Each of the reasonable people with responsibility approaches the choice of those products that he eats. However, recently there have been more frequent cases of the so-called “ orthorexia nervosa “ — a behavioral disorder associated with a pathological desire for a healthy diet, as a person subjectively imagines it. The term itself was coined quite recently (1997) by the physician Steven Bratman, who himself has gone from ordinary health care to the loss of the ability to lead a normal life in society.
Orthorexia nervosa is an eating disorder with excessive concern for proper nutrition has not yet been sufficiently studied, and in medical classifications there is neither such a concept nor, of course, developed diagnostic criteria. But there is a concept of orthorexia nervosa, and it is a real eating disorder.
Symptoms of orthorexia nervosa
For a person who suffers from orthorexia nervosa, concern for the correct way of eating behavior becomes all-consuming, displacing all other interests and hobbies from life over time. According to the personal classification of such a person, all food products are either healthy or harmful, without regard to taste preferences. Any deviation from a well-thought-out diet entails increased anxiety and a pronounced sense of guilt. After a short time, the manifestations of nervous orthorexia become noticeable to others.
Since most of the ideas of proper and healthy nutrition are drawn from articles in popular media, people who take excessive care of their diet exclude many foods from the diet, including those absolutely necessary for the body, which supply the necessary vitamins, minerals, trace elements, phytonutrients. Under the ban are sweets, table salt, fats, especially animals, or starch. Over time, the list of foods that are considered harmful for such a person is replenished: some types of meat or, in general, all animal products, alcohol, yeast, vegetable protein (gluten), caffeine or anything else can get into it. Appropriate restrictions are also imposed on the methods of cooking, for example, only raw foods are included in the diet. Gradual narrowing of the range of food products,
The most characteristic sign of this disorder can be called the dichotomous principle of food division, in which there are no shades: the product is either harmful and should never be consumed, or beneficial and should be eaten as much as possible. In some people, the fear of potentially dangerous foods takes the form of phobias, and such a person will not consume food that he himself considers unhealthy, under any circumstances. In the event that he failed to restrain his desires, and ate something from unauthorized foods, ideas of guilt, lowering self-esteem, self-flagellation and imposing serious punishments on himself for misconduct — even more severe dietary restrictions, abstinence from food or increased physical Loads.
Over time, concern for rational nutrition becomes even more intrusive: internal rules are adopted on how to cut food, choosing the right dishes or kitchen utensils exclusively from specific materials . All these actions become a kind of rituals and take on the character of an obsessive state. People suffering from orthorexia nervosa always meticulously calculate their diet for a long time ahead. They do not eat meals unless they have the opportunity to find out how and from what products these dishes are prepared. Therefore, they very rarely eat food that was not made by themselves or their like-minded people.
After a very short time, such people begin to relate to themselves and others, based on a single criterion: a healthy or unhealthy (according to their ideas) diet. In their opinion, only people who adhere to proper nutrition are worthy of respect.
To identify some of the symptoms of orthorexia nervosa, Stephen Bratman developed a short questionnaire, including, for example, the following statements:
Do you devote at least three hours a day to thinking about how you should eat?
- your food restrictions do not allow you to eat in cafes and restaurants?
- Does your self-esteem increase due to the fact of proper nutrition?
If a person answers positively to five or more of the eleven questions presented in the questionnaire, then, according to Stephen Bratman, it is highly likely that he suffers from orthorexia nervosa.
Strict restrictions on the choice of products and their preparation lead to a significant impoverishment of the life of a person suffering from orthorexia nervosa, to difficulties in communications and to limit the circle of contacts. It happens that it even has a decisive influence on the choice of a life partner, profession or hobbies. Obsessive preoccupation with the characteristics of the diet leads to the fact that most of the time a person spends in studying information about the properties of products, eventually losing criticality in assessing its reliability.
In parallel with this, voluntary severe restrictions on the choice of food cause an irresistible craving for the consumption of prohibited foods, up to episodes of bulimia nervosa. Such a person, if for some reason he consumes food that he considers harmful, may experience anxiety or low mood, up to a depressive state.
Orthorexia nervosa significantly narrows the list of products allowed for consumption, and can lead to serious deterioration in a person’s vital signs. This can be caused by an excess of some elements in the diet, but most often — their significant deficiency. Most of the surveyed, who had a serious history of significant food restrictions such as raw food or strict vegetarianism, suffered from a lack of vital elements in the diet. Studies have unequivocally confirmed that many of the popular diets for people with orthorexia nervosa have a negative effect on the functioning of most body systems.
Causes of orthorexia nervosa
An exact definition and developed diagnostic criteria for orthorexia nervosa have not been developed, the causes of its occurrence are not yet known. Some authors are inclined to believe that orthorexia nervosa is one of the manifestations of hypochondriacal disorder. According to another hypothesis, this is not an eating disorder, but a variant of obsessive-compulsive disorder (OCD), that is, obsessive states. But here it is necessary to take into account a serious discrepancy — in the case of OCD (obsessive thoughts and actions), the patient is aware of the irrationality and unreasonableness of his behavior, and those who show signs of orthorexia nervosa are convinced of the correctness of their actions. Or maybe this is one of the new variants of dependent states?
The psychological cause of orthorexia nervosa may be, according to Stephen Bratman (the physician who first described the disorder), an obsessive desire for a sense of one’s own exclusivity and superiority over others who are incapable of such self-discipline.
Other authors consider orthorexia a variant of anorexia nervosa, since those suffering from both conditions exhibit similar personality traits: perfectionism, a high degree of anxiety, a need for total control of their own lives. . But, unlike anorexia nervosa, in people with orthorexia, there is no desire to reduce body weight, but there is a desire to maintain maximum health.
Anorexia nervosa is an eating disorder. According to the modern classification of diseases, anorexia nervosa refers to mental disorders, under the codes F50.0 and F50.1. It manifests itself as a pronounced desire to reduce body weight and a pathological fear of gaining weight. People with anorexia nervosa have distorted ideas about their own bodies and beauty standards. They deliberately limit themselves in nutrition, exhaust themselves with diets and exercise, take laxatives and diuretics.
There is an opinion that the condition called orthorexia nervosa does not belong to mental disorders, but is a social trend that will eventually go out of practice. However, the signs of orthorexia need to be watched closely as it can cause severe health problems in the long term. In addition, orthorexia nervosa can be a harbinger of serious mental disorders associated with eating disorders — bulimia and anorexia.
Bulimia nervosa is an eating disorder (F 50.2 according to the International Classification of Mental Diseases ICD 10), a mental illness characterized by a combination of an obsessive desire to lose weight and episodes of overeating, after which the patient causes vomiting or takes other measures to reduce the effect of the food eaten on his organism.
At the same time, there is also a point of view in society according to which nervous orthorexia should not be equated with pathological conditions, since it is nothing more than the desire of a socially wealthy person to lead a healthy lifestyle.
Discussions about whether such behavior is pathological are associated with cases where orthorexia nervosa is obviously an excessive hobby and begins to take a dominant position, crowding out other natural interests of the individual.
Treatment of orthorexia nervosa
Although orthorexia nervosa is not currently recognized as a separate nosological entity (disease), it can cause significant harm. In addition to social maladaptation, a person with this disorder has a high probability of a lack of vital substances. Individuals who prefer a vegan diet and adhere to a raw food diet may suffer from iron deficiency anemia, all examined are found to be deficient in substances such as calcium, magnesium, iodine, zinc, vitamins E, D, B12, etc. The harm that an obsessive desire for healthy diet and objectively unreasonable refusal to eat certain foods leads to strong recommendations about the need to treat orthorexia nervosa.
With this disorder, a consultation with a psychotherapist, psychologist is indicated. It is also possible to contact a psychiatrist if a person suffering from an obsessive desire for a healthy diet has symptoms of neurotic disorders, such as anxiety, phobias, sleep disturbances, etc. Then drug treatment is necessary. In addition, a good doctor and a professional psychotherapist, psychologist, who inspire confidence in their patient, can debunk persistent myths about the exceptional usefulness or harm of certain types of food, help the patient return the necessary products to his diet. They will also be able to find out the original reason that made a person unconsciously accept such strict food prohibitions for himself, adjust his life attitudes, restore full social functioning,