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By providing a nurturing and understanding environment, family support can reduce feelings of isolation and stigma, creating a safe space for individuals to share their struggles and challenges during recovery. Integrating mindfulness and acceptance into treatment helps individuals cultivate a more balanced and flexible relationship with food, promoting psychological resilience and overall well-being. This approach allows individuals to observe their obsessive thoughts and anxiety about food without reacting to them impulsively, promoting a sense of detachment from these distressing experiences. The dietitian collaborates with the individual to develop a structured meal plan that meets their nutritional needs, considering their food preferences and dietary restrictions and encouraging variety and moderation.
By searching PubMed using the keywords "eating disorders", we were able to identify 52,781 articles, which were further refined by including additional keywords such as "orthorexia nervosa", "diagnostic scales", and "risk factors". Addressing these diagnostic challenges and establishing clear distinctions between orthorexia nervosa and other eating disorders is essential to improving clinical recognition, early intervention, and evidence-based treatment approaches for individuals struggling with these complex eating behaviors. Although orthorexia nervosa shares some features with other eating disorders, it is distinguishable by its emphasis on the perceived health benefits of food choices and the absence of concerns about body shape or weight. However, for some people, a focus on healthy eating can become obsessive and develop into an eating disorder known as orthorexia, or orthorexia nervosa. This includes a 2008 German study, which based its research on the widespread suspicion that the most nutritionally-informed, such as university nutrition students, are a potential high-risk group for eating disorders, due to a substantial accumulation of knowledge on food and its relationship to health; the idea being that the more one knows about health, the more likely an unhealthy fixation about being healthy can develop. This suggests that intense orthorexia nervosa individuals likely take pride over their healthy eating habits over others and that is the driving force behind their orthorexia as opposed to body image like anorexia.citation needed These factors influence the development of orthorexia nervosa in this age group, shaping their approach to healthy eating and diet-related behaviors.
To address the impact of sociocultural influences and media on disordered eating behaviors, public health campaigns and education initiatives are needed to promote body positivity, challenge unrealistic beauty ideals, and foster a balanced and evidence-based approach to nutrition and overall well-being. Moreover, individuals with low self-esteem or body dissatisfaction may seek a sense of identity and self-worth by pursuing an idealized "healthy" lifestyle, using food choices to gain a sense of accomplishment and validation . The relentless pursuit of "clean eating" can lead to social isolation and impaired functioning in various domains of life as the focus on food dominates these individuals’ thoughts and behaviors. Individuals grappling with these disorders often experience significant distress and anxiety surrounding their food choices, leading to an all-encompassing preoccupation with dietary purity and health . Additionally, the literature has attempted to distinguish between healthy orthorexia and orthorexia nervosa 31,32,33. The lack of standardized criteria also hampers the accurate estimation of the prevalence and incidence rates of orthorexia nervosa, impeding our understanding of this emerging eating disorder’s full extent and impact. Furthermore, a history of dieting and body dissatisfaction can contribute to developing disordered eating patterns centered around food purity and health obsession 23,24.
Proposed diagnostic criteria include a dietary theory or set of beliefs about healthy foods, exaggerated emotional distress in relationship to food choices that are perceived as unhealthy, and clinical impairment because of compulsive dietary behaviors and mental preoccupation (2). However, for some people, there’s a fine line between healthy eating and developing an eating disorder. The health effects of orthorexia can be just as severe as those of other eating disorders. Although studies on orthorexia are limited, this condition is likely to lead to many of the same medical complications as other eating disorders.
With the acknowledgment that further research into orthorexia may serve to reify a culturally-constructed condition,72 the information reviewed in the preceding sections leaves us with more questions than firm answers (Table 3). Beyond this one exploratory neuropsychological investigation of orthorexia, there is no published research on the genetic, neuroanatomical, neurochemical, or psychophysiological correlates of the orthorexic syndrome. As WM is a multifaceted cognitive domain, future research on orthorexia should attempt to dissociate the executive (eg, cognitive control) from nonexecutive (eg, storage) elements in order to provide a more nuanced analysis of WM dysfunction and to help disambiguate the brain pathways that underlie the dysfunction. Evidence suggests that food-related thoughts reduce WM capacity in dieters,57 and dysfunction has been reported in anorexic patients particularly in the visuospatial sketch pad and central executive components of WM.58 With regard to OCD, there is meta-analytic evidence59 to implicate WM as the link between executive dysfunction and long-term memory impairment such that repetitive, intrusive thoughts interfere with episodic binding during WM.
Given the widespread dissemination of health and wellness trends through digital media and the internet, orthorexia nervosa will likely transcend geographical boundaries. Moreover, understanding the global prevalence of orthorexia nervosa is crucial to address its impact on public health. Individuals can embark on a healing journey by developing greater self-awareness and self-compassion, gradually overcoming the grip of orthorexia nervosa and cultivating a healthier and more fulfilling life . Mindfulness and acceptance-based treatments are emerging as promising therapeutic approaches for individuals with orthorexia nervosa . Intuitive eating helps individuals overcome rigid dietary rules and adopt a more mindful and non-judgmental approach to eating, promoting self-compassion and body acceptance . Nutritional counseling and intuitive eating approaches are valuable components in the comprehensive treatment of orthorexia nervosa.
However, ON is a serious condition with severe health detriments if left untreated. MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. Additionally, longitudinal studies can assess the impact of interventions and treatment approaches, examining their effectiveness in promoting recovery and preventing relapse. Ultimately, the combined impact of family and social support can create a robust support network that bolsters an individual’s resilience and commitment to recovery, providing a solid foundation for sustained progress and improved overall well-being. Support groups or group therapy sessions allow individuals to share experiences, offer encouragement, and exchange coping strategies.
Based on available studies, orthorexia can be considered a disorder that falls within the spectrum of eating disorders, though it should not be classified as a classic subtype of anorexia or a pure form of OCD. Studies conducted among medical and nursing candidates reveal that people in these professions, where taking care of health and body appearance plays a key role, are more likely to develop orthorexia nervosa. Perfectionism, which may be reinforced by idealized body images presented in social media, is also a significant risk factor for orthorexia nervosa 19,42. Additionally, easy access to the so-called "experts" and dietary challenges online may promote unhealthy eating practices that may worsen ON symptoms. Studies on orthorexia nervosa in the younger population reveal a number of significant associations with various risk factors, which emphasizes the complexity and multifaceted nature of this disorder. In addition to comorbidities, body image also plays a key role in the development of orthorexia, as it often forms the basis for the creation of unhealthy eating patterns. Such studies can be enriched with imaging diagnostics and more precise screening tests, which will reveal people affected by disorders and people at risk for this type of condition.
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