Orthorexia Nervosa

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**Orthorexia Nervosa (ON)**, also called simple **Orthorexia**, is the obsession with proper or 'healthy' eating. Being aware of and concerned with the nutritional quality of food one eats isn't a problem in and of itself, but those with orthorexia become so fixated on 'healthy eating' that they damage their own well-being. This desire may result in weight loss, but the desire to lose weight is either absent, hidden, or subordinate to ideation about healthy eating.

Othorexia is not formally recognized in the DSM, being considered an unspecified eating disorder.

## Signs & Symptoms

* Obsessive focus on food choice, planning, purchase, preparation and consumption.
* Food regarded as a source of health rather than pleasure.
* Distress or disgust when in proximity to prohibited foods.
* Exaggerated faith that inclusion or elimination of particular kinds of food can prevent or cure disease or affect daily well-being.
* Periodical shifts in dietary beliefs while other processes persist unchanged.
* Moral judgement of others based on dietary choices.
* Body image distortion around sense of psychological impurity rather than weight.
* Persistent belief that dietary practices are healthy-promoting despite evidence of malnutrition.

### Diagnosis

Proposed diagnostic criteria for orthorexia nervosa include:

* Obsessive focus on healthy eating, as defined by a dietary theory or set of beliefs whose specific details may vary; marked by exaggerated emotional distress in relationship to food choices as unhealthy; weight loss may ensue as a result of dietary choices, but this is not the primary goal. As evidence by the following:
	+ Compulsive behavior and/or mental preoccupation regarded affirmative and restrictive dietary practices by the individual to promote optimum health.
	+ Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
	+ Dietary restrictions escalate over time, and may come to include elimination of entire food groups and involve progressively more frequent and/or severe cleanses (or partial fasts) regarded as purifying or detoxifying.
* The compulsive behavior and mental preoccupation becomes clinically impairing by any of the following:
	+ Malnutrition, severe weight loss, or other medical complications from restricted diet.
	+ Intrapersonal distress or impairment in social, academic, or vocational functioning secondary to beliefs or behaviors about healthy diet.
	+ Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined healthy eating behavior.

## References

Scarff JR. Orthorexia Nervosa: An Obsession With Healthy Eating. Fed Pract. 2017 Jun;34(6):36-39. PMID: 30766283; PMCID: PMC6370446.

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia