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Choose food accurately to maintain a healthy lifestyle is a very positive attitude. Unfortunately, when this behavior is taken to the extreme, one could suffer from orthorexia.
Orthorexia is a disorder of the food sphere that transforms the idea of healthy eating into a pathological obsession.
When taken to the extreme, attention to a healthy diet becomes a sort of fanaticism, a behavior that has nothing to do with well-being.
Causes and Risk factors
Let’s see where this disorder originated, first diagnosed in 1997 by the English doctor Steven Bratman.
The term orthorexia derives from the Greek Orthos (right) and Orexis (appetite). It describes a condition characterized by an excessively rigid eating behavior and an obsession towards healthy, biological, and pure food.
Thus, those suffering from this disorder are not concerned about the amount of food in their diet, but rather about quality.
Causes of orthorexia are to be found in social and cultural trends of our age, such as attention to what we eat.
This renewed interest in food, which is positive in itself, becomes problematic when attention to healthy eating becomes the essential aspect of a person’s life.
The reasons for this food anxiety depend on several factors, such as overwhelming information about the risks deriving from contaminated food. There is a lot of talk about diets and contaminated foods that can cause damage to health.
For most people, this is essential information that helps them take better care of themselves and understand how to eat better.
In some subjects, they can cause an extremity, excessive attention to physical appearance. People who suffer from orthorexia turn their attention to their physical form into an obsession.
Furthermore, they develop a tendency to obsessive-compulsive behavior or hypochondria.
Those with obsessive and compulsive character traits, or tending to control mania, are more likely to develop this disorder.
These people irrationally fear diseases and think that they can remove them through adequate nutrition, religious, and ethical food motivations.
The orthorexia disorder often also affects people who, for religious or moral reasons, eliminate from their diet foods that are important for the well-being of the organism.
Symptoms of Orthorexia
Some typical signs and behaviors characterize this hypochondriac attitude towards everything that is not considered natural.
One of these is the sensation of feeling good only when eating in the right way. On the other hand, one experiences frustration and intense feelings of guilt when one fails to do so and also to devote excessive time to studying the characteristics of everything one wants to eat.
In summary, the person suffering from orthorexia is tormented by continuous thoughts about food, which results in the following obsessive symptoms/behaviors.
Observing scrupulously one’s excessive dietary rules brings great satisfaction to the person. On the contrary, every transgression generates feelings of guilt, which will tend to narrow the rules to be respected more and more.
Complications and Consequences
The obsession with what to eat leads to nutritional deficiencies as the first consequence since the diet is depleted and moves away from a portion of genuinely healthy food, made of a balanced group of ingredients to the most frequent imbalances, avitaminosis (vitamin deficiencies), osteoporosis, muscle atrophy.
Then, this exaggerated search for perfectionism and the need to control everything that is brought to the table also has emotional and hysterical consequences.
Among the emotional consequences, there is the constant fear of contaminating one’s body, the anxiety of failing to eat food not considered pure, and a high severity with oneself, which transforms the act of eating into a situation that generates diseases.
The consequences of affective and social levels are also quite substantial.
Those who suffer from this disorder feel right about eating a particular type of food and end up considering themselves superior to those who make different choices, to the point of even feeling disgusted for people who eat in a usual way.
This causes a divergence and a problematic relationship with those who do not share their ideas.
The quality of food becomes more important than anything else, compromising the socialization, work performance, and general well-being of the person.
Orthorexia, if not adequately treated, can frequently develop into an even more severe eating disorder and result in anorexia nervosa, leading to increasingly drastic dietary restrictions, up to the rejection of food.
Treatment of Orthorexia
Those suffering from orthorexia tend to exaggerate the information they receive, freeing them from the context. Thus, news of the link between excessive consumption of red meat and tumors can push orthorexics to eliminate all sources of meat from their diet.
Hardly anyone suffering from this eating disorder will admit they have a problem: they think are right and convinced of what they believe. Thus, the remedy for orthorexia begins – as for all addictions – with admitting the pathology.
The first step to cure orthorexia should be to do work on the emotions that fuel the obsession, particularly on the fear of contamination and disease.
In this way, one can then make the person more aware of what moves him or her to get to do a more in-depth job that touches the triggering causes.
Ideally, treatment should involve joint work between a psychotherapist and a nutritionist. Proceeding in small steps, you can allow the orthorexic person to acquire gradual flexibility in feeding, going to fill the nutritional deficiencies that have formed.
In cases where orthorexia has already become a severe maniac form, you can turn to centers specializing in eating disorders.
The Bratman Orthorexia Self-Test*
If you recognize yourself in some of these symptoms, you can try the test you find below, developed by Steven Bratman, the dietician who neologized the term orthorexia for the first time.
If you are a healthy-diet enthusiast, and you answer yes to more than 4 of the following questions, you may be developing orthorexia:
(1) I spend so much of my life thinking about choosing and preparing healthy food that it interferes with other dimensions of my life, such as love, creativity, family, friendship, work, and school.
(2) When I eat any food I regard to be unhealthy, I feel anxious, guilty, impure, unclean and/or defiled; even to be near such foods disturbs me, and I feel judgmental of others who eat such foods.
(3) My personal sense of peace, happiness, joy, safety, and self-esteem is excessively dependent on the purity and rightness of what I eat.
(4) Sometimes I would like to relax my self-imposed “good food” rules for a special occasion, such as a wedding or a meal with family or friends, but I find that I cannot. (Note: If you have a medical condition in which it is unsafe for you to make ANY exception to your diet, then this item does not apply.)
(5) Over time, I have steadily eliminated more foods and expanded my list of food rules in an attempt to maintain or enhance health benefits; sometimes, I may take an existing food theory and add to it with beliefs of my own.
6) Following my theory of healthy eating has caused me to lose more weight than most people would say is good for me or has caused other signs of malnutrition such as hair loss, loss of menstruation or skin problems.
*There are a number of orthorexia self-tests on the Internet, including several that are purportedly designed by me. However, this is the only self-test that I actually authorize and approve. I freely make it available to anyone who wishes to use it. Republishing is fine, just credit me.
Steven Bratman, MD, MPH