Orthorexia: a new eating disorder?

When it comes to eating disorder (ED), Anorexia nervosa or Bulimia Nervosa are the most common one disorder mention within ED. However, Orthorexia nervosa has gained more attention the past decade due to the past trend the last decades with dieting. As a result, there is continued being argued and discussed if should Orthorexia should be officially disorder within ED.

Orthorexia nervosa (ON) is seen today as an eating disorder that involve excessive selectivity in diets or fixation with healthy eating. Compare to Anorexia nervosa of focuses on the amount of food eating, Orthorexia has a fix focus on the quality of the food they eat, which already makes ON stand out to connect to similar traits as obsessive-compulsive disorder. Theoretically, this means a person with anorexia nervosa will give excessive attention of how much they and therefore end up not eating very little to nothing at all, while a person with orthorexia using an obsessive amount of time and energy to plan what to eat and restrict what they can eat. Even though for some this can be seen as “healthy” in this modern because dieting and restricting is trendy and positively associated by influencers and high-social status people, orthorexia is to that degree where dieting lead a person not getting enough fuel or nutrition from food to function physically and psychologically, such like with Anorexic or Bulimic patients.

On the contrary, Orthorexia Nervosa has many shared features with Anorexia Nervosa as well as obsessive-compulsive disorder, which leading developing a clear diagnose more difficult. According to APA, Orthorexia Nervosa is referred as an “unhealthy obsession with eating healthy” yet still not fitting the billing code to be recognize in DSM-5 and do be treated by psychiatrists or psychologist. Nonetheless, APA do recognize Orthorexia to be able to be treated to clinical dietitians with the goal of the treatment to develop a flexible approach to food options. Therefore, different Questionnaire to help diagnose a patient for the criteria of Orthorexia, such as Bratman and knight Questionnaire (200) and ORTO-15 by Donini (2004), was develop. Bratman Questionnaire involve criteria’s around obsessive and ego-dystonic behaviours around food, like spending many hours a day planning or achieve a feeling of self-worth by following a diet. ORTO-15 focuses on valuating if one`s choice of food in total is healthy or unhealthy. Nonetheless, both of these questionnaires have limitation to work, such as being too clinical or in-valid to use significantly to diagnose.

In general, Orthorexia Nervosa have now got more attention due to the modern dieting culture in the 21th century, in similar way an Anorexia had increase attention during the 90s due to the heroic chic trend where extreme thinness was in fashion. Yes, Orthorexia are not an official diagnose yet for mental health manual, but due to the increasing research of Orthorexia Nervosa, it could be just a matter of time before it does.

Reference:

Roy, L. D. (2014, September 6). Orthorexia Nervosa | Eating Disorder - Diagnosis. Medindia. https://www.medindia.net/patients/patientinfo/orthorexia-nervosa-diagnosis.htm

Thomas, L., MD. (2019, February 27). Diagnostic Criteria for Orthorexia. News-Medical.Net. https://www.news-medical.net/health/Diagnostic-Criteria-for-Orthorexia.aspx

Lomke, E. (2016, November 21). Orthorexia Nervosa: Not in the DSM-5. American Mental Health Foundation. https://americanmentalhealthfoundation.org/2016/11/orthorexia-nervosa-not-in-the-dsm-5/

Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., & Cannella, C. (2005). Orthorexia nervosa: Validation of a diagnosis questionnaire. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 10(2), e28–e32. https://doi.org/10.1007/bf03327537