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To address the impact of sociocultural influences and media on disordered eating behaviors, public health campaigns and education initiatives are needed to promote body positivity, challenge unrealistic beauty ideals, and foster a balanced and evidence-based approach to nutrition and overall well-being. Moreover, individuals with low self-esteem or body dissatisfaction may seek a sense of identity and self-worth by pursuing an idealized "healthy" lifestyle, using food choices to gain a sense of accomplishment and validation . The relentless pursuit of "clean eating" can lead to social isolation and impaired functioning in various domains of life as the focus on food dominates these individuals’ thoughts and behaviors. Individuals grappling with these disorders often experience significant distress and anxiety surrounding their food choices, leading to an all-encompassing preoccupation with dietary purity and health . Additionally, the literature has attempted to distinguish between healthy orthorexia and orthorexia nervosa 31,32,33. The lack of standardized criteria also hampers the accurate estimation of the prevalence and incidence rates of orthorexia nervosa, impeding our understanding of this emerging eating disorder’s full extent and impact. Furthermore, a history of dieting and body dissatisfaction can contribute to developing disordered eating patterns centered around food purity and health obsession 23,24.
Though the field lacks data on therapeutic outcomes, current best practices suggest that orthorexia can successfully be treated with a combination of cognitive-behavioral therapy, psychoeducation, and medication. An evaluation of current orthorexia measures indicates a need for further psychometric development to ensure that subsequent research has access to reliable and valid assessment tools. If you have or suspect you may have a health problem, talk to your healthcare provider and follow their advice regardless of any result you have obtained on this quiz.
The obtained research results indicate significant associations between orthorexia (ON) and eating disorders (ED). Positive content can sometimes support a healthy relationship with food, while negative content can increase obsessions with healthy eating. The results of a study conducted in Germany indicate a link between following accounts related to health and physical fitness and orthorexia nervosa tendencies. The White Mika study involved 103 male university students who completed an online survey assessing the symptoms of orthorexia nervosa. One large study conducted on a group of 864 people showed that people with a higher BMI are more likely to develop orthorexia nervosa .
People with orthorexia feel anxious or threatened when they consider giving up their perceived control around food. People with orthorexia can experience intense frustration when their food-related habits are disrupted. But the phrase "clean eating" moralizes food by painting other foods as "dirty" or undesirable. Although researchers aren’t sure exactly what causes orthorexia, many factors seem to play a role in its development. They can be caused by any combination of biological, social, cultural, and environmental factors — not just by exposure to diet culture. Although orthorexia is not recognized as a mental disorder by the American Psychiatric Association, and it is not listed in the DSM-5, as of January 2016, four case reports and more than 40 other articles on the subject have been published in a variety of peer-reviewed journals internationally. Following the publication of the book, in 2004 a team of Italian researchers from La Sapienza University of Rome, published the first empirical study attempting to develop a tool to measure the prevalence of orthorexia, known as the ORTO-15.
Sociocultural influences, on the other end, play a significant role in shaping societal norms and attitudes toward food, body image, and health. Moreover, pursuing "clean eating" and rigid dietary rules can provide a sense of identity and purpose, offering a way to define oneself within a health-conscious community . This highlights the complex interplay between a genuine concern for health and the development of an unhealthy preoccupation with food choices.
This is primarily due to the restrictive nature of their eating habits, which can lead to avoidance of social gatherings involving food, dining out, or participating in shared meals . It is crucial for healthcare professionals to be aware of the potential nutritional consequences of orthorexia and to provide appropriate support and intervention to address both the physical and psychological aspects of the disorder. The fear of consuming "impure" foods can also lead to heightened anxiety and stress surrounding eating, further exacerbating the psychological impact of orthorexia . Individuals with orthorexia often follow restrictive diets, eliminating entire food groups or severely limiting their food choices based on self-imposed criteria for purity and healthiness. Orthorexia, characterized by an obsessive fixation on consuming only "pure" and "healthy" foods, can lead to various nutritional deficiencies and health complications. Feelings of guilt, shame, and failure may arise when individuals deviate from their self-imposed dietary rules, exacerbating anxiety and reinforcing the cycle of obsessive thoughts and compulsive behaviors .
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. Preventing orthorexia in athletes requires a good understanding of relationships that can exacerbate eating disorders. Genetics, socioeconomic factors, and psychological factors all play a role in eating disorders and disordered eating.
With the former, individuals experience one or more chronic somatic symptoms – whether or not medically unexplainable – about which they are excessively preoccupied or fearful, prompting frequent use of traditional and sometimes nontraditional health care services. Within the OCPD syndrome, which itself belongs to the cluster of personality disorders characterized by fear and behavioral inhibition,14 notable similarities to orthorexia include perfectionism, rigid thinking, excessive devotion, hypermorality, and a preoccupation with details and perceived rules. In anorexia, individuals are preoccupied with body image and fear of obesity, altering their eating patterns in order to lose weight. Such preoccupation with health from food may elicit eating patterns that are especially complex (eg, internalized rules governing which foods can be combined at one sitting or at certain times of day) and/or require unusually long periods of time to execute (eg, beliefs that maximal digestion of one food type occurs a certain amount of time after ingestion of another food type). Optimized assessment will not only permit a clearer understanding of prevalence rates, psychosocial risk factors, and comorbid psychopathology but will also be needed to index intervention effectiveness. Answer some general questions about how you feel about food, your current eating habits, how you feel after you eat, and other indicators of an eating disorder. Take this quiz to help you decide whether or not you need to seek professional advice or treatment for orthorexia nervosa. or they have only been used in a handful of studies yet e.g., the Eating Habits Questionnaire (10) or the Orthorexia Nervosa Inventory (11); cf. However, studies have shown consistently that this instrument has poor psychometric properties, the most prominent of which is its low internal reliability e.g., (7–9). The large majority of studies on ON have been based on a questionnaire measure called the ORTO−15 (3) or several short versions of it e.g., (4–6).
Additionally, no reviews have explored the overlaps between ON and obsessive-compulsive personality disorder or ON and autism spectrum disorders (ASDs). As eating and exercise addiction can be intertwined for orthorexic individuals as highlighted by Strahler et al. , this should be an area for future research. Not adequately disentangling health from impairing orthorexia is also a methodological issue in much of the measurement literature for ON. Several authors, including Shisslak et al. and Brooks et al. , have proposed a spectrum of possible eating behaviors. However, individuals with ON have symptoms and concerns reminiscent of those with EDs. This goes beyond the pursuit of a healthy diet and delves into an obsession that can adversely affect an individual’s quality of life. Health anxiety could potentially exacerbate symptoms and be the underlying cause of ON; however, health anxiety is also poorly defined in the literature .
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