Orthorexia is an eating disorder characterized by an excessive concern with healthy eating. People with orthorexia may only eat foods they consider pure, such as foods without pesticides, contaminants, or animal products.
They may also limit their diet to foods with a low glycemic index and low amounts of fat and sugar. Another common feature is an intense concern with how food is prepared.
This can lead to excessive care around avoiding too much salt, sugar, or fat. Over time, this concern can make the diet very restrictive and low in variety, which can cause weight loss, nutritional deficiencies, and problems in a person’s social life.
Main symptoms
The main symptoms of orthorexia are:
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Excessive concern about the quality of foods that will be eaten and how they are prepared
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Feelings of guilt and anxiety when eating something considered unhealthy
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Food restrictions that become more intense over time
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Complete avoidance of foods considered impure, such as those containing food dyes, preservatives, trans fats, sugar, or salt
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Eating only organic foods and excluding genetically modified foods and foods grown with pesticides from the diet
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Excluding several food groups from the diet, especially meat, milk and dairy products, fats, and carbohydrates
It is common for people with orthorexia to avoid eating out completely and to frequently turn down invitations from friends and family. In some cases, they may accept invitations but bring their own food.
Confirming a diagnosis
Orthorexia should be diagnosed by a doctor or registered dietitian through a detailed evaluation of eating habits. This helps identify whether there are major food restrictions and excessive concern about food.
An evaluation by a psychologist is also important to assess the person’s behavior and identify any possible triggers.
Possible complications
The consequences of orthorexia are related to inadequate and restrictive eating, as well as psychological effects. The main complications include:
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Malnutrition
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Too much or too little of certain vitamins, depending on the diet followed
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Anemia
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Weight loss
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Osteoporosis
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Thyroid problems
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Hormonal changes
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Weakened immune system
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Cardiovascular problems
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Infertility
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Mental health conditions, such as depression, anxiety, and obsessive-compulsive disorder
In addition, the person may be more likely to become socially isolated and may pay less attention to work responsibilities because they spend so much time focused on food.
According to the American Psychiatric Association, eating disorder warning signs can include rigid food rules, emotional distress around eating, and withdrawal from food-related social situations.
When treatment is needed
Treatment for orthorexia nervosa should include regular medical follow-up, and mental health care may also be needed in some cases. Based on the National Institute of Mental Health, eating disorder treatment plans may include psychotherapy, medical care and monitoring, nutritional counseling, medications, or a combination of these approaches.
Nutritional supplements can be recommended when there are vitamin or mineral deficiencies, or related health problems such as anemia.
In addition to medical care, family support is essential to help identify and overcome orthorexia and to encourage a balanced eating pattern that does not put the person’s health at risk.
It is also important to remember that orthorexia is different from muscle dysmorphia, which involves an excessive focus on physical exercise to achieve an extremely muscular body.