Orthorexia is an eating disorder manifested by the obsession with balanced eating. However, from a scientific point of view, the specific eating habits of orthorexia are not considered healthy.

Although the official diagnostic criteria are not yet well clarified, the term "nervous orthorexia" appeared as early as 1997, and specialists are increasingly sounding the alarm about the increasing cases in recent years.

Learn what orthorexia means, how it manifests and what its dangers are.

What is orthorexia

The notion of orthorexia comes from the Greek word "ortho", meaning correct, and "orexis", meaning appetite. Nervous orthorexia is an eating disorder characterized by the obsession with eating healthy, as described by Eating Disorders Victoria.

The condition can start from the desire to adopt a balanced diet, but as it progresses, the diet becomes increasingly restrictive and may be associated with the elimination of entire food groups. Patients with orthorexia are excessively concerned with the quality or "purity" of food, as well as the benefits of healthy eating, but not with the quantity of food.

However, individuals with orthorexia do not base their choices on correct principles of nutrition but rather on personal opinions they have formed over time. Misinformation online and confusion about what constitutes healthy nutrition are risk factors for the development of orthorexia.

Thus, scientists believe that promoting restrictive diets, unqualified nutritional advice and the concept of "pure eating" on social media, at the expense of healthy habits, may be responsible for amplifying orthorexic behaviors, as shown by Omer Horovitz and Marios Argyrides in the work "Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment".

Of course, making balanced nutrition a priority is the best choice for your health, as long as nutritional habits are based on correct principles recommended by specialists. However, if you have orthorexia, the obsession is taken to such an extreme that it can have the opposite effect—compromising health. This has a major impact on relationships with others, predisposes to malnutrition and significantly reduces quality of life.

Sometimes, this medical condition can be accompanied by other eating disorders or conditions, such as obsessive-compulsive personality disorder.

Although not yet clearly defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), the official guide for specialists, orthorexia is a serious medical condition associated with a series of serious complications, which is why it should not be neglected.

How orthorexia manifests

According to Walden Behavioral Care, Healthline and WebMD, nervous orthorexia can produce the following manifestations:

• Extreme fixation on the quality, purity and the ingredients of food products, regardless of quantity;

• Obsessive checking of nutritional labels and ingredient lists;

• Perfectionism;

• Adoption of a diet based only on organic, vegan or raw-vegan foods, along with a categorical refusal to consume conventional foods;

• Obsession with nutrition and food—this can manifest through excessive research of nutrition information online, not necessarily from official sources, and strict meal planning;

• Elimination of food groups considered erroneously unhealthy and without medical, cultural or religious reasons, for example, orthorexic patients may avoid consuming fruits and vegetables, justifying that they contain pesticides, they may avoid gluten-containing grains without a diagnosis of intolerance, and may completely restrict foods containing fats, carbohydrates, animal products, sugar, salt and additives;

• Inflexibility and inability to deviate from established eating habits without feeling anxiety—if the diet's "rules" are violated, patients experience strong feelings of guilt, shame, agitation and worry;

• Feeling of superiority over others regarding personal nutritional principles;

• Increased self-esteem after consuming foods considered healthy;

• Extreme fear of consuming food prepared by others or at restaurants;

• Excessive criticism of how others eat, without a valid scientific justification for individual nutritional choices;

• Categorizing foods as "good" or "bad" - associating "bad" foods with imminent illness, so they are considered "poisonous", often unjustifiably;

• Spending a long time worrying about what types of food will be served at a social event—people with orthorexia may bring their own food to such an event, fearing that the food served does not meet their standards;

• Social isolation—avoiding activities with those who do not share the same principles;

• High stress when healthy foods are not available;

• Feelings of anxiety at the sight of foods considered "unhealthy" - orthorexic patients feel incredibly uncomfortable if these products are present and may even leave the room;

• Mood disorders, anxiety and depression.

Unlike other eating disorders, such as anorexia nervosa, the dietary restrictions in orthorexia are not related to distorted body image or weight control.

Orthorexia complications

Although weight loss is not necessarily a goal of individuals with orthorexia, it inevitably occurs as a result of dietary restrictions. Even though weight loss may be seen as a positive effect, weight loss caused by restrictive diets is not healthy, but rather the opposite.

Restrictive diets associated with orthorexia do not provide sufficient amounts of calories, proteins, lipids, carbohydrates, vitamins and minerals. Thus, patients with orthorexia have a high risk of developing protein-calorie malnutrition (deficient body mass index associated with muscle wasting), vitamin and mineral deficiencies, osteoporosis and weakened immune system, as Omer Horovitz and Marios Argyrides present in the work "Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment".

Other possible consequences of orthorexia, according to Healthline, are:

• Anemia;

• Cardiac rhythm disorders;

• Metabolic acidosis;

• Hydroelectrolyte imbalances;

• Exhaustion;

• Hormonal disorders.

Some of these can be life-threatening, so they should not be underestimated.

On the other hand, orthorexia severely affects relationships with others, professional life, and can have negative effects on mental health and mood. This is associated with chronic stress, anxiety and risk of depression. Prioritizing nutrition can compromise the ability to perform daily activities, reducing productivity at work.

How to manage orthorexia

The first step in treating orthorexia is recognizing the symptoms, followed by seeking specialized help. This step is probably the most difficult because individuals with eating disorders categorically deny the existence of a problem and refuse to seek specialist help.

Although diagnostic criteria are not yet clearly defined, psychologists and health specialists can use different questionnaires to detect the presence of orthorexia and differentiate it from other eating disorders.

The main treatment measures for orthorexia are psychological counseling and cognitive-behavioral therapy, along with nutritional counseling. First and foremost, it is necessary to understand the negative effects of these habits, combat food-related stress and modify eating behavior.

Licensed dietitian-nutritionists also play an important role in managing this condition. They provide correct nutritional education based on science and teach you how to improve your relationship with food.

The approach to orthorexia should be multidisciplinary. Psychological counseling and nutritional counseling work most effectively together to achieve therapeutic success.

Therefore, eating healthy should be a priority, but not one taken to extremes. Orthorexia is an increasingly common eating disorder that requires specialized diagnosis and treatment. To prevent this medical condition, consider educating yourself properly about nutrition by discussing with an authorized nutritionist-dietitian.