also showed more symptoms related to what people with Orthorexia suffer from. Moreover, it has been reported that individuals with Orthorexia have a 11-69% higher chance to also have OCD. This has led researchers to the idea that Orthorexia can evolve into OCD. This is portrayed as the excessive preoccupation with healthy food together with the fear for ‘unhealthy foods’ and the repetitive actions and routines surrounding the preparation of the food. 

However, I would like to point out that individuals with orthorexic tendencies also showed higher rates of symptoms of other eating disorders. This association with other eating disorders was even stronger than that of orthorexia symptoms and OCD symptoms. Besides that, in contrast to OCD where the patient realizes that the obsessional thoughts in their heads are unreasonable and untrue but gives them feelings of distress, thoughts surrounding food are perceived as normal by patients with Orthorexia. Therefore, Orthorexia nowadays is seen and treated as an eating disorder whereby the risk for developing OCD as well is higher compared to most people. 

Nonetheless, even when Orthorexia is treated as an eating disorder, research is still debating if Orthorexia can be seen as an eating disorder or if it should be seen on a spectrum together with OCD. An interesting theoretical approach which really resonates well with the current time frame of social media and all the ‘fitgirls and boys’ promoting a healthy lifestyle, is the idea that Orthorexia can be seen as an ‘accepted’ way by society to express symptoms similar to what is observed in the case of Anorexia. Nonetheless, hopefully we can spread the word about this disorder whereby we can detect it in an early stage. The take-home message will then be that eating healthily and doing some sort of exercise in any shape or form is of no harm, however too much of it can be harmful in the long run.

Author: Joyce Burger

References:

  • Brytek-Matera, A. (2012). Orthorexia nervosa–an eating disorder, obsessive-compulsive disorder or disturbed eating habit. Archives of Psychiatry and psychotherapy, 1(1), 55-60. 
  • Koven, N. S., & Abry, A. W. (2015). The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric disease and treatment, 11, 385. 
  • Zagaria, A., Vacca, M., Cerolini, S., Ballesio, A., & Lombardo, C. (2022). Associations between orthorexia, disordered eating, and obsessive–compulsive symptoms: A systematic review and meta‐analysis. International Journal of Eating Disorders, 55(3), 295-312. 
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