History of Orthorexia Disorder

Orthorexia is a term first coined in the early 1990’s by Steve Bratman, MD to describe unhealthy and obsessive eating habits in which one only eats foods that are clean, healthy, pure organic, etc to maximize their health. The word Orthorexia in itself translates from Greek with  Orthos meaning “Correct” and  Orexia meaning “Appetite”. Orthorexia is often characterized by a disruption of the natural cycle of intuitive eating which can lead to feelings of depression, anxiety, social isolation and despair. When presented with a food that Orthorexia can also paradoxically lead to what it seeks to avoid: Malnutrition.  Orthorexia is similar to Anorexia and Bulimia in these regards but it is different in that sufferers do not limit their intake of food. 

While Orthorexia is not considered a disorder by the DSM or the American Psychiatric Association, the medical and scientific community has begun to recognize it as a phenomenon. Orthorexia in some ways could be considered a culture bound syndrome that arises from health centric and diet-centric trends. Much like the end goal of Orthorexia, The end goal of many trending diets is nourishment and the obtainment of maximum health benefits. Orthorexia, however, takes this pursuit of maximum health benefits to an extreme that some experts have compared to Obsessive Compulsive Disorder, with the obsession being the quality of food intake.

Eating a balanced diet is important. The food that we put in our body is a direct reflection of our health outcomes. It is important to consume a full and well rounded diet with plenty of greens, fresh fruits, fresh vegetables, whole grains and antioxidants. It is also important to consume probiotics and opt into buying organic and sustainably sourced food and lifestyle items, but sometimes being too healthy can be unhealthy. It is said that some symptoms and behaviors associated with Orthorexia are an extreme preoccupation with food preparation, nutritional content and general eating habits, strict dietary rules, feelings of emotional distress and unstable attitudes in relation to food, and a “black and white” way of viewing food: foods are either “good” or “bad”. 

         The most common symptom of Orthorexia is described as a preoccupation with “good” foods that affects social interactions. Somebody with Orthorexia might encounter significant interpersonal stress when put in a social situation in which only what they consider to be “bad” foods are available. For example, an Orthorexic may feel extreme anxiety when offered free donuts at work. When Orthorexics eat “good” foods, they often feel a sense of accomplishment, and when they eat bad foods, they feel an equal sense of shame, guilt and devastation. 

           Some personality types and people with certain personality traits  may be more inclined to develop Orthorexia. These are generally type A personality types who seek a strong sense of control over their lives. Others develop Orthorexia because they desire a sense of structure in their lives. These people may also be perfectionists and suffer from low self esteem. They often report difficulty managing emotions and sometimes suffer from chemical imbalances in the brain. 

Orthorexia Sources

Scarff JR. Orthorexia Nervosa: An Obsession With Healthy Eating. Fed Pract. 2017;34(6):36-39.

Strahler J, Hermann A, Walter B, Stark R. Orthorexia nervosa: A behavioral complex or a psychological condition?. J Behav Addict. 2018;7(4):1143-1156. doi:10.1556/2006.7.2018.129

Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat. 2015;11:385-394. Published 2015 Feb 18. doi:10.2147/NDT.S61665

Thomas M. Dunn, Steven Bratman,

On orthorexia nervosa: A review of the literature and proposed diagnostic criteria, Eating Behaviors,

Volume 21, 2016, Pages 11-17, ISSN 1471-0153,https://doi.org/10.1016/j.eatbeh.2015.12.006.

(https://www.sciencedirect.com/science/article/pii/S1471015315300362)Parra Carriedo, A., Tena-Suck, A., Barajas-Márquez, M. et al. When clean eating isn’t as faultless: the dangerous obsession with healthy eating and the relationship between Orthorexia nervosa and eating disorders in Mexican University students. J Eat Disord 8, 54 (2020). https://doi.org/10.1186/s40337-020-00331-2

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