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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Orthorexia, Another Kind of Eating Disorder

Allan Schwartz, LCSW, Ph.D. Updated: Oct 11th 2012

Another Kind of Eating Disorder: OrthorexiaWe all want to eat healthy, right? However, what if you are someone who is obsessed with eating healthy to the degree that little else matters in your life? Or, what if you know someone like this?

Orthorexia is not listed in the DSM as yet but is considered to be an eating disorder by mental health practitioners. While it might appear to be similar to Anorexia it is actually quite distinct. First, let's define what Orthorexia actual is.

While most of us want to eat healthy, for a person with Orthorexia, eating health becomes something like a religion. For them, eating healthy is a way to achieve physical, emotional, and spiritual purity. By striving towards this kind of purity, they believe they are being very virtuous. Being virtuous means being moral, upright and ethical. This is how it's different from anorexia. The goal of the anorectic is to be thin. They become obsessed with thinness because they see themselves as fat. In that sense, the anorectic is delusional because they look in the mirror and see themselves as fat even when they are dangerously skinny. They deny the fact that they are skinny and see only fat. In the case of orthorexia, the individual knows they are thin. However, the purpose of their behavior is religious in nature, moving towards spiritual purity. That is why they punish themselves for the slightest infraction. While the anorectic views food as something disgusting there is not such thought in orthorexics. For them, the only question about food is whether or not it helps them become spiritual and pure.

Some mental health specialists view orthorexia as an Obsessive Compulsive Disorder. This is problematic because those with OCD are aware of their symptoms and want to end them because it causes them great discomfort. Those with OCD, there is a huge amount of anxiety with which they cope.  For the person with orthorexia, there is nothing wrong. They do not report any symptoms of anxiety and do not believe they have a problem. They believe they are making a rational choice and see nothing wrong with their strivings. That is why it is easier to do psychotherapy with someone with OCD and even someone with Anorexia as compared to someone with Orthorexia.

Even though Orthorexics see nothing wrong with their behavior, they experience real problems in the way they function. In the DSM some basic symptoms must be present in order for a person to be diagnosed with a disorder. There must be impairment in the social and occupational functioning of the individual so that the disorder interferes with the work and private life of the person. Those with Orthorexia are socially isolated because they are so obsessed with how they eat that there is room for little else in their lives. They become socially isolated, unable to work and unable to have any kind of social life that includes a significant other.

The great dilemma for the mental health community is how to treat someone who is clearly non functional but who sees nothing wrong. Even the anorectic can be made so see there is a problem after multiple health problems occur. Not so for the orthorexic for whom dedication to their religious and spiritual goal is all that's important. Therefore, they resist cognitive behavior therapy because they see nothing wrong with their thinking and therefore, there is no need to change it. The only hope for accepting treatment might be the dangerous loss of weight that they experience and are aware of.

Orthorexia is a new type of eating disorder that was first brought to attention during the middle 1990's. A great deal more research will be done in order for successful treatments to be developed.

Do you know anyone with Orthorexia?

Your knowledge and experiences could be very helpful for everyone. Please send in your comments.

Allan N. Schwartz, PhD.

 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    Orthorexia into binge eating - Jason - Jun 11th 2014

    Hi Sarah,

    I had a very similar experience and now I suffer from binge eating. I am not able to find a middle ground with my exercise and eating. I am either on a strict routine and counting marco's or doing nothing and eating what ever I want.

    Coincidence of Anorexia and Orthorexia - Sarah - Jan 7th 2013

    How likely are these to overlap?  I'm trying to understand my period of being extremely underweight a few years back (and borderline overweight and helpless now), when I was influenced by my brother to prioritize the "purity" of foods (I only wanted to take into myself "that which made me stronger" -- meaning no junk food, media, literature, or any other "unworthy" pursuits), but was at the same time restricting my calories (by the end it was probably around 800 or less a day, because I wouldn't allow myself the yogurt or dark chocolate I'd originally been allowing for dessert, or the nuts in my foods, or any cheese or milk or bread, and eating "unhealthy" or 200+ kcal foods caused me extreme stress).  I lost my period for a year, and was 30 lbs underweight at my thinnest.  Do orthorexics tend to suffer similar health issues to anorexics?  Or are their symptoms/obstacles more of the social/obsessive nature? 

    I wish I could stop looking back on this period with a mixture of intense nostalgia and regret for having lost that "freedom".  (I've flipped sides -- am now, by all apperances, a binge eater.)

    Doesn't Sound Like OCD to Me - Janet Singer (ocdtalk) - Oct 15th 2012

    I'm not that familiar with orthorexia, but from your description, it sure doesn't sound like a type of OCD. Also, as you say, it can be very difficult to treat if sufferers don't realize they have a problem. Those with OCD know their thoughts and behaviors are not rational. I look forward to learning more about this disorder.

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