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January 13, 2018

Orthorexia and Anorexia: Comparison and Correlation, Part I

Woman struggling with orthorexia

Orthorexia Nervosa (ON) is a reasonably new eating disorder that is becoming more common and more well-known. Many compare this disorder to Anorexia Nervosa (AN) as they have a few overlapping symptoms.

However, it is essential to be aware that both need to be considered different disorders and approached as such when it comes to treatment.

This is a three-part blog series that builds on the behavioral foundations of each disorder, exploring how they may correlate as well as how they differ and why this knowledge is vital in providing distinct and effective interventions for both.

History & Definitions

Anorexia Nervosa is the most commonly known eating disorder, likely because it has been around since religious self-starvation incidences in 323 BC.

The motivation for self-starvation shifted toward a focus on the body and self-representation and the term “anorexia nervosa” was coined to describe these self-starving behaviors in the late 1800’s [1].

AN now refers to a psychological disorder defined by extremely low body weight, extreme weight loss, illogical fear of weight gain, and distorted perception of self-image and body [2].

While “new” compared to AN, ON has been around longer than it may seem, having been identified in the late 1990’s [3].

The term itself is derived from the Greek words “orthos (correct) and orexis (appetite) [1].” This origin lends to how the disorder is defined, as “an exaggerated, obsessive, pathological fixation on healthy food, eating healthy, or rather health-conscious eating behaviors [4].”

Behavioral Foundations

AN is characterized by an extreme fear of weight gain, obsession with calories and fat contents of food, engaging in ritualistic eating patterns, and fixation on food topics.

ON is characterized by an obsession with perceived health, a fixation on maintaining the perfect diet, avoidance of foods because of undiagnosed allergies, reduction in acceptable food choices, and irrational concern over food origin and preparation [4].

Both disorders show “excessive focus on food-related topics, strict diet, perfectionism, co-occurrence of anxiety, need of control, (and) stiffness of behavior and rituals related to preparation of meals [5].”

Further, individuals experience intrusive food-related thoughts when experiencing both AN and ON.

Even with these similarities, one key distinction is crucial to understanding them –
AN is characterized by a focus on how food impacts body appearance and image representation,
ON is characterized by a focus on how food impacts perceived health.

Woman in wheat fieldIndividuals with AN may restrict to avoid weight gain.

Restriction is not the intention of the individual with ON. Instead, it is a symptom of their fear of consuming “unhealthy” foods. As they become more fearful of eating certain foods they have deemed “unhealthy,” the list of what they will allow themselves to eat becomes shorter.

While these disorders may have some similarities, their differences go a long way in defining, recognizing, and treating them.

Read Part II of this blog series to learn the prevalence of each disorder.


Image of Margot Rittenhouse.About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


References:

[1] Dell’Osso, L. et al. (2016). Historical evolution of the concept of anorexia nervosa and relationships with orthorexia nervosa, autism, and obsessive-compulsive spectrum. Neuropsychiatric Disease and Treatment, 12, 1651-1660.
[2] 2017. Anorexia nervosa: causes, symptoms, signs, & treatment help. Eating Disorder Hope. Retrieved on 27 November 2017 from https://www.eatingdisorderhope.com/information/anorexia.
[3] Koven, N. S., Abry, A. W. (2015). The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385-394.
[4] 2017. Orthorexia symptoms and effects. Timberline Knolls. Retrieved on 27 November 2017 from https://www.timberlineknolls.com/eating-disorder/orthorexia/signs-effects/.
[5] Gramaglia, C., Brytek-Matera, A., Rogoza, R., Zeppegno, P. (2017). Orthorexia and anorexia nervosa: two distinct phenomena? A cross-cultural comparison of orthorexic behaviors in clinical and non-clinical samples. BMC Psychiatry, 17:75.


The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on January 13, 2018.
Reviewed By: Jacquelyn Ekern, MS, LPC on January 13, 2018.
Published on EatingDisorderHope.com

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