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Orthorexia: When Healthy Eating Becomes a Disorder

Healthy eating can lead to major improvements in health and well-being.However, for some people, the focus on healthy eating can become obsessive and morph into an eating disorder known as orthorexia.

What is Orthorexia?
Orthorexia, or orthorexia nervosa, is an eating disorder that involves an unhealthy obsession with healthy eating.Unlike other eating disorders, orthorexia mostly revolves around food quality, not quantity. Unlike with anorexia or bulimia, people with orthorexia are rarely focused on losing weight.
Instead, they have an extreme fixation with the “purity” of their foods, as well as an obsession with the benefits of healthy eating.A few years ago, orthorexia was in the media spotlight because of Jordan Younger, a successful blogger with more than 70,000 Instagram followers.The term “orthorexia” was first coined in 1997 by the American physician Steve Bratman. The term is derived from “orthos” – which is Greek for “right.”

What Causes Orthorexia?
Although you may begin a diet simply intending to improve your health, this focus can become more extreme.Over time, good intentions can slowly morph into full-blown orthorexia.Research on the precise causes of orthorexia is sparse, but obsessive-compulsive tendencies and former or current eating disorders are known risk factors.Other risk factors include tendencies towards perfectionism, high anxiety or a need for control.
Several studies also report that individuals focused on health for their career may have a higher risk of developing orthorexia.Frequent examples include healthcare workers, opera singers, ballet dancers, symphony orchestra musicians and athletes.The risk may also depend on age, gender, education level and socioeconomic status, but more research is needed before conclusions can be reached.

How Common is Orthorexia?
In some cases, it can be hard to differentiate between orthorexia and a normal preoccupation with healthy eating.For this reason, it is hard to determine how common orthorexia is. The rates in studies range from 6% to 90%. Part of this is also because the diagnostic criteria are not universally agreed upon.
What’s more, the criteria don’t assess whether the behaviors negatively impact the person’s social, physical or mental health, which is a crucial part of orthorexia.Enthusiasm for healthy eating only morphs into orthorexia when it turns into an obsession that negatively affects everyday life, such as extreme weight loss or a refusal to eat out with friends.

How is Orthorexia Diagnosed?
To make the distinction between healthy eating and orthorexia clearer, Bratman and Dunn recently proposed the following 2-part diagnostic criteria:
1. An Obsessive Focus on Healthy Eating
The first part is an obsessive focus on healthy eating that involves exaggerated emotional distress related to food choices. This can include:
• Behaviors or thoughts: Compulsive behaviors or mental preoccupations with dietary choices believed to promote optimal health.
• Self-imposed anxiety: Breaking self-imposed dietary rules causes anxiety, shame, fear of disease, sense of impurity or negative physical sensations.
• Severe restrictions: Dietary restrictions that escalate over time and can include the elimination of entire food groups and addition of cleanses, fasts or both.
2. Behavior that Disrupts Daily Life
The second part is compulsive behavior that prevents normal daily functioning. This can happen through any of the following ways:
• Medical issues: Malnutrition, severe weight loss or other medical complications.
• Lifestyle disruption: Personal distress or difficult social or academic functioning due to beliefs or behaviors related to healthy eating.
• Emotional dependence: Body image, self-worth, identity or satisfaction is excessively dependent on complying with self-imposed dietary rules.

Negative Health Effects of Orthorexia
1. Physical Effects
Although studies on orthorexia are limited, this condition is likely to lead to the many of the same medical complications as other eating disorders.
For instance, a shortage in essential nutrients caused by restrictive eating can result in malnutrition, anemia or an abnormally slow heart rate.
Additional consequences include digestion problems, electrolyte and hormonal imbalances, metabolic acidosis and impaired bone health.
These physical complications can be life-threatening, and should not be underestimated.

2. Psychological Effects
Individuals with orthorexia can experience intense frustration when their food-related habits are disrupted. What’s more, breaking self-imposed dietary rules is likely to cause feelings of guilt, self-loathing or a compulsion towards “purification” through cleanses or fasts.

How to Overcome Orthorexia
The consequences of orthorexia can be just as severe as those from other eating disorders. If left untreated, they can result in irreversible damage to health. The first step towards overcoming orthorexia is identifying its presence. This can be challenging, because individuals who have this disorder often fail to recognize any of its negative effects on health, well-being or social function.

Once the problem has been recognized, help should be sought from a multidisciplinary team that includes a doctor, psychologist and dietitian. Common treatments include exposure and response prevention, behavior modification, cognitive restructuring and various forms of relaxation training. However, the effectiveness of these treatments for orthorexia has not been scientifically confirmed.

Finally, education about scientifically valid nutrition information may also help orthorexic patients get rid of false food beliefs. Those who have eliminated entire food groups may be suffering from lack of proper nutrition. As a result, supplementation can be helpful in treating orthorexia. However, be advised that not all supplements are equal. Melaleuca products, for example, deliver vitamins and mineral via patented Oligo technology, which improves absorption. These products from Melaleuca include multivitamins, antioxidants, and more.