Orthorexia: when proper nutrition becomes dangerous

What associations does the phrase “healthy eating” usually evoke? As a rule, the majority remembers a balanced diet, fresh fruits and vegetables, organic products that do not contain chemical additives. And it would seem that in order to maintain good health, one must eat just such food. But what if we say that sometimes even such seemingly ideal food for the human body can cause health problems? Don't believe? This means that you do not know anything about what orthorexia is and what consequences it causes.

What is orthorexia

Orthorexia or orthorexia nervosa is an unhealthy fixation on the ideas of proper nutrition. To date, this diagnosis is not included in the ICD-10, however, specialists around the world actively use this term to describe the condition of patients.

The pioneer of the Health Food Junkies was California-based American physician Steven Bratman, author of Health Food Junkies: Overcoming the Obsession with Healthful Eating. It was he who in 1997 proposed the term "orthorexia" (from the Greek "correct appetite"). And it all started with the fact that Bratman himself in the 1970s first became a vegetarian, and then gradually began to exclude from his diet, as it seemed to him, harmful foods. The doctor himself came to his senses in time and did not cross the red line. But later, the doctor began to notice in his patients what in time he would call orthorexia.

Orthorexia nervosa is an obsession with the quality of the food you eat. People with orthorexia often also have signs of anxiety disorders that are accompanied by anorexia or other eating disorders. Orthorexic is so obsessed with eating healthy that it becomes his main goal in life, overshadowing everything else. And it all starts with, so to speak, excessive interest in healthy eating. Over time, this interest intensifies and takes the main place in the life of an orthorexic, and the use of products from the list of "forbidden" causes him feelings of guilt, anxiety and panic attacks.

Despite the fact that orthorexia has not yet been recognized as an official disease, today specialists have already developed a classification for this disorder.

Orthorexia of the first type implies that a person has a craving for a healthy diet, but with a rather noticeable pickiness to the quality and purity of products.

Type 2 orthorexia is when a person becomes obsessed with proper nutrition, and in his behavior, in particular in terms of choosing products, signs of a mental disorder are noticeable.

Experts also concluded that orthorexia usually develops in two stages. At the first stage, a person begins to pay attention to all kinds of healthy eating systems. As a rule, the most popular dietary theories at the present time fall under the scope. For example, a raw food diet, a vegan diet, a paleo diet, and others. But, importantly, many of these systems are unsafe for long-term adherence. For example, you can't just eat smoothies, no matter how healthy those drinks are, and still be healthy. The problem, however, is that orthorexics are so obsessed with healthy foods that they don't notice when such foods become unsafe.

Over time, the amount of food in the orthorexic's diet gradually decreases. He spends more and more time thinking about healthy and unhealthy foods, as well as ways to prepare meals. And this is the second stage of the progression of the deviation. And if in the life of an orthorexic there is a breakdown on “bad” food or he finds himself in a situation where he has to eat even a little from his list of prohibited foods, then after that, almost everyone is followed by hard cleansing to detoxify the body. But interestingly, in most cases, even after the most severe detox programs, an orthorexic will not say that his body is sufficiently cleansed of toxins and toxins. In other words, his whole life turns into a kind of pursuit of cleansing and protecting his body from harmful substances.

Many experts compare orthorexia with other eating disorders. But if anorexia and bulimia is an obsession with the quantity of food consumed, then orthorexia is an unhealthy obsession with the quality of foods. But as studies have shown, people suffering from orthorexia nervosa are also prone to developing anorexia. However, while anorexics try to hide the presence of a problem from others in every possible way and deny their diagnosis, orthorexics, on the contrary, are proud of their principles and try to convince others of the correctness of such eating habits.

How to recognize orthorexia

Despite the absence of this disorder in the International Classification of Diseases, specialists have already described and classified the symptoms of orthorexia. So, what should you pay attention to in time to recognize the signs of nervous orthorexia in yourself or a loved one.

Of course, the desire to eat ecologically clean and wholesome food in itself cannot be called a deviation. However, orthorexics do not select certain foods for their menu with the goal of achieving or maintaining ideal body weight. It is important for them to follow a healthy diet as such. Therefore, such individuals may (and usually almost always do) refuse any food that they consider unhealthy, even if they feel very hungry.

Orthorexics generally avoid foods that contain:

  • flavors, colors, or preservatives ;
  • fat;
  • sugar ;
  • salt ;
  • pesticides;
  • GMOs;
  • other ingredients that are considered harmful in orthorexic terms.

Orthorexics also tend to avoid dairy and animal foods.

Orthorexics can be recognized by their particular eating behavior. They strictly divide all food into good and bad, environmentally friendly and polluted. They always have obsessive concerns about the impact of food on health. That is, such a person always remembers the "dark side" of food. For example, citrus fruits are healthy, but they contain too many acids; milk is healthy, but may contain bacteria or cause indigestion; fruits are useful, but can cause fungal diseases; sea ​​fish is healthy, but it can cause mercury poisoning.

Another serious symptom that may indicate the presence of orthorexia is a very limited list of foods that a person allows himself to consume. Often in orthorexics, this list is reduced to 10 or even fewer types of food.

The third sign of deviation: a person excludes from his menu all foods that can cause allergies. And this is even though he has never been diagnosed with an allergy.

In contrast, orthorexic diets are always high in (often too much) foods containing probiotics as well as plants with medicinal properties and nutritional supplements that are supposed to have a beneficial effect on the body.

And of course, all people with orthorexia are overly scrupulous about the process of cooking. In particular, in everything related to washing and sterilizing both the products themselves and dishes. Such people in every possible way avoid eating outside the home. They categorically refuse food purchased or prepared by others, because they are not sure of the quality of such dishes.

In addition to behavioral symptoms, a person suffering from orthorexia also has a number of emotional reactions. He always experiences happiness and satisfaction from eating healthy and environmentally friendly food, and, on the contrary, “nibbles” himself if he has eaten a product that, in his opinion, is harmful. Such persons usually think about food and its effect on the body often and for a long time. Orthorexics clearly plan their nutrition program in advance, and if they deviate from it, they feel guilty. And almost every orthorexic condemns people who, in their opinion, eat wrong, which often creates conflict situations in the family and between friends.

In addition, according to experts, other disorders often occur in people with orthorexia, such as:

  • increased anxiety and panic attacks;
  • depression ;
  • obsessive-compulsive disorder (obsession with an idea);
  • bipolar disorder;
  • mood swings;
  • tendency to social isolation;
  • substance abuse disorders.

Consequences of orthorexia

The symptoms of orthorexia are usually chronic. The obsession with healthy food can progress to such an extent that over time it begins to crowd out other interests, worsens a person’s relationships with others, and even becomes physically dangerous. In particular, we are talking about the condition when orthorexia acquires the symptoms of anorexia or bulimia. The obsession with healthy food often limits the amount of food consumed (they seem harmful to a person) and, consequently, the daily calorie intake decreases. If a person places too severe food restrictions on himself, this can lead to chronic malnutrition. As a result, there is a strong weight loss and various diseases develop, including in the form of cardiovascular problems and even death.

In the late 1990s, German experts examined people who strictly adhered to the raw food diet. It turned out that about a third of women of childbearing age suffer from amenorrhea, almost half of men and 15% of women have iron deficiency anemia. All raw foodists were deficient in calcium, iron, zinc, magnesium, iodine, as well as vitamins B12, E and D. Some of the useful elements simply ceased to be absorbed by the body, even though they were present in sufficient quantities in the food consumed.

Constant severe restrictions can cause relapses on prohibited foods, but after that the orthorexic feels guilty about what he did. As a result, a person tries to quickly cleanse his body of "harmful" food. Because of what the development of bulimia is possible. On the other hand, such breakdowns undermine the psyche of an orthorexic: because of what happened, he can become depressed, experience anxiety disorders, and lose self-esteem.

In addition, orthorexia nervosa leads to a deterioration in social activity, up to complete isolation. One of the consequences of trying to eat only the right foods, prepared only in the healthiest way, is the disruption of relationships with relatives and friends. Such a person often begins to impose his own nutrition system on his loved ones. For an orthorexic in the later stages of the disorder, maintaining good relationships with loved ones becomes less important than adherence to the chosen diet.

Diagnosis and treatment

You can check for a tendency to orthorexia yourself at home. To do this, you need to answer several questions compiled by experts:

  1. Do you think about the benefits and harms of food more than any other topic?
  2. When choosing any product, do you first of all study how harmful it can be to health?
  3. Do you feel guilty or ashamed if you deviate from your ideal diet?
  4. Does all food prepared by you not look suspicious to you?
  5. Do you only feel safe if you stick to your meal plan and eat your own food?
  6. Do you openly or mentally condemn people who are not as scrupulous in their food choices as you are?

Answers yes to at least some of these questions may indicate the presence of orthorexia nervosa.

Stephen Bratman, who developed the theory of orthorexia, also identified possible risk factors that can lead a person to become obsessed with proper nutrition. So, according to his theory, people are more prone to orthorexia:

  • who have been on a strict diet for a long time;
  • whose parents placed excessive emphasis on healthy food;
  • who have suffered or are suffering from a disease requiring a special diet;
  • who have signs of perfectionism or obsessive-compulsive disorder;
  • suffering from phobias associated with illness or death.

Orthorexia treatment is usually a complex therapy aimed at restoring balance and moderation in life. Patients with this disorder always need to consult a psychotherapist and a nutritionist. The first will help get rid of obsessive conditions and unreasonable fears, the second will help you choose a healthy eating plan without harm to the body. This does not mean that the new diet will be contrary to the rules of healthy eating. The most important thing to convince the orthorexic is that the daily diet must contain a certain amount of calories, proteins, fats, carbohydrates, essential vitamins and minerals. In other words, a person must realize that he can adhere to almost any healthy diet, with the only condition: such a diet must provide him with enough nutrients.

In addition to "talking" therapy, such patients often need medical treatment. For orthorexia nervosa, antidepressants and sedatives may be prescribed to relieve the symptoms of the mental disorder. The drugs in this group allow you to correct the activity of brain waves, which helps to change the mood and thinking of the patient.

If due to orthorexia and malnutrition complications such as digestive, cardiovascular or hormonal disorders occur, the patient is prescribed an appropriate treatment program aimed at restoring health.

The desire to eat healthy is a great approach, but only as long as it does not go beyond common sense. If this idea acquires the symptoms of an unhealthy obsession, it can cause mental and physical disorders.

  1. Fateeva M. S. Orthorexia Nervosa: history of the term, diagnostic criteria and place among known eating disorders. / Fateeva M. S. // Science and Education a New Dimension. Pedagogy and Psychology. – IX

    . – Issue: 245. – 2021 Feb. - with. 64-71.