Can the effort to eat as healthily as possible reach the point of becoming harmful? When food is strictly divided into “good” and “bad,” many foods are ruled out and eating a meal away from home causes intense anxiety, then the pursuit of a healthy diet may have gone too far.
That is where the fine line between simply choosing healthy foods and orthorexia can be found, explains Vaia Lampadiari, professor of Pathology and Endocrinology at the National and Kapodistrian University of Athens, to the Athens-Macedonian News Agency.
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“Orthorexia nervosa is characterized by an inflexible and rigid adherence to the consumption of healthy, ‘clean’ food, a fact that often leads to harmful consequences for physical and mental health, as well as to a severe restriction of daily life and social interaction,” says Ms. Lampadiari.
The difference, as she explains, lies mainly in the way in which diet begins to take up an increasingly larger part of a person’s life. Anxiety and compulsive behavior surrounding food, spending long hours obsessively preparing meals, cutting out entire food groups considered unhealthy or high in calories, refusal to eat food prepared by others, and, ultimately, social isolation are some of the characteristics it describes.
The term “orthorexia nervosa” was coined in 1997 by the American physician Steven Bratman, from the Greek words “orthos” and “orex.” Despite growing scientific interest in the phenomenon, orthorexia is not currently recognized as a distinct mental disorder in the international diagnostic systems DSM-5-TR and ICD-11.
“There is considerable debate over whether it should be classified within the broader framework of obsessive-compulsive disorders or eating disorders,” notes Ms. Lampadiari. As she explains, a consensus statement by 47 experts, published in 2022, proposed classifying it as an eating disorder due to the common characteristics it shares with them.
When “proper” eating takes over daily life
The image of a person who gradually organizes their life around what they are allowed and not allowed to eat is described to the APE-MPA, by Professor of Psychiatry at the Medical School of the National and Kapodistrian University of Athens and head of the Eating Disorders Unit at the First Psychiatric Clinic at Aeginiteio Hospital, describes his life to the Athens-Macedonian News Agency (ANA-MPA).
“Some people have developed such an obsession with health, proper, rule-based diet that it takes them endless hours to decide what to buy at the supermarket, at organic food stores, or online. It takes them many hours to cook, and all of this affects their work, personal, and social lives,” he explains.
The search for “clean” food can thus cease to be merely a dietary choice and become a fundamental criterion around which the day is organized. The rules are becoming increasingly strict, and with them, people’s choices are also becoming more limited.
A typical example is going out to eat. Someone might start avoiding restaurants or get-togethers with friends because they don’t know exactly where the food comes from, what ingredients were used, or how it was prepared.
“This person will think they can’t go out to eat with their friends because they feel that their friends are eating junk food. And we’re not just talking about fast food, but also restaurants, taverns, and food establishments in general. “They feel that their friends aren’t mindful of what they eat, so they can’t go out to eat with them,” explains Mr. Gonidakis.
The consequences can extend even to close personal relationships, as living with someone who doesn’t follow the same strict dietary rules can be a source of constant friction. Even work can be affected when searching for, selecting, and preparing the “right” food takes up a disproportionately large part of the day.
The Difference from Anorexia Nervosa
Orthorexia overlaps with eating disorders, though it is not identical to them.
Regarding anorexia nervosa, Mr. Gonidakis points out a key difference: “The focus is not on the body, as it is in anorexia. In orthorexia, the focus is primarily on the quality and purity of food and on categorizing foods as ‘allowed’ and ‘forbidden.’”
However, as the number of food restrictions increases, the diet may ultimately become increasingly limited. A person may develop nutritional deficiencies, health problems, and even become severely underweight, as the professor explains, but “through a different path than that of anorexia.”
Social media adds another dimension, as the concept of “clean” eating is a popular topic on accounts focused on nutrition and fitness. As Mr. Gonidakis observes, today “people of all ages, but especially young people, are very aware of the need to eat something ‘cleaner’ and avoid foods that may be tasty but not nutritious.”
Why It’s Hard to Recognize
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One of the distinctive features of orthorexia is that it can easily, at least in the early stages, be perceived as a positive behavior. After all, eating mindfully and avoiding foods considered unhealthy are associated with the image of someone who takes care of their health.
“It’s often part of an overall picture of a healthy lifestyle, which, in theory, is a positive thing,” notes Ms. Lampadiari. The person themselves, she adds, does not consider themselves to be suffering from a disorder, but rather believes they are taking care of their health and, consequently, does not seek medical help.
Mr. Gonidakis addresses the same issue. “People with orthorexia have no awareness of their condition. They don’t consider this a problem and almost never seek help,” he says.
Relatives of people exhibiting orthorexic behavior have reached out to the Eating Disorders Unit at Aeginiteio Hospital, realizing that the situation is going beyond normal limits.
In contrast, those exhibiting this behavior usually consider the concerns of those around them to be exaggerated and view the strict rules they follow as “minimum necessary protection against the toxins of an unhealthy diet,” according to the professor.
Orthorexia at the Center of Research
In recent years, scientific interest in orthorexia has intensified. Researchers are examining, among other things, possible associations with sports and competitive athletics, compulsive exercise, and perfectionism, while, according to Mr. Gonidakis, the strongest links are found with eating disorders.
As he explains to the Athens-Macedonian News Agency (ANA-MPA), “it is a phenomenon that appears to lie in a zone where characteristics of eating disorders and obsessive-compulsive symptoms intersect.”
The dividing line between this and simply being mindful about one’s diet, however, does not lie in an interest in the quality of food, but in the point at which dietary rules cause significant anxiety and restrict our daily lives and choices.
Source: KYPE
