Orthorexia Nervosa: Symptoms and Treatment

Introduction:

Healthy eating is undoubtedly an excellent habit as it was always thought in our schools that a balanced or completely healthy diet is the key to a healthy and long life. These days have become an obsession to many; it is more often considered a statement to describe standards amongst youngsters. According to the psychiatrist, people who are excessively obsessed with their diet are considered to have a mental health condition, and this disorder is called orthorexia nervosa.

What Is Orthorexia Nervosa?

Orthorexia nervosa is a disorder in which the affected individuals have an excessive obsession with healthy eating. This condition was first described by an American physician Steve Bratman in 1997. The condition's name is derived from the Greek word orthos, which means correct, and orexis, which means appetite. This term for ease of use is translated as the correct diet. Individuals with orthorexia nervosa are mainly concerned with the hygiene and quality of the food rather than their health benefits or quantity. Though healthy eating is of utmost importance for well-being, it can harm a person's health if it is overdone. Orthorexia nervosa and its etiology are not completely understood; some experts consider it a symptom of mental health disorders, while others categorize it as an eating disorder.

What Are the Symptoms of Orthorexia Nervosa?

Orthorexia nervosa is an obsessive healthy eating disorder. Some of its common signs and symptoms include:

• Avoiding unhealthy food due to extreme fear of an unhealthy diet.

• Professional who advises on healthy food, nutrition, and eating.

• Experiences anxiety when the diet is altered, which makes it impossible for a person to have anything apart from the planned regimen.

• Always checks the ingredients and the contents of the food before purchasing or consuming it.

• Avoiding many food products for no known reason. This food item can be gluten, sugar, all carbs, all fats, and animal products.

• These individuals have too much interest in others' diets and eating habits for no reason.

• Spending a lot of time planning, buying, and preparing meals that they consider healthy is done to the extent that it interferes with other daily activities and work.

• Overthink the nutritional value of the meals served at the events.

• Avoid meals cooked and served by others.

• Carry tiffins at the events or office, considering the food served cannot meet their standards.

• Are malnourished or underweight due to an imbalanced diet or popularity of food as quantity is compromised over quality.

• These people are very meticulous about their eating habits, and violating any meal or diet plan makes them feel guilty.

What Are the Causes and Risk Factors for Orthorexia Nervosa?

The exact cause or etiology of orthorexia nervosa has not been described by experts. Still, it is considered to be developed due to an obsession with food habits which begins with the intention of improving and maintaining a healthy lifestyle. These pure intentions of improving health unknowingly are transformed into an obsession with food and eating habits. Many factors play a role in the development and progress of the condition; these factors include

• The history of obsessive-compulsive disorder.

• History of eating disorders.

• Tendencies of achieving perfection.

• Anxiety disorders.

• Higher socio-economic group.

• Access to clean food.

• Incomplete knowledge of nutrition.

• The influence of social media emphasizes clean food by presenting other foodstuffs as bad and unhealthy.

How Is Orthorexia Nervosa Diagnosed?

As orthorexia is related to healthy eating, certain diagnostic criteria have not been formulated to confirm the diagnosis. It is still unclear if orthorexia is an eating disorder or a symptom of other mental health conditions. Researchers use various healthcare and diagnostic tools to study and conclude the diagnosis, including

• ORTO-15: This 15-question screening tool is designed to detect signs and behaviors associated with orthorexia. Diagnosis is typically established when a score of 40 or more than that is achieved. Nevertheless, this tool has been criticized due to its inability to distinguish between eating-related values such as religious purposes, ethical veganism, and pathological eating behaviors.

• ORTO-R: This updated version called ORTO-15 comprises the six appropriate questions linked to orthorexia symptoms and behaviors.

• Bratman Orthorexia Test (BOT): This is a 10-question screening instrument that has a choice of ‘Yes or No’ responses. The questions are based on obsessive thinking about food, beliefs about nutrition and health, restrictions, and other factors. However, it’s not commonly used.

• Eating Habits Questionnaire (EHQ): This 21-item questionnaire will help in assessing knowledge, problematic behaviors related to healthy eating, and positive versus negative feelings. Nevertheless, research has indicated that it needs further refining before considering it a reliable diagnostic tool for diagnosing orthorexia.

Bratman and Dunn proposed diagnostic criteria to distinguish between healthy eating and orthorexia. The diagnostic criteria focus on categorizing the individuals into obsessive healthy eaters and abnormal eating behaviors.

What Are the Side Effects of Orthorexia Nervosa?

Individuals with orthorexia nervosa are excessively obsessed with their food and eating habits. Hence these individuals have many negative health effects, which include:

• Physical Effects: As these people do not have balanced nutrition and focus more on having clean food, they have physical effects like malnourishment, Anemia, digestive problems, and compromised immune system; some of these physical conditions can progress to become so severe that they can be life-threatening.

• Psychological Effects: Individuals with orthorexia are very particular about their food-related habits; in situations where these habits are disrupted or their routine is disturbed, subjects develop guilt and anger, which can extend to a level where a person is intensely frustrated. This ultimately affects their social and professional lives.

How Is Orthorexia Nervosa Treated?

Treatment for orthorexia has not been formulated, but improving symptoms and avoiding the social and psychological effects of obsessive eating habits can be done by accurately diagnosing the condition. Diagnosing orthorexia is a challenge in itself as these people do not realize this is a problem, hence has many negative effects. The potential consequences of orthorexia on one’s health can be equally as serious as those of other types of eating disorders. When this disease is not treated appropriately, orthorexia can result in irreversible harm to the affected person’s health.

Once the condition is diagnosed following are the treatment modalities used:

• Psychotherapy: A person is counseled and explained about the ill effects of their eating habits. This mainly aims at converting the thought process of an individual.

• Gradual exposure to foods that are considered bad or are avoided.

• Behavior modification.

• Cognitive behavioral therapy.

• Various forms of relation training like meditation, yoga, tai chi, guided imagery, and breathing exercises.

• Weight restoration- if needed.

Conclusion:

Orthorexia is an eating disorder where a person is excessively obsessed with food and eating habits. The reason for the development of the condition is unknown, but some believe it to be caused as a symptom of underlying eating disorders or mental health conditions. The treatment aims at preventing the symptoms and overcoming the habits.