Orthorexia nervosa

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Orthorexia, or orthorexia nervosa is a term coined by Steven Bratman, a Colorado MD, to denote an eating disorder characterized by excessive focus on eating healthy foods. In rare cases, this focus may turn into a fixation so extreme that it can lead to severe malnutrition or even death.[1][2]

Bratman coined the term in 1997 from the Greek orthos, "correct or right", and orexis for "appetite"[3]. Literally "correct appetite", the word is modeled on anorexia, "without appetite", as used in definition of the condition anorexia nervosa. Bratman describes orthorexia as an unhealthy obsession (as in obsessive-compulsive disorder) with what the sufferer considers to be healthy eating. The subject may avoid certain foods, such as those containing fats, preservatives, animal products, or other ingredients considered by the subject to be unhealthy; if the dietary restrictions are too severe or improperly managed, malnutrition can result. Bratman asserts that "emaciation is common among followers of certain health food diets, such as rawfoodism, and this can at times reach the extremes seen in anorexia nervosa." In addition, he claims that "anorexic orthorexia" can be as dangerous as anorexia. However, he states, "the underlying motivation is quite different. While an anorexic wants to lose weight, an orthorexic wants to feel pure, healthy and natural. Eating disorder specialists may fail to understand this distinction, leading to a disconnect between orthorexic and physician."[1][4]

According to the Macmillan English Dictionary, the word is entering the English lexicon.[5]. It is not an official medical diagnosis, and it is not listed in the DSM-IV[6]. However, it is used as a diagnosis by some practitioners who have documented the damaging results of the condition, as they have seen in their practices.[7][8][9]


[edit] Diagnostic criteria

As of January 2007, two peer-reviewed studies have been published on the condition. [10] [11] In the studies, Donini et al define orthorexia nervosa as a "maniacal obsession for healthy foods" and propose several diagnostic criteria.[10] Sufferers of orthorexia often display symptoms consistent with obsessive-compulsive disorder and have an exaggerated concern with healthy eating patterns. A diagnostic questionnaire has been developed for orthorexia sufferers, similar to questionnaires for other eating disorders.[11] Bratman proposes an initial self-test composed of two direct questions: "Do you care more about the virtue of what you eat than the pleasure you receive from eating it?... Does your diet socially isolate you?" [12]

[edit] Symptoms and Theory

Symptoms of orthorexia nervosa may include obsession with healthy eating, emaciation, and death by starvation. Orthorexic subjects typically have specific feelings towards different types of food. Preserved products are described as "dangerous", industrially produced products as "artificial", and biological products as "healthy". Sufferers demonstrate a strong or uncontrollable desire to eat when feeling nervous, excited, happy or guilty. According to the abstract of a 2004 study quoted on PubMed, a service of the National Institutes of Health, "The analysis of the physiological characteristics, the social-cultural and the psychological behaviour that characterises subjects suffering from ON shows a higher prevalence in men and in those with a lower level of education."[10]

[edit] Biology of orthorexia nervosa

There has been no investigation into whether there may be a biological cause specific to orthorexia nervosa. However, Donini et al link orthorexia to a food-centered manifestation of obsessive compulsive disorder, which is thought to have specific biological causes.

[edit] See also

[edit] References

  1. ^ a b The Orthorexia Home Page by Steven Bratman, MD
  2. ^ Health Food Junkies Essay by Bratman, reprinted from Yoga Journal, October 1997
  3. ^ S. Bratman, D. Knight: Health food junkies. Broadway Books, New York, 2000.
  4. ^ Palo Alto Medical Foundation Summary of Eating Disorders
  5. ^ Macmillan English Dictionary entry for Orthorexia Nervosa
  6. ^ Orthorexia nervosa
  7. ^ Web MD report: Orthorexia: Good Diets Gone Bad
  8. ^ Orthorexia: Too Healthy? Specialists have coined a new term-orthorexia-to describe an obsessive concern with healthy eating that often leads to social isolation, Psychology Today, Sept/Oct 2004.
  9. ^ Observer Guardian Newspaper, Sept 9, 2001, column reporting on Orthorexia
  10. ^ a b c Donini L, Marsili D, Graziani M, Imbriale M, Cannella C (2004). "Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon". Eat Weight Disord 9 (2): 151–7. PMID 15330084. 
  11. ^ a b Donini L, Marsili D, Graziani M, Imbriale M, Cannella C (2005). "Orthorexia nervosa: validation of a diagnosis questionnaire". Eat Weight Disord 10 (2): e28–32. PMID 16682853. 
  12. ^ McCandless, David (29 March 2005). "'I am an orthorexic'". BBC News. http://news.bbc.co.uk/1/hi/magazine/4389849.stm. 

[edit] External links


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