Orthorexia

When healthy eating becomes a dangerous obsession

The growing interest in eating healthy can at times have unhealthy consequences. Some doctors and registered dietitians say they are increasingly seeing people whose desire to eat pure or “clean” food—from raw vegans to those who cut out multiple major food sources such as gluten, dairy and sugar—becomes an all-consuming obsession and leads to ill health. In extreme cases, people will end up becoming malnourished.

Some experts refer to the condition as orthorexia nervosa, a little-researched disorder that doesn’t have an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, considered the bible of psychiatric illnesses. Often, individuals with orthorexia will exhibit symptoms of recognised conditions such as obsessive-compulsive disorder or end up losing unhealthy amounts of weight, similar to someone with anorexia.

Researchers in Colorado recently proposed a series of criteria they say could help clinicians diagnose orthorexia. The guidelines, published online in the journal Psychosomatics earlier this year, also could serve as a standard for future research of the disorder, they say.
Ryan Moroze, a psychiatry fellow at the University of Colorado Denver School of Medicine and senior author of the study, said more research needs to be done to develop a valid screening instrument for orthorexia, determine its prevalence and differentiate it from other more well-known eating disorders.

“There are people who become malnourished, not because they’re restricting how much they eat, it’s what they’re choosing to eat,” said Thomas Dunn, a psychologist and psychology professor at the University of Northern Colorado in Greeley, Colo, and a co-author of the article.

“It’s not that they’re doing it to get thin, they’re doing it to get healthy. It’s just sort of a mind-set where it gets taken to an extreme like what we see with other kinds of mental illness,” Dunn said.

Among the proposed criteria: an obsession with the quality and composition of meals to the extent that people may spend excessive amounts of time, say three or more hours a day, reading about and preparing specific types of food; and having feelings of guilt after eating unhealthy food. The preoccupation with such eating would have to either lead to nutritional imbalances or interfere with daily functional living to be considered orthorexia.

Some orthorexia patients are receiving treatments similar to those for obsessive-compulsive disorder. “We’re getting the people who aren’t being treated well under an eating-disorder diagnosis and their disorder is better treated under the OCD dial,” said Kimberley Quinlan, clinical director of the OCD Center of Los Angeles, an outpatient clinic.

The condition seems to start with an interest in living healthy and then, over time, people develop an increased anxiety about eating food that is contaminated or that they deem unhealthy, said Ms. Quinlan. Treatment often involves cognitive behavioral therapy, a type of psychotherapy aiming at behavior modification. “We’ve basically taken a model that we use to treat OCD and applied it to this disorder which is so similar,” she said…..

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