Orthorexia – do you truly know how to identify it?

As nutrition professionals, it is quite common for us to see people with eating disorders, mainly Anorexia Nervosa, Bulimia Nervosa, and Binge Eating.

In a society obsessed with body image, when does being overly concerned about health, become dangerous or a problem?

In this article, we will discuss Orthorexia, how we can identify it during a nutrition consultation, and what should be considered for the nutritional intervention.

What is Orthorexia?

When having an excessive worry about the quality and purity of our food, we can be dealing with an eating disorder known as Orthorexia Nervosa, from the Greek word "orthós" which means right and "orexsis" which means hunger.

It is defined by an "obsession of eating healthy", looking to consume only clean foods, raw, fresh, organic, with no Genetically Modified Organism (GMOs), avoiding high levels of fat, cis and trans, salt or sugar, etc.

This obsession leads to the exclusion of essential nutrients important for physical and mental well-being, causing severe nutritional deficiencies and weight loss due to the decrease in nutritional variety and daily caloric ingestion. With no diagnosis criteria defined, it becomes difficult to diagnose this disorder and to know with precision the number of people that suffer from it.

How to identify if being concerned with eating well is a risk?

Wanting to be especially careful when selecting healthy foods that are less processed and with adequate cooking methods is not a synonym for orthorexia.

The presence of this disorder usually includes suffering and interferes with one's life quality as people tend to have a hard time fitting in social events that include non-controlled food options, most of the time feeling guilty and overwhelming anxiety.

The exclusion of these types of events, like dinner with friends, is very common. However, as a solution, individuals with orthorexia many times choose to take their own food so they can have control over every food ingested, from its composition, quality, and confection. Studies have shown that many individuals with orthorexia also suffer from obsessive-compulsive disorder.

Signs to look for during a nutrition consultation:

• Obsession regarding the list of ingredients and its respective nutritional composition;
  
  
• A more significant concern with the nutritional benefit of ingredients;
  
  
• Severe restriction of a large number of foods;
  
  
• Incapability to eat foods that are not considered "healthy" or "pure";
  
  
• Atypical interest in what others eat;
  
  
• Spending a significant amount of their day to think about these foods and ways of preparing;
  
  
• To feel anguish and despair in social situations where "safe/healthy/approved" meals aren't available;
  
  
• There may or may not exist a concern with body image;
  
  
• To avoid eating out.

Treatment and nutritional intervention

There isn't a specific treatment for this condition, as it is still quite challenging to diagnose. Nonetheless, the presence of a multidisciplinary team including a psychiatrist and psychologist, as well as a dietitian/nutritionist, is essential to the treatment of these types of disorders.

As dietitians, we should prioritize the exposure and variety of suppressed foods in eating choices, work towards the goal weight, and tackle nutritional deficits. Having family support is crucial for the improvement in behavior.

We should be aware of these behavioral signs during the consultation so that they can be treated accordingly, with no physical or emotional setbacks for the individual.

Providing nutritional literacy, together with food education during the consultation, are the main tools for adopting healthy food habits in a controlled and informed manner.

Orthorexia is an eating disorder that is becoming quite common in today's modern society. A nutrition professional needs to be prepared to identify and flag these cases so that early intervention is made.

Tools such as Nutrium allow a dietitian to have more regular contact with their patients and to be able to follow up and guide them more easily during this treatment.

If you haven't tried it, register here and see how easy it is to keep up with your clients through the mobile app.

References:

• Koven, Nancy S., and Alexandra W. Abry. "The clinical basis of orthorexia nervosa: emerging perspectives." Neuropsychiatric disease and treatment 11 (2015): 385
  
  
• Nevin, Suzanne M., and Lenny R. Vartanian. "The stigma of clean dieting and orthorexia nervosa." Journal of eating disorders 5.1 (2017): 37.
  
  
• https://www.nationaleatingdisorders.org/