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Orthorexia
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htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.0 -
lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.0 -
htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.
Then you disagree with the researchers who think anorexia is a type of OCD, and that's fine. Time will tell. The DSM lags behind research.1 -
lithezebra wrote: »htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.
Then you disagree with the researchers who think anorexia is a type of OCD, and that's fine. Time will tell. The DSM lags behind research.
Perhaps you have some links to that research? I work in the field, so it is an interest of mine. Like I said, I don't dispute there are similarities in the presentation, but the ego-dystonic nature of the thoughts is part of what makes OCD what it is, as opposed to the ego-syntonic thoughts of someone with an eating disorder.
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htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.
Then you disagree with the researchers who think anorexia is a type of OCD, and that's fine. Time will tell. The DSM lags behind research.
Perhaps you have some links to that research? I work in the field, so it is an interest of mine. Like I said, I don't dispute there are similarities in the presentation, but the ego-dystonic nature of the thoughts is part of what makes OCD what it is, as opposed to the ego-syntonic thoughts of someone with an eating disorder.
Our disagreement is starting to sound more semantic. I don't remember what paper I was reading. I've been treated for an eating disorder, and still get treatment for my broader issue. So I look them up from time to time. There are a lot of papers on the topic, whether you feel that eating disorder are separate from, but related to, OCD, or whether you feel that eating disorders are one way that OCD can be manifested.
https://scholar.google.com/scholar?hl=en&q=eating+disorders+ocd&btnG=&as_sdt=1,5&as_sdtp=0 -
htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.
Then you disagree with the researchers who think anorexia is a type of OCD, and that's fine. Time will tell. The DSM lags behind research.
Perhaps you have some links to that research? I work in the field, so it is an interest of mine. Like I said, I don't dispute there are similarities in the presentation, but the ego-dystonic nature of the thoughts is part of what makes OCD what it is, as opposed to the ego-syntonic thoughts of someone with an eating disorder.
It's my understanding the intrusive thoughts in EDs are not fully ego-syntonic or ego-dystonic and vary significantly from patient to patient. While AN may tend to be syntonic, it isn't always.
Is there a school of thought that classifies it as clear cut as you present it here?
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Wiki: Orthorexia nervosa
There's this Dutch video. A woman explains orthorexia and how she suffered from it. It's a - unclassified - eating dissorder where someone is obsessed with eating "healthy". Such as sugar free, gluten free, carb free, etc.
I don't know how to feel about this. Being obsessed about food can be dangerous, allowing yourself to be underfed because you believe it's healthy and becoming anorexic. On the other hand, are people going to use orthorexia as an excuse? People would say that weighting everything I eat and minding the calories and macro's is obsesive behavoir. While people on MyFitnessPal consider it normal.
I also get this feeling that we are trying to classify everything. Do we need to classify it as "orthorexia", or is "eating dissorder" and "obsession" good enough?
Yes it is nessary, how do you think doctors can bill the insurance companies without a diagnosis?
How are they going to bill without a recognized diagnosis code?0 -
Need2Exerc1se wrote: »Wiki: Orthorexia nervosa
There's this Dutch video. A woman explains orthorexia and how she suffered from it. It's a - unclassified - eating dissorder where someone is obsessed with eating "healthy". Such as sugar free, gluten free, carb free, etc.
I don't know how to feel about this. Being obsessed about food can be dangerous, allowing yourself to be underfed because you believe it's healthy and becoming anorexic. On the other hand, are people going to use orthorexia as an excuse? People would say that weighting everything I eat and minding the calories and macro's is obsesive behavoir. While people on MyFitnessPal consider it normal.
I also get this feeling that we are trying to classify everything. Do we need to classify it as "orthorexia", or is "eating dissorder" and "obsession" good enough?
Yes it is nessary, how do you think doctors can bill the insurance companies without a diagnosis?
How are they going to bill without a recognized diagnosis code?
Easily - the majority of ED disorders are codified as EDNOS (eating disorder not otherwise specified) - or physicians can bill for a procedural code (a consultation) in the absence of a diagnostic code when they aren't present.
You come in, you present symptoms that don't clearly give place to a diagnostic tableau - do you think physicians don't bill? Or you take an x-ray and there is no issue on the film. Do you think they don't get paid?
A diagnosis is not needed to bill.3 -
htimpaired wrote: »lithezebra wrote: »htimpaired wrote: »CattOfTheGarage wrote: »Yes I agree, from all I've read about mental health, that is generally the threshold. You can be as weird as you like, but are you functional? Able to get on with day to day life and cope with ordinary circumstances? Yes? Then you don't have a disorder.
I do wonder about this need for everything to be specifically diagnosed, and I agree it probably has more to do with insurance company paperwork than medical benefit. There certainly doesn't seem to be the same drive to diagnose here, where funding is not subject to insurance approval. I would say I suffer from anxiety, for example, and I am on medication for it, but I have not been diagnosed with Generalised Anxiety Disorder or anything like that - the doctor just noted my symptoms and said I could try this medication to see if it would help.
As for orthorexia, I believe it is a type of OCD (as is anorexia) and since it lacks the immediate danger of death associated with anorexia, and its effects are more similar to regular OCD, I can understand why it doesn't have its own category. If someone needs treated for it, can't they just be diagnosed with OCD?
OCD is not an eating disorder. OCD by diagnostic criteria is an intrusive, unwanted, ego-dystonic thought (obsession) and a behavior that the person does to reduce the fear/anxiety caused by that thought (compulsion). It does not have to do with body image, weight, etc. While some other disorders can carry over and present as similar to OCD, it's really about the intrusive nature of the obsessions.
OCD isn't an eating disorder. The current thinking on eating disorders is that they are a type of OCD.
No, it's not. OCD is listed in its' own catergory in the DSM V, along with disorders such as trichotillomania, compulsive skin picking, hoarding, and body dysmorphic disorder. Anorexia, bulimia, and Eating disorder NOS are in Feeding and Eating disorders. Yes, there is an obsessive nature to the way someone with an eating disorder thinks, but it is not an obsession in the manner of someone with clinical OCD.
I understand the need for diagnostic differentiation, but virtually all people I knew with anorexia, or any other eating disorder, did also suffer from trichotillomania and of course body dysmorphic disorder. (Myself included.) Many others were self-destructive in other ways and had drug/alcohol addictions or cut themselves.
Keeping all these labels separated is great for treating symptoms, but I think it ignores the underlying problem. Orthorexia is a legitimate health concern. It's not diagnosed just because someone weighs their food, but it's pretty easy, should a legitimate mental health professional speak with the individual, to spot. I hope that it would be treated as seriously as other EDs.2 -
I don't know that I would have ever been diagnosed with orthorexia, but I was definitely suffering physically from too narrowly defining what "healthy" food was and being malnourished after a couple years of too large of a deficit. I think if naming and labeling the thing helps people get approved for treatment, then all the better. Labeling them as OCD might only qualify them for appointments with behavioral therapists and medication. But maybe labeling them with orthorexia means their insurance will pay for a nutritionist appointment, bone density tests, special supplements, and some CBT appointments.0
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My therapist thought I had orthorexia. I don't know, I mean, I do feel bad if I eat unhealthy food. I did cut out food groups when I became vegan but that's for the animals and the environment. I am obsessed with eating healthy, but that doesn't mean I won't go out for dinner or anything like that... I don't know, but it's not as if I'm at an unhealthy weight. In my opinion I could stand to lose a few kilos.0
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I can honestly say I don't have it. I may be obsessed concerned with eating right, but I sure don't stick to it.
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My therapist thought I had orthorexia. I don't know, I mean, I do feel bad if I eat unhealthy food. I did cut out food groups when I became vegan but that's for the animals and the environment. I am obsessed with eating healthy, but that doesn't mean I won't go out for dinner or anything like that... I don't know, but it's not as if I'm at an unhealthy weight. In my opinion I could stand to lose a few kilos.
Not to get hyper-technical, but vegans don't eliminate any food groups (at least as food groups are currently defined by the US government). There are specific items within each food group that we choose not to eat, but there are items within each that we can choose. One group is called "Dairy," but when you dig into it, there are plant options (like soy products, plant milks, and greens).0 -
lithezebra wrote: »lithezebra wrote: »I think it's an excuse to order a Big Mac and large fries and to sit on the couch watching TV for hours. If there really is an obsession, it should be considered OCD. There's no reason to vilify a healthy lifestyle unless you're trying to avoid putting in the work. Yeah, there's an extreme, but what's next? Are we going to label ex-smokers who can't stand to be around cigarette smoke? Former alcoholics who refuse to be in situations that involve alcohol?
Unfortunately, some people will avoid all social situations, because they will only eat whole foods they prepare themselves. They stop going to family holiday celebrations. They become obsessively fearful that people they care about are going to get diabetes or cancer because they eat processed foods. They start missing work because they exercise for hours a day. They start exhibiting signs of nutritional deficiencies due to cutting all grains or all "sugars" or some other food out of their diet. The point is they go so far trying to be healthy, they become unhealthy.
I don't avoid social situations. I take my own food. And there's nothing unhealthy about cutting out sugar and grains, which contain nothing and little, respectively, in the way of nutrients, other than calories.
People who would be considered orthorexic tend to cut out a lot of different food types at once, so the total affect causes nutritional deficiencies. I'm sorry if I didn't finish that thought. And there are people who won't eat fruit or most vegetables because they are avoiding "sugar", in other words cutting out too many healthy foods because they are taking a reasonable idea too far. That's what makes it an ED.
I don't understand why you are saying what you do, did someone say you have an ED?
I'm saying that you can be on a restrictive diet, even one that cuts out fruit and vegetables, without being orthorexic. People can have medical reasons for not eating vegetables. I think that avoiding social situations might be a flag for orthorexia, though I admit that someone having trouble sticking to a diet for diabetes, for celiac disease, or for a seizure disorder might find it easier not to be in situations where a lot of forbidden foods are staring them in the face.
It's not about simply being on a restrictive diet...it's a total illogical fear of certain foods...orthorexics live in literal fear of various foods and these foods cause mental anguish...orthorexics take it to a whole other level0 -
The DSM-5 is not infallible.
It still lists "Disassociative Identity Disorder" (AKA Multiple Personality Disorder) as a thing, which Allen Frances, the editor of the DSM-4 wishes he'd left out of the DSM-4, and the vast majority of psychology agrees.0 -
cwolfman13 wrote: »lithezebra wrote: »lithezebra wrote: »I think it's an excuse to order a Big Mac and large fries and to sit on the couch watching TV for hours. If there really is an obsession, it should be considered OCD. There's no reason to vilify a healthy lifestyle unless you're trying to avoid putting in the work. Yeah, there's an extreme, but what's next? Are we going to label ex-smokers who can't stand to be around cigarette smoke? Former alcoholics who refuse to be in situations that involve alcohol?
Unfortunately, some people will avoid all social situations, because they will only eat whole foods they prepare themselves. They stop going to family holiday celebrations. They become obsessively fearful that people they care about are going to get diabetes or cancer because they eat processed foods. They start missing work because they exercise for hours a day. They start exhibiting signs of nutritional deficiencies due to cutting all grains or all "sugars" or some other food out of their diet. The point is they go so far trying to be healthy, they become unhealthy.
I don't avoid social situations. I take my own food. And there's nothing unhealthy about cutting out sugar and grains, which contain nothing and little, respectively, in the way of nutrients, other than calories.
People who would be considered orthorexic tend to cut out a lot of different food types at once, so the total affect causes nutritional deficiencies. I'm sorry if I didn't finish that thought. And there are people who won't eat fruit or most vegetables because they are avoiding "sugar", in other words cutting out too many healthy foods because they are taking a reasonable idea too far. That's what makes it an ED.
I don't understand why you are saying what you do, did someone say you have an ED?
I'm saying that you can be on a restrictive diet, even one that cuts out fruit and vegetables, without being orthorexic. People can have medical reasons for not eating vegetables. I think that avoiding social situations might be a flag for orthorexia, though I admit that someone having trouble sticking to a diet for diabetes, for celiac disease, or for a seizure disorder might find it easier not to be in situations where a lot of forbidden foods are staring them in the face.
It's not about simply being on a restrictive diet...it's a total illogical fear of certain foods...orthorexics live in literal fear of various foods and these foods cause mental anguish...orthorexics take it to a whole other level
Which is probably why they would bring their own food to say a party...0 -
I wonder if people had orthorexia when food was pretty much scarce and the choices were limited to what grew - or was huntable - during certain seasons and within specific geographical locations. Food choice overload and overabundance is a very new phenomena.
People got obsessed with food choices for religious reasons sometimes - there are historical examples of people who in their quest for spiritual purity would fast or cut whole food groups out of their diet for weeks or months or years. Not so different from today's orthorexia when people listen to gurus who tell them to cut out nightshades or to only drink milk from certain breeds of cows in order to attain physical purity.0
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