Multiple distinct factors-social, psychological, and biological-play a role in the development of eating disorders. These disorders disrupt individuals’ daily routines, impair their functionality, and significantly diminish their quality of life. One such condition, known as Orthorexia Nervosa, is often referred to as a “healthy eating obsession.” Although it has not yet been formally recognized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), ongoing research continues to explore and define its psychopathological features.
What Is Orthorexia Nervosa?
Orthorexia Nervosa is not a disorder with a long-standing history. The term was first introduced in 1997 by Bratman, who derived it from the Greek words “orthos” (meaning “correct” or “right”) and “orexia” (meaning “appetite”) (Ramacciotti et al., 2011). Orthorexia Nervosa can be described as an obsessive effort to consume foods that the individual perceives as pure, unprocessed, and healthy. Although it is not classified as a distinct diagnosis in the current literature, orthorexia shares several commonalities with recognized eating disorders (Arusoglu et al., 2008). Similar to anorexia, individuals may exhibit restricted food intake and experience weight loss. However, instead of a persistent and obsessive desire for thinness often seen in anorexia and bulimia, accompanied by strict calorie restriction, individuals with orthorexia demonstrate a compulsive drive to consume only healthy, additive-free, and pure foods (Arusoglu et al., 2008).
The pursuit of clean eating and a desire to maintain health and vitality are not inherently pathological. However, when such behaviors lead to a decline in quality of life or impair daily functioning, they may be considered indicative of a disorder (Donini et al., 2004). If individuals begin to prioritize their self-imposed dietary rules above all other aspects of life, if their social relationships and interpersonal functioning deteriorate as a result, and if they devote a significant portion of their day to thinking about food and its contents, it becomes appropriate to consider the presence of a pathological condition.
The Development of Orthorexia
Due to the limited number of studies on Orthorexia Nervosa, etiological findings remain relatively weak. As with other eating disorders, a wide range of factors-including social environment, biological predisposition, and psychological variables-are known to contribute to the development of the pathology. Additionally, some studies suggest that past medical conditions and psychological issues may also play a role in the onset of orthorexic behavior (Getz, 2009).
While access to information has become easier through social media and online platforms, reaching accurate and evidence-based information remains challenging. As a result, dietary trends that are widely discussed but not scientifically valid may influence the development of Orthorexia Nervosa.
As previously noted, the desire to eat clean and healthy is not inherently pathological. However, it becomes a concern when such behavior begins to negatively affect an individual’s quality of life or impairs their daily functioning.
So, How Does the Silent Destruction of Orthorexia Occur?
As previously discussed, Orthorexia Nervosa is marked by a persistent and obsessive preference for foods perceived as pure, natural, and free from additives. Individuals with orthorexia frequently engage in restrictive dietary behaviors, such as limiting their food variety, skipping meals, and practicing various forms of fasting. These unbalanced eating patterns may result in a range of medical complications (Bosi et al., 2007).
When individuals fail to adhere to their self-imposed dietary rules, they often experience intense feelings of worthlessness, inadequacy, and guilt. The consumption of foods they deem taboo typically leads them to impose even stricter dietary restrictions as a form of compensation. For many, self-worth becomes closely tied to the perceived purity of their eating habits.
These rigid food-related beliefs and behaviors frequently lead to social withdrawal, as individuals with orthorexia often view others’ food choices or meals served in social settings such as restaurants as incompatible with their own standards. Over time, this can contribute to a host of negative outcomes, including physical health problems, psychological distress, heightened anxiety and guilt, and significant social isolation.
Treatment of Orthorexia Nervosa
As with all eating disorders, acknowledging individual differences at the outset of treatment for Orthorexia Nervosa is crucial for both the effectiveness and the course of therapy (Okumuşoğlu, 2017). One of the primary goals of treatment is to address the dysfunctional cognitions that contribute to the disorder and to prevent relapse following recovery. A multidisciplinary approach carried out by professionals such as dietitians, psychologists, and psychiatrists can facilitate the treatment process and provide a more comprehensive and effective intervention.
References
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Arusoğlu, G., Kabakçi, E., Köksal, G., & Merdol, T. K. (2008). Ortoreksiya Nervoza ve Orto-11’in Türkçeye Uyarlama Çalışması. Türk Psikiyatri Dergisi, 19(3).
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Bosi, A. T. B., Çamur, D., & Güler, Ç. (2007). Tıp fakültesinde asistan tıp doktorlarında ortoreksiya nervoza prevalansı (Ankara, Türkiye). Arzu, 49(3), 661–666. https://doi.org/10.1016/j.appet.2007.04.007
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Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., & Cannella, C. (2004). Orthorexia nervosa: A preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eating and Weight Disorders, 9(2), 151–157. https://doi.org/10.1007/bf03325060
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Getz, L. (2009). Orthorexia: When Eating Healthy Becomes an Unhealthy Obsession. Today’s Dietitian, 11(6), 40. https://www.todaysdietitian.com/newarchives/060109p40.shtml
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Okumuşoğlu, S. (2017). Yeme Tutumunun, Düşünce Beden Biçimi Kaynaşması, Cinsiyet ve Vücut Kitle İndeksi ile İlişkisinin Araştırılması. Yaşam Becerileri Psikoloji Dergisi, 1(1), 59–65. https://doi.org/10.31461/ybpd.317730
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Ramacciotti, C. E., Perrone, P., Coli, E., Burgalassi, A., Conversano, C., Massimetti, G., & Dell’Osso, L. (2011). Orthorexia nervosa in the general population: A preliminary screening using a self-administered questionnaire (ORTO-15). Eating and Weight Disorders – Studies on Anorexia Bulimia and Obesity, 16(2), e127–e130. https://doi.org/10.1007/bf03325318