8. Obsessing over healthy lifestyle influencers on social media
If you look at the accounts you follow on Instagram and Twitter, you may realize you follow an alarming number of healthy lifestyle influencers. You could spend tremendous amounts of time viewing their content. Your timeline may contain topics related to clean eating, food preparation, and trendy diets, such as the ketogenic diet. You may follow many accounts that post recipes that adhere to your strict dietary regimen.3
Possible physical symptoms of orthorexia
Similar to anorexia, people with orthorexia severely restrict the amount and variety of foods they consume, which can cause malnutrition and nutritional deficiencies.4 Although more long-term research is needed, anecdotal evidence indicates that orthorexia nervosa affects the body similarly to anorexia nervosa and may result in the following physical symptoms:1,4,5
- Severe weight loss
- Weak bones and loss of bone mass
- Fatigue, weakness, lethargy
- Fainting or dizziness
- Vomiting and rapid breathing (due to metabolic acidosis)
- Stomach bloating
- Constipation
- Stomach pain, nausea, and vomiting (due to pancreatitis)
- Abnormally slow heart rate
- Difficulties falling or staying asleep
- Numbness or tingling in extremities
- Muscle cramps
- Feeling cold due to a drop in body temperature
- Brittle hair and dry skin
- Fine hair growth all over the body (lanugo)
Isn’t healthy eating a good thing?
Eating nutritious and balanced meals has countless benefits on your life. But when your pattern of eating becomes pathological and obsessive to the point of restricting food, engaging in ritualized eating, and avoiding various food types deemed “unhealthy,” the consequences can be significant. Over time, these restricting behaviors due to a fixation on healthy food can lead to imbalance, malnutrition, medical complications, and nutritional deficiencies, as well as a poor sense of well-being.3
One study called orthorexia nervosa “a disease disguised as a virtue.”10 Indeed, this eating disorder may go under-diagnosed because it presents differently than other eating disorders and some of the behaviors are glorified, especially on social media.
Orthorexia nervosa may go under-diagnosed because it presents differently than other eating disorders.
Another study on the link between Instagram use and orthorexia nervosa symptoms found that frequent Instagram use was associated with higher rates of orthorexia nervosa. The authors found a high prevalence of orthorexia nervosa symptoms among healthy eating influencers, which in turn affect the mental health of users consuming their content.6
What causes orthorexia nervosa?
Like other eating disorders and mental health conditions, there is not one isolated cause of orthorexia nervosa. Rather, several factors, known as risk factors, influence the development of orthorexia. Risk factors that increase the likelihood of developing orthorexia nervosa may include:1,4,6,7
- Perfectionism
- Anxiety
- A need for control
- Achievement-oriented attitude
- Fearful and dismissing attachment styles
- Past trauma
- A belief in food as medicine
- Exposure to extreme views as a child
- Preoccupation with being weight, health, and fitness
- History of an eating disorder
- Parent with a history of an eating disorder
- Preoccupation with appearance
- Impaired flexible problem-solving
- Excessive Instagram use
- Obsessive-compulsive disorder
Additionally, some demographics may have a higher prevalence of orthorexia than the general population.
These may include:
1,8
- Athletes
- People who work in healthcare
- Performance artists
Lastly, research has shown that following a restrictive diet, such as a paleo, ketogenic, or raw food diet, may increase your risk of developing orthorexia. People who believe in the health benefits of these diets and engage in this type of rigid eating tend to engage in compensatory behaviors, such as increased restriction or fasting, if they violate their diet.9
How is orthorexia treated?
There is no established treatment protocol for orthorexia nervosa. However, professionals have suggested best practices, such as:1,4
- Individualized treatment based on one’s unique needs
- A multidisciplinary team comprised of dieticians, doctors, and therapists
- Cognitive behavioral therapy
- Psychoeducation
- Selective serotonin reuptake inhibitors (SSRIs)
- Antipsychotics, such as olanzapine
- Exposure and response prevention
- Habit reversal training
- Cognitive restructuring
- Relaxation methods
- Psychoeducation related to dietetic science
- Physical exam and lab studies
Individuals with orthorexia may reject medications since they are not natural or pure, so pharmaceutical intervention may not be possible, at least not until they are committed to recovery.
Treatment for orthorexia may occur on an inpatient or outpatient basis. Inpatient programs involve living at the facility for the duration of the eating disorder treatment program. Outpatient care is more flexible and involves living at home and attending scheduled treatment sessions. Still, many treatment barriers exist. Virtual care may be viable if you lack treatment access due to geography, transportation, or scheduling.
Help is available
If you think you or a loved one have experienced any symptoms of orthorexia nervosa, it’s important to seek eating disorder treatment right away.
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