Biological orthorexia causes
Many orthorexia nervosa causes are related to genetic or biological factors that can influence diet, psychological perspective, and other issues that can lead to the condition.
Digestive issues
There may be a link between childhood digestive issues and the development of orthorexia nervosa later in life. If a child suffers recurrent abdominal pain or another form of digestive symptoms, they may start to avoid certain foods they associate with the pain and distress. This could set them on a path to disordered eating behaviors, like restricting foods considered not to be “pure.”
1
Scientific literature has also found a link between non-specific gastrointestinal symptoms and the
symptoms of orthorexia nervosa.
2 Similar to childhood digestive issues, these issues may cause concern over—and fixation on—foods that won't cause gastrointestinal distress. As a result, individuals may start to obsess over diet, cutting out foods they fear may be contaminated, impure, or otherwise unhealthy.
History of eating disorders
Generally speaking, a person is more likely to develop an
eating disorder, such as orthorexia nervosa, if there is a family history of eating disorders or issues surrounding food restriction.
14 This link can be attributed to both observed behaviors and genetics.
An Australian study discovered that a history of eating disorders is one of the strongest predictors of developing orthorexia nervosa.
3 A similar link has been found with other eating disorders, including
anorexia nervosa (AN) and
bulimia nervosa (BN).
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Psychological orthorexia nervosa causes
Like other eating disorders, orthorexia causes can also be related to psychological health. As a mental health disorder, orthorexia nervosa is particularly tied to these factors.
Health anxiety
Anxiety is very frequently a factor in all types of eating disorders. Orthorexia nervosa may manifest as a fear of falling ill or eating "unclean" or "unhealthy" foods, causing someone to obsess over diet and form a rigid routine around food and planning meals.4
These types of concerns are known as health anxiety, and they've been linked to an obsession with food and problematic changes in eating behaviors.4
In some cases, people with ON believe they can heal present symptoms with a healthy diet. These individuals tend to be preoccupied or anxious about these symptoms, prompting them to devote excessive amounts of time and energy to their food and diet to combat the actual or perceived illness.4
Personality and cognitive traits
Certain cognitive traits contribute to orthorexia nervosa causes.
Studies have shown that participants with ON perform poorly in the areas of:
4
- Working memory
- Cognitive rigidity
- External focus
- Set-shifting (the ability to shift attention between one task and another)
Several personality traits are also positively associated with the likelihood of developing orthorexia nervosa, including:
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- Perfectionism
- The need for control
- A drive to be thin
- Obsessive-compulsive traits
Obsessive compulsive disorder (OCD), in particular, seems to have a thorough connection to ON and disordered eating in general.
5 Additionally, some tests have tied obsessive-compulsive symptoms to feelings of guilt in those with ON if they don’t follow their strict healthy eating habits.
5
History of anxiety and depression
It’s common for individuals with orthorexia nervosa to have
comorbid—or co-occurring—mental disorders, including anxiety and depression.
6
The connection has not been thoroughly studied, but it's likely that symptoms of ON may develop as maladaptive coping mechanisms to help someone "manage" symptoms of
depression or anxiety or vice versa.
Poor body image
While many people with orthorexia nervosa fixate on health as the reason behind their behaviors, some studies have shown that these individuals also struggle with poor
body image, which plays a large factor in many eating disorders.
Recent studies suggest that those identifying as female who demonstrate ON-like eating behaviors have a worse body image and are less accepting of their body than females with low orthorexia tendencies.
3
Environmental orthorexia causes
Orthorexia causes can exist outside of the individual, as well. Someone's environment can have many influences on the way they deal with stress, the types of trauma they experience, and the kind of support they may have access to, which can all play roles in eating disorder development.
History of trauma
The association between a history of trauma and the development of eating disorders has been comprehensively described in the literature. Sadly, rates of eating disorders are significantly higher in people who have experienced past trauma or post-traumatic stress disorder.
7
The types of trauma linked to eating disorders include, but are not limited to:
- Unhealthy relationships
- Bullying
- Sexual assault and sexual harassment
- Emotional and physical abuse
- Neglect
- Conflict and/or alcohol or drug use within the home
- Death of a loved one
- Divorce
- Financial instability
Generally, what causes orthorexia nervosa is not the trauma itself. Rather, the condition develops as a maladaptive coping mechanism for the pain associated with the traumatic experience.
Having certain careers
Research has estimated the prevalence rate for orthorexia is between 1-7% for the general population. However, an estimated 35-57.8% of dietitians and other healthcare professionals experience ON.8
High-risk groups may not be limited to healthcare professionals. Evidence suggests those with careers in the entertainment industry (such as actors and artists) are at greater risk of developing orthorexia nervosa than the general population, thanks to an industry-wide focus on image and the pressure to model “healthy” behaviors for others.14
Social media obsession
Social media is one of the most modern orthorexia nervosa causes and one of the most dangerous, thanks to the perennial presence of the technology.
One 2017 study found that higher Instagram use was associated with a greater risk of developing orthorexia nervosa.9 Study results indicated that almost 50% of Instagram users who regularly follow health food accounts showed symptoms of ON. The more often an individual used Instagram, the more orthorexia symptoms they had.9
The accounts were not limited to health professionals but also non-professionals and influencers who regularly posted about their diets. The wider scope of participants demonstrates that an obsession with social media may play a key role in the development and maintenance of disordered eating behaviors.
Societal pressure
Perhaps thanks in part to social media, society in general has developed a fixation with "eating clean" and "eating healthy." The recent increase in a societal trend known as “clean eating” has contributed to these pressures.
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In many ways, this message has replaced the idea of "losing weight" as a primary goal, and while it sounds better to focus on health over weight, the fixation on achieving a "clean eating" diet can be just as dangerous as diets designed for weight loss. That type of fixation has been connected to an increase in
orthorexia nervosa symptoms in people.
10
An interest in healthy food has also been considered a prerequisite for developing orthorexia nervosa.
12 This idea is only spread further by social media.
Treatment of orthorexia nervosa
There are many orthorexia causes, and treatment for the condition must be equally diverse, including care for mental and physical health. No specific method has been determined for ON treatment, but several therapeutic interventions can help.
Overall, the goal of treatment is to create a healthy relationship with food and not concentrate on the perceived health value of food. Challenging the flawed dietary theory of those with orthorexia can help them adopt a more flexible eating plan, as well as challenge their misconceptions that certain foods are not “pure” or “clean.”
A multidisciplinary team, including dietitians, physicians, and psychotherapists, will devise a treatment plan based on a person’s individual needs. Therapies can include:
Partners and family members of those with orthorexia nervosa can also benefit from attending support groups, where they, too, can discuss their concerns and better understand the condition.
While there are no medications designed specifically to treat orthorexia nervosa, selective serotonin reuptake inhibitors, such as fluoxetine or paroxetine, can be a very effective treatment to manage accompanying mood disorders. Plus, nutritional supplements may be recommended to combat any deficiencies.
Get help for orthorexia nervosa
Seeking help for an eating disorder can be daunting. Each individual will need support, compassion, and empathy. Within Health offers virtual care programs for anyone dealing with an eating disorder like orthorexia nervosa. Call our team today to learn about our clinical superior care.
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