Orthorexia and anorexia are both types of eating disorders, but they differ in fundamental ways. You may already be familiar with anorexia nervosa, one of the more common eating disorders. Anorexia nervosa is especially common in teenage girls and young adults, but there’s a growing number of middle-aged adults that suffer from it too. Anorexia is characterized by low weight, fear of gaining weight, and a strong desire to be thin, resulting in food restriction, overexercising, and other unhealthy habits to lose weight.
Many people with anorexia see themselves as overweight even though they are of normal weight or underweight. People with this disorder are obsessed with their body weight, eat only small amounts, and avoid foods high in calories. Anorexia nervosa is a serious psychological disorder and one that can damage health and even lead to death. It has the highest death rate of any mental disorder, including depression.
People with anorexia restrict the number of calories and types of food they eat to lose weight. Despite the significant weight loss, they still see themselves as overweight. This distorted body image may lead them to avoid social situations or wear baggy clothes to hide their bodies.
Some signs and symptoms of anorexia nervosa include:
- Abnormally low body weight
- Body mass index (BMI) below 17.5
- Intense fear of weight gain, even if they aren’t overweight
- Distorted body image
- Menstrual abnormalities. Some people with anorexia stop menstruating for long periods. Fatigue. Brittle nails
- Dry hair and hair loss
- Fine hair growth on the body (lanugo)
- Mild anemia, muscle wasting, and weakness
- Constipation
- Low blood pressure, slowed breathing and pulse
- Electrolyte imbalances (in severe cases)
A person with anorexia is focused on getting as thin as possible, but psychiatrists point out that the obsession with being thin is also about maintaining control and this extends to other areas of their life. People with anorexia nervosa may have other personality issues like being obsessive-compulsive or overly regimented and organized. Counting calories and restricting food offer a temporary sense of control.
Anorexia vs. Orthorexia: How Orthorexia Differs from Anorexia
While a person with anorexia nervosa obsesses over thinness, someone with orthorexia is hyper-focused on health. Orthorexia is a fixation on eating only the healthiest foods and avoiding foods. The term is the Greek word ortho, meaning “right,” and orexis, meaning “appetite.”
As the name suggests, orthorexia is marked by an unhealthy obsession with eating “pure” food and avoiding foods that contain toxins or chemicals. It is a type of eating disorder classified as an obsession with proper or “healthful” eating. A person with orthorexia obsessively checks the ingredient list of every food they eat and may discard large numbers of foods from their diet, such as meat, carbohydrates, or dairy.
We should all be concerned about what we put on our plates, but people with orthorexia take the concept of healthy eating too far. The exclusion of foods from their diet can lead to vitamin or mineral deficiencies and they may develop anxiety or depression from the pressure of excessive dietary restriction.
Where Did the Term Orthorexia Come From?
Orthorexia was coined in 1997 by Dr. Steven Bratman, M.D. who recognized that healthy eating can become an unhealthy obsession and called this condition orthorexia nervosa. Orthorexia is not a formal diagnosis, but a pathological food fixation and a preoccupation with health.
Orthorexia has some similarities to anorexia nervosa, including an obsession with maintaining control over eating habits. However, people with orthorexia are less likely to die from their condition than a person with anorexia, who may go days without eating or eating only a small number of calories.
In contrast to anorexia, people suffering from orthorexia are often normal weight or even overweight and obsessed with the healthfulness of their diet rather than the quantity of food they eat or the calories they burn through exercise.
Like those with anorexia nervosa, people with orthorexia display extreme behaviors, such as only consuming organic foods or only eating fresh raw fruits and vegetables. They may also avoid entire food groups or eliminate all processed or preserved foods from their diet.
Orthorexic eaters tend to spend inordinate amounts of time preparing meals, reading ingredient lists, and researching health and nutrition information online to ensure they’re choosing only what they see as the healthiest, purest foods.
The Bottom Line
As you can see, there are many similarities between anorexia and orthorexia. Both types of disordered eating are an attempt to exert control over body weight or health by controlling diet. The key difference between orthorexia and anorexia is the former is obsessed with food purity and healthfulness while the latter focuses on the quantity of food, they eat with weight loss as the goal.
Both conditions can lead to mental and physical harm and usually require help from a professional to sort through the psychological issues that trigger these behaviors. Some experts believe that such preoccupation with food can’t be cured but only brought into remission, as stress can trigger a relapse. This is particularly true of people with anorexia nervosa.
Recent research also suggests that there may be a genetic tendency toward developing anorexia nervosa and it’s not simply societal pressure to stay thin. However, both eating disorders can be managed with counseling and it’s important to get help early on to avoid risks such as nutritional deficiencies and electrolyte imbalances.
References:
- “Orthorexia: When Healthy Eating Becomes a Disorder.” 02 Apr. 2020, healthline.com/nutrition/orthorexia-nervosa-101.
- “Orthorexia – National Eating Disorders Association.” nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia.
- Scarff JR. Orthorexia Nervosa: An Obsession With Healthy Eating. Federal practitioner: for the health care professionals of the VA, DoD, and PHS. 2017;34(6):36-39. Accessed February 24, 2022. ncbi.nlm.nih.gov/labs/pmc/articles/PMC6370446/
- “Anorexia nervosa – Symptoms and causes – Mayo Clinic.” 20 Feb. 2018, mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591.
- “Anorexia – Harvard Health.” 19 Dec. 2014, health.harvard.edu/diseases-and-conditions/anorexia.
- “Anorexia Nervosa | MentalHealth.gov.” 22 Aug. 2017, mentalhealth.gov/what-to-look-for/eating-disorders/anorexia.
- National Collaborating Centre for Mental Health (UK). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. Leicester (UK): British Psychological Society (UK); 2004. (NICE Clinical Guidelines, No. 9.) 6, Treatment and management of anorexia nervosa.
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