Is Orthorexia a real condition?

When he coined the term Orthorexia Nervosa in 1997 to describe an unhealthy obsession with eating healthily, Dr Steven Bratman ignited a debate that continues today.  Is it an obsessive-compulsive disorder like anorexia nervosa or bulimia nervosa or not?

It is not recognised as such by the American Psychiatric association and is not included in its Diagnostic and Statistical Manual of Mental Disorders (DSM). Indeed, acknowledging that he is not an eating disorder specialist, Bratman himself does not claim that it should be included. He does, however, say that Orthorexia Nervosa is an obsession in which some individuals become so fixated on healthy eating that in rare cases it can lead to malnutrition or death.

Orthorexia Nervosa is an apparent eating disorder in which people focus on the quality of food they eat, as opposed to disorders like anorexia nervosa and bulimia nervosa in which sufferers are concerned with the quantity. It begins with a rejection of processed foods and those with artificial colouring and flavouring, foods that have been treated with chemicals like pesticides and may also include animal products. Those with the “disorder” will eventually limit themselves to eating only fresh foods they have bought (or grown) themselves and that which they have prepared themselves. This results in them withdrawing into a world dominated by their obsession with “pure” foods and can lead to their withdrawal or exclusion from society and to dietary habits that are in fact harmful.


Dr Bratman’s book “Health Food Junkies:  Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating” (published by Random House, 2004) analyses the problem and offers solutions for those afflicted. In the book, he identifies Orthorexia Nervosa as an obsession with the quality of food eaten rather than the quantity and claims that sufferers adopt increasingly rigid diets that lack essential food groups and nutrients leading to poor health and emotional well being and to breakdowns in personal relationships.

The symptoms include:

  • Avoidance of: preservatives, artificial flavours and colouring; food treated with herbicides and pesticides; fat, salt and sugar; and diary or meat.
  • Drastic restriction of food choices.
  • Increased consumption of herbal remedies and supplements.
  • Irrational concerns over food preparation and food hygiene.
  • Over-concern about the relationship between food and health.
  • Guilt feelings after straying from a diet regime.
  • Avoidance of food prepared by others.
  • Criticism of others who do not follow a rigid diet.
  • Self-satisfaction from “healthy” eating.
  • Distancing from others with different views on food.
  • Excessive time devoted to thinking about food and diet.

According to Dr Bratman, Orthorexia Nervosa usually begins innocently enough with a desire to eat healthily for any number of reasons. These can be psychological like body image, irrational fears, spiritual satisfaction, self-punishment and escapism. But there are also more practical reasons such as allergies to certain food groups or physical intolerance of certain foods. Taken to the extreme, the result is Orthorexia Nervosa.

Dr Bratman’s contention is that some individuals become so fanatical about eating healthy food that they become obsessed. They restrict their diets to the extent that they virtually withdraw from social interaction in case they are exposed to unhealthy foods and, more dangerously, eschew all other foods, not recognising that their own food choices are failing to provide all the nutrients their bodies need, leading to ill-health and, in extreme cases, death.

But there are many advocates of healthy eating who disagree with the notion of Orthorexia Nervosa being an obsessive-compulsive disorder, and some who even scoff at the idea. How, they argue, can someone be defined as having an illness simply because they prefer to eat simple healthy food as opposed to processed or artificial foods or foods they believe to have a toxic affect on the body?

The answer, of course, is that there is nothing wrong with choosing to eat healthy food. However, that is not what Dr Bratman is suggesting; indeed, he admits that he was once himself an enthusiast of eating healthy food to the exclusion of non-natural and treated foods. Rather, he is suggesting that some people go too far.

There has been limited scientific examination to determine the prevalence of Orthorexia Nervosa. Dr Bratman devised a simple yes/no questionnaire to decide if a subject had Orthorexia but the most quoted test is the ORTO-15 multiple-choice questionnaire (based on Dr Bratman’s) devised by an Italian team headed by L M Donini. Using this test in a survey, the results of which were published in “Eating Weight Disorders” in 2005, the team found that 6.9% of subjects might have Orthorexia Nervosa while just over 17% were defined as being “health fanatics”. A similar study in Turkey among doctors in Turkey found that some 45% were overly sensitive in their eating habits.

The concept of Orthorexia Nervosa is relatively new and what research that has been done suggests that it is a very real condition and that it is related to anorexia nervosa and bulimia nervosa, but that it is also closely allied to obsessive-compulsive disorders and could be treated as such. However, as yet there is neither a universally accepted definition for Orthorexia Nervosa nor are there sufficiently verified diagnostic criteria.

While the experts continue to debate the status of Orthorexia Nervosa, the fact is that some people do succumb to an overwhelming and eventually irresistible urge to maintain what they perceive to be a healthy diet at any cost. To the layman this would appear to be obsessive-compulsive behaviour that requires treatment. And, in fact, medication and cognitive behavioural therapy has proved to help sufferers effectively overcome their problem.



The Major Symptoms of Binge Eating Disorder

It has become very common to find people suffering from eating disorders now-a-days because of the cultural obsession that exists with weight, appearance, and shape and body size. Bulimia, binge eating and anorexia are considered to be the most common types of eating disorders among which binge eating disorder is the most dangerous. This is a disorder where people get into the habit of eating very large amounts of food regularly. The urge to eat is uncontrollable but this disorder is very frustrating, disgusting and distressing for a person and therefore it is very important to treat such a disorder by having a clear idea about its symptoms.

The urge to eat large quantities

This is one of the most common symptoms of binge eating disorder. The life of a person suffering from this disorder revolves around dieting, weight and most importantly food. Food is the only thing that an individual thinks about. There are a number of diet options that are tried out by an individual but he is not able to find the correct diet that can stop binge eating because deprivation is caused by many diets which again brings back an individual to binging.

Binge Eating Disorder

Feeling of shame

This symptom is very common because many a times it happens that people start feeling embarrassed and ashamed of the quantity of food that they take. It is because of this reason that people start eating in private because they do not want people to know the amount or the quantity of food taken by them which, in turn, leads to social isolation.

Fluctuation in weight

This is another very important symptom of binge eating where the weight of an individual starts fluctuating. There are people who consume a lot of food and are overweight but the measurement of their weight is the same for a very long span of time. Apart from this people who do not get carried away by food and are also eager to stop their habit of binging are found to lose and gain weight very often. Dieting or binging does not have any role to play in the management of weight of an individual because great fluctuations in weight take place while a person is in the habit of bringing.

Feeling of compulsion

This is a symptom where an individual is not able to control his or her desire to eat. A person might be aware of the consequences of eating too much but for certain reasons, he might not be able to control or satiate his hunger because of this disorder. People often feel compelled to take some food even if they do not have hunger and this is something that cannot be controlled by a person suffering from binge disorder.

Fast eating tendencies

People who suffer from binge eating disorder have a tendency to eat very fast. Such people do not take time to eat their food and this can be considered as one of the most common symptoms of this disorder.

Steps Involved in Treatment for Eating Disorders

The path towards the treatment for eating disorders begins with admitting the fact that an individual is suffering from the problem. It is ideally tough for anyone to admit that they are suffering from eating disorders but sooner they do better it is for them. Following the things mentioned below would certainly prove beneficial:

Ask someone for help

Although it might sound weird to get help from a friend or a known person to help in gettingcured from this disorder, it is advisable to approach a close friend or a family member. Another thing that might be done is confiding to a treatment specialist or a nutritionist. While talking to anyone regarding the problem it would be important to be as specific as possible. It would give the better opportunity to get answers to the queries. Answering specific questions would also prove to be beneficial to a large extent.

Get in touch with a specialist

In a situation where an individual suffering from the disorder has a specialist and experienced person to take care of their health the recovery is much faster. Therefore it is very important to get in touch with a professional counselor or some nutritionist specializing to deal problems related to anorexia and bulimia. While conducting the search, the focus should be to find the right person who can actually make the patient feel comfortable.

eating disorders treatment

Address the health related problems

Anorexia or bulimia could prove to be deadly. It is not only harmful for the people who are drastically underweight but can be threatening for normal people as well. There are possibilities of the health to be in danger which is why it is recommended to undergo a medical examination. In case the examination reveals some health concerns, they should be addressed with best solutions available.

Develop a treatment plan

The moment health problems of an individual get in control it would be recommended to consult the doctor or the therapist to develop a long term recovery plan. The steps would need assembling of complete eating disorder treatment team. The team might comprise of the family doctor, nutritionist, social worker, psychologists, or the psychiatrist. After this has been done the patient along with the team would need to develop the treatment plan which individualizes the process to meet the patients’ needs.

The basis of an effective training program to treatment of eating disorders needs to be addressed more than the symptoms which have been there in the patient. Along with that destructive eating habits should also be addressed. There are other root causes for the problems such as emotional triggers which lead to disordered eating. Moreover the plan should be to address the stress levels, fear factor, uncomfortable emotions, etc.

Know Some of the Causes of Eating Disorders

Eating disorders can affect the health of a person. The alternative names for the disease are anorexia, binge eating, and bulimia. There can be a number of reasons that trigger eating disorders. They can be mental, psychological, or simply due to irregular appetite. No particular cause has yet been found that leads to eating disorders. For some, this disorder in eating habits may simply emerge from the concerns for keeping the body in proper shape. There can be a number of causes of eating disorders and some of them have been discussed below. Even while there’s no escape from these disorders irrespective of the age and gender, help for bulimia and eating disorders is within your reach. You can regain your self confidence and overcome these eating disorders with the right treatment and support coupled with some self-help strategies.

Genetic factors

Reports show that most of the cases of anorexia arise from genetic factors. The twins in general show a tendency of sharing some eating disorders such as bulimia nervosa, anorexia nervosa, and obesity. Certain chromosomes have been identified as being associated with anorexia and bulimia. The regions on chromosome 10 have particularly been identified as being associated with bulimia and anorexia. There have also been reports that there is link between the disorder and the genetic factor that is responsible for the brain chemical, serotonin, which is associated with appetite and well being. Researches also show connection between the disorder and certain proteins like BDNF. This protein influences the susceptibility of an individual to developing disorders in eating.

Causes of Eating Disorders

Negative influences of family

The causes of eating disorders can lie in the family as well. Negative influences in the family can also trigger such disorders. One of the major causes in the family can concern the issues of parenting. Emotional disorders can also lead to anorexia or bulimia. Children who have their parents addicted to alcohol are at a greater chance of being anorexic than other children.

Hormonal abnormalities

Hormonal disorders and hormonal abnormalities can also lead to eating disorders. There can issue abnormalities in the thyroid, regions relating to stress, reproductive regions, appetite and well being. Such disorders originate in the limbic system of the brain. There is a particular system, viz. HPA or the hypothalamic-pituitary-adrenal axis. The neurotransmitter or chemical messenger, dopamine is associated with reward seeking behavior. The dopamine receptors have been reported as having an increased activity in people who are anorexic. It is this over activity that lays out the reason for the diminished interest to eat in anorexic people. The production of reproductive hormones is also severely diminished in people having anorexia and bulimia.

Cultural pressures

Studies reveal that the concept of beauty and attractiveness underlying the feminine principle has changed with the economic independence of women. Earlier, when women were economically depended and had stronger marital status they made attempts to be curvaceous. But in the modern times, rather, from the time women are economically independent, they believe in slimness as the epitome of beauty. The media can also be held as one of the greatest cultural pressures marketing products for weight reduction which is one of the major causes of eating disorders found in the youth these days.

The Key Facts Related to Eating Disorders

Eating disorders are complex, real and devastating conditions where the consequences can be severe for health, relationships and productivity. Eating disorders can be extremely serious and sometimes prove to be life threatening which affect the person’s physical and mental health. It is extremely important for people with eating disorders to consult with doctors as soon as possible. Provided below are the different types of eating disorder facts based upon thorough research and studies:

eating disorders facts

  1. Millions of people especially women fall prey to eating disorders throughout the year and out of that, thousands die because of complications that arise from anorexia nervosa. Nearly eighty percent female college students practice binge eating which is considered to be a bulimia predecessor.
  2. When it comes to eating disorder facts, it is interesting to note that the practice usually begins at teenage and for some it develops around the age of twelve. It has been observed that five to ten percent of girls suffer from eating disorders.
  3. Women affected with anorexia although might seem to be admired for their competence and often well liked suffer from low self esteem. These women are constantly seeking approval and often get the feeling of inadequacy. As a result of that they use dieting and food as the main weapons for fighting stress.
  4. Without proper treatment it is hard to get rid of eating disorders. According to studies, eating disorders are considered to be mental illnesses which can prove deadly and devastating if not treated immediately. But there are lots of women who have overcome this problem through treatment and are now living satisfying and happy lives.
  5. The eating disorders treatment usually involves a combination of strategies, including nutritional counseling, psychological counseling, and family therapy and even use of antidepressants medications.
  6. One of the most startling eating disorder facts is that women affected with bulimia tend to remain more depressed. Although antidepressants are used for treating such type of conditions but cognitive behavioral therapy needs to be used with it to make it more effective.
  7. People affected with Anorexia are more likely to develop anaemia, low blood pressure, shrunken organs, slowed reflexes and metabolism, osteoporosis and irregular heartbeat. In case the condition is severe, the chances of cardiac arrest increase to a great extent.
  8. The purging and binging of bulimia can cause kidneys, liver and bowel damage. Apart from that it can also result in ruptured esophagus, tooth erosion, electrolyte imbalance which ultimately leads to cardiac arrest.
  9. Nearly thirty three percent of teen boys along with fifty percent of teen girls use unhealthy methods for controlling their weight like skipping meals, smoking cigarettes, taking laxatives, vomiting and fasting.
  10. Almost seventy percent of teenage girls admit that celebrities and model pictures in magazines inspired them to achieve such body types.

Different Types of Eating Disorders and Their Cure

Eating disorders can happen due to problems in eating pattern or change in diet. It can go either ways whether people tend to over eat or don’t eat at all. This is not good for the mental or the physical health of any person and should be treated properly. Some of the common types of eating disorders are:

Anorexia Nervosa

This disease is mainly caused when people eat very less. This disease can affect people at any age but it is mainly seen to be affecting girls in their early twenties or late teens. To achieve the diagnosis of Anorexia Nervosa effectively, doctors need to ensure that four specific criteria are present. Firstly people should maintain proper weight and should try to keep their weight at normal. Secondly people should remove the fear of getting fat. Thirdly people should get out of the denial state when it comes to their current weight. Finally it is important to see that amenorrhea is present or not.

Anorexia Nervosa

Bulimia Nervosa

Among different types of eating disorders this problem is caused by purging episodes or cyclical bingeing. While people are suffering from bingeing they consume more food as compared to the normal food pattern. When there is lack in control of food intake a person is said to be suffering from Bulimia Nervosa. People who are suffering from this problem face different purging behaviors like use of laxatives, vomiting, use of enemas, using diuretics, etc.

Bulimia Nervosa

Anorexia Athletica

This problem is said to be caused due to some disordered behavior in eating patterns. This is different from Bulimia Nervosa and Anorexia Nervosa. This disease is related to mental health and creates problems that cause excessive exercising in a patient. Some of the common forms of this problem are Compulsive exercising, Hypergymnasia, Sports Anorexia, etc. People who suffer from Anorexia Athletica get involved in excessive workouts and also reduce their calorie intake.

Anorexia Athletica


This problem does not require any specific diagnosis and involves an incident of eating extra during a specific period or habitual excessive eating. This could become problematic as it relates to compulsive relation with food. To treat this problem it is important to modify the behavior of a person.


Night Eating

This syndrome is emerging fast and has been seen in many people it is related to obesity and most of the people who suffer from this problem tend to be overweight. There are negative health effects of this problem and it is mainly caused due to delayed timing of food.

Night Eating

Orthorexia Nervosa

Orthorexia Nervosa is a common eating disorder and shares the symptoms of both Bulimia and Anorexia Nervosa. This problem is a bit similar to workaholism. It is a state where people get addicted to excess food. It tends to bring change in mood of the patient and sometimes isolates them. People can get rid of this problem by consuming the right food instead of consuming huge amounts of food.

Orthorexia Nervosa