Orthorexia Nervosa: the new eating disorder

I would say anytime you have to embarass your kid to refuse a piece of birthday cake that you are medicaly cleared to consume or have a food scale with you at a restaurant...you might have orthorexia nervosa.

If you've ever trimmed the fat on a boneless chicken breast...you might have orthorexia nervosa.

If you'll eat a cake from whole foods but won't eat a salad at mcdonalds...you might have orthorexia nervosa.

Sounds just about right to me

I don't know how this conversation keeps coming back to "it's not a disorder, this is modern society being crazy and vilifying healthy people."

Criteria for psychological disorders involve extreme disruption to life and inability to function normally in everyday life -- e.g. stories mentioned in this thread about people unable to maintain a healthy body weight and suffering from malnutrition because they believe that foods vital to their survival are "impure." If you are healthy and happy, it's not a disorder.

On the contrary, eating disorders are underdiagnosed because of the "it needs to be coming pretty close to killing you" criteria -- I've seen several overweight individuals on this forum admit to debilitating anxiety and OCD style behavior relating to food, but such individuals are rarely diagnosed, because generally to get an eating disorder diagnosis you need to be underweight or vomiting enough to cause serious health issues.

This eating disorder would probably be under "eating disorder nonspecific" rather than actually being in the DSM. There are also ridiculously specific terms for phobias -- did you know Xanthophobia is a fear of the colour yellow? -- but these terms do not specifically appear in the DSM and are instead covered by just a general diagnosis of phobias.

Finally, as many have said, this disorder is not about food. Just like phobias are not about colours and OCD is not about germs. These disorders are deeply rooted in needing to find control and security in life, and ultimately expressing that need by being controlling and secure to a self-injurious extent when it comes to mundane activities of everyday life.

TL;DR: Does your healthy eating cause you debilitating fear, anxiety, self-loathing, and consume all of your thoughts all day every day? Does it make you a social recluse, cause you to hide your food consumption habits from even your friends and family, and make you cry yourself to sleep when you eat the wrong thing? No? You don't have a disorder. Can we all agree that would be hell to go through, and make living a regular life nearly impossible? That's why it's a disorder.

This is a good description, except it's not an on or off thing. It can affect someone severely, mildly, not at all, or anywhere else between the extremes. You can find a lot of people on this site (especially in topics involving 'clean eating') who are at least mildly affected. You will find them telling people they are going to get cancer because they drink diet coke or eat at mcdonalds or eat something with added sugar, etc.

if you start denying yourself any 'treats' or 'cheat days' (no matter how rare) it starts to become an obsession.

I don't think that is true..
I am Jewish, I keep kosher, I don't eat pork.. its not an obsession.. its a life style that is chosen.

This is a good description, except it's not an on or off thing. It can affect someone severely, mildly, not at all, or anywhere else between the extremes. You can find a lot of people on this site (especially in topics involving 'clean eating') who are at least mildly affected. You will find them telling people they are going to get cancer because they drink diet coke or eat at mcdonalds or eat something with added sugar, etc.

For the symptomology of a disorder, it is true that people can experience it anywhere from mildy to severely, with of course the sliding scale you would expect to be found in human diversity. We all can be a bit OCD sometimes.

To actually be diagnosed by a mental health practitioner, though, you would have to reach a robust level of severity. The line of where you cross between just having some of the symptoms to being diagnosed with the disorder is something that mental health practitioners, and increasingly insurance companies, are always contentiously discussing.

I'm guessing it would fall under this one here from the DSM-5:

Avoidant/Restrictive Food Intake Disorder (ARFID)

According to the DSM-5 criteria, to be diagnosed as having ARFID a person must display:

An Eating or Feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
Significant nutritional deficiency
Dependence on enteral feeding or oral nutritional supplements
Marked interference with psychosocial functioning

The behavior is not better explained by lack of available food or by an associated culturally sanctioned practice.
The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way one’s body weight or shape is experienced.
The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. When is does occur in the presence of another condition/disorder, the behavior exceeds what is usually associated, and warrants additional clinical attention.

This is a good description, except it's not an on or off thing. It can affect someone severely, mildly, not at all, or anywhere else between the extremes. You can find a lot of people on this site (especially in topics involving 'clean eating') who are at least mildly affected. You will find them telling people they are going to get cancer because they drink diet coke or eat at mcdonalds or eat something with added sugar, etc.

For the symptomology of a disorder, it is true that people can experience it anywhere from mildy to severely, with of course the sliding scale you would expect to be found in human diversity. We all can be a bit OCD sometimes.

To actually be diagnosed by a mental health practitioner, though, you would have to reach a robust level of severity. The line of where you cross between just having some of the symptoms to being diagnosed with the disorder is something that mental health practitioners, and increasingly insurance companies, are always contentiously discussing.

I'm guessing it would fall under this one here from the DSM-5:

Avoidant/Restrictive Food Intake Disorder (ARFID)

According to the DSM-5 criteria, to be diagnosed as having ARFID a person must display:

An Eating or Feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
Significant nutritional deficiency
Dependence on enteral feeding or oral nutritional supplements
Marked interference with psychosocial functioning

The behavior is not better explained by lack of available food or by an associated culturally sanctioned practice.
The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way one’s body weight or shape is experienced.
The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder. When is does occur in the presence of another condition/disorder, the behavior exceeds what is usually associated, and warrants additional clinical attention.

My point is that there are people who are affected by it whether or not it is recognized or diagnosed, and their lives (and in many cases the lives of those around them) would be improved if they were less affected or unaffected.

Why would any one be embarrassed to refuse or be around anyone who refused cake? I would be more impressed at their will power. This is why peer pressure gets people to do stupid things. If refusing cake embarrasses someone I hate to see what else they might do just to avoid being embarrassed. LOL

Its stupid and just another money maker for them to say people that are very conscience about what they put in their mouth and body is an eating disorder.

Most Dr's want their patients to be mindful of what goes in their mouth and is digested through their bodies.

My husband and I eat out within the guidelines of our eating plan, we cook most of our meals, buy the highest quality foods that we can afford and search out healthy ways of living.

If that is a disorder, I am happy to have it.

I'm with you on this one! I have the right to refuse birthday cake - and it shouldn't embarrass my kid because we've taught him that forced social eating is not a good habit. If you don't want it, politely say "no thank you" and move along.

Perhaps it depends on their reason for refusing cake. If someone refused cake because they already had enough for lunch, that is not the same as someone refusing cake because they think the added sugars and fats and imaginary toxins are going to shorten their lifespan.

What if I don't want to eat cake because it's garbage and I'd rather not eat it. Cake's not healthy and I'd most often rather eat nothing than eat cake - even if I was hungry. Does this mean I have a disorder?

Just because someone offers me something to eat, it doesn't mean I have the social responsibility to eat it. It's this mindset that drives me nuts. Why is there such a stigma attached to refusing junk food? Why do people get so judgy if I turn down a muffin or take a club soda instead of a beer? Or take a burger with no bun and substitute my fries for a salad at the restaurant? Why do people care what I eat?

I don't have orthorexia. I eat junk food occasionally but I eat it when I want to eat it. It's not worth it to me to eat some crappy chocolate cake my colleague bought at the Loblaws this morning. If my mother-in-law makes her triple chocolate brownies or pumpkin ice cream cake, I'll generally have a piece.

Wow! And I thought weighing my food was obsessive.

And in to read later.

It's extremely important to continuously make up new disorders and other things that people need to buy products and medications to fix. The book, supplement, drug, and fitness industries depend on it, just as they depend on Dr. Oz to parrot their talking points and sell their snake oil.

If everyone simply lived a semi-healthy lifestyle and ignored junk science and fake disorders, a very large portion of our economy would collapse.

You can do your part by figuring out all the fake things that are wrong with you, and purchasing items to rectify those things.

Thank you, good citizen.

As a disclaimer, I have not yet read all 5 pages of comments so some of what I write may be repetition or in conflict with the comments of others.

I do wholeheartedly agree that ON is a thing. I have seen multiple posts on the message boards both here and on other sites that display an unhealthy obsession with healthy behavior. There are people who are deathly afraid of holiday meals, dinner parties with friends, eating at restaurants, travel, etc b/c they will be taken out of their comfort zone and will not have the security of their food scale and the control over what they eat and how it is prepared. These people will opt out of spending time with people they love in favor of maintaining that obsessive control. Some take it down a notch and attend the events, but bring their own food...personally, unless the person suffers from a medical disorder and cannot eat the food I prepared, I would be a bit offended. There are so many people that have lost all enjoyment from food b/c they have one or two meals that they eat every day...the same thing over and over b/c they have no idea how to translate the formula for a healthy meal to include other foods either in their own kitchen or at a restaurant or in the homes of family/friends.

Others force themselves to exercise daily at high intensity for long periods of time despite being sick or injured. Granted, I heed the advice of exercising if sick from the neck up and resting if sick below the neck, but I listen to my body 1st and foremost and rest at least one day a week and as required otherwise. Some people will exercise late into the night b/c they were too busy during the day cutting into their sleep, log multiple workouts to burn enough calories for the day, add workouts b/c they ate this or that and have to burn off the calories (often the calories they feel the need to burn are disproportionate to what they consumed in the 1st place) And again, many people will make exercise a higher priority than family, friends, work, sleep and general health and well-being.

I've also seen people spend an incredible amount of money on supplements that they just don't need for their goals. They spend huge amounts of time and effort on researching various products. In their quest to be healthy, they are sacrificing the basics of eating well and exercising regularly for ingesting a pantry full of shakes, powders and pills with questionable chemicals and minimal results.