Orthorexia, that dietary practice that flirts with TCAs

Are you obsessed with healthy eating to the point where you spiral into an eating disorder? Perhaps you suffer from orthorexia … Transcription with a specialist.

“Orthorexia is when you are really pathologically obsessed with healthy food. It doesn’t happen overnight. We are really in the so-called installation obsession. »

It is with these words Nelly GuthodierLecturer in Clinical Psychology and Psychopathology at the University of Poitiers and Research Fellow at the Center for Research on Cognition and Learning at CNRS, defines “food practice” increasingly present in our society. Do you decipher every food label? Do you control the quality of everything you eat? These are the first signs of orthorexic behavior.

As I explained to you in my article on food anxiety, currently Only three pathologies are officially recognized: anorexia nervosa, bulimia and compulsive overeating. However, it still remains some gray areas in our relationship with food. Food anxiety is one thing, orthorexia too.

For Madmoizelle, I decided to meet Nellie Gouthodier, author of the first report in French on this phenomenon, “Orthorexia: a new form of eating disorder?”, published in 2019.

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Interview: Let’s analyze the concept of orthorexia

Mademoiselle: Healthy eating is highly desirable and good for your health… So doesn’t this dietary practice called “orthorexia” affect us all at some point?

Nelli Guthodier: It is not yet known if this is an eating disorder. We are in something that is a bit like anorexia, though different from it. In anorexia, we do have a fixation on the amount of food the patient(s) have swallowed. You should eat little to accurately control your weight, because all these problems are related to body image. We don’t have that component there in orthorexia. It is very rare to see a patient with orthorexia eating healthy food to lose weight.

In general, with orthorexia, it’s really an idea to focus on the quality of the food.. What is interesting behind this is that we have two different types of motivation, and in general this is something that can indicate whether we are in healthy or pathological orthorexia. In the first case, we have more women and men who will eat healthy food out of conviction. For example, we find a lot of orthorexia in vegans or vegans. They consume healthy food out of a concern in terms of protecting animals or to control their health, to prevent cardiovascular disease. But in the second case, pathological orthorexia concerns people who eat healthy food for aesthetic reasons.. Trying to control your weight, have more beautiful skin… These problems will be a little more like anorexia.

“Pathological orthorexia concerns people who eat healthy food for aesthetic reasons. Trying to control your weight, have more beautiful skin…”

But when do we switch from healthy orthorexia to pathological?

N.G.: It is much easier to diagnose anorexia because we have the minimum number of symptoms we need to develop in order to be able to talk about the disorder. The threshold that causes a person to go from healthy orthorexia to pathological orthorexia has not yet been determined. We proceed from the principle that it should require care and observation when a person changes or even suffers..

When you suffer from pathological orthorexia, you end up disconnecting from your social network a bit because you have this sense of superiority in eating.. As soon as we see that this begins to affect the social sphere, that a person can no longer go, for example, to a restaurant, this signals alertness. Of course when you start there are health implications too. Orthorexia is a continuum that goes from normal to pathological and which, if taken to extremes, can cause nutritional deficiencies, sometimes lower BMI. It can also cause problems with the gastrointestinal tract… So there is also a health area.

According to your research, we’ve been talking about orthooxia since Dr. Steven Bratman’s first scientific study on the subject, back in 1997. However, we still do not know how many people suffer from pathological orthorexia. What is the prevalence of this “disorder”?

N.G.: If we read all the scientific literature, we find that the prevalence of orthorexia varies greatly, from 6 to 88.7%. Perhaps in some studies, healthy orthorexia is mixed with pathological. But we noticed that the people most affected by this disorder are people who follow a restrictive diet – vegans, vegetarians – or those who study or have a profession related to food and the body.

We see prevalence above 30% among health students, among nutritionists… But also high among high-level athletes or those who are physically active 3-4 times a week.. Finally, people for whom the body is the basis of sports practice or work, as, for example, among ballet dancers.

Mademoiselle: Do we know what causes orthorexia? Is this “food practice”, if we dare say, characteristic of our time and rich societies?

N.G.: This is an excellent question. We still do not know the reasons why we will develop or not develop pathological orthorexia. We are indeed in the sickness of our time because we are constantly being hammered by public health media campaigns. Thus, it encourages people to accept this practice is encouraged and socially acceptable.

In addition, we see in some studies that some patients who go to medical centers for anorexia and recover in order to have a more varied diet in more acceptable amounts become orthorexic. The pathological nature of quantity turns into quality. It is also fueled by the abundance of “more responsible” food diversification that we face daily. There are organic rays, nutri-accounts… It’s still hard for us to get some people to understand that healthy eating is good, but everything depends on the degree. By pressing too hard, we can enter pathology.

“It is still difficult to get some people to understand that healthy eating is good, but it all depends on the degree. To go to excess, you can enter into pathology. »

Madmoizelle: If you think you have pathological orthorexia, what treatment should you take? And can we cure it?

N.G.: In general, whatever the disorder, be it a biological disease or a mental disorder, it is the Supreme Health Authority that makes recommendations on what to do or not to do. Since orthorexia is not yet recognized as an eating disorder, there are no official recommendations..

But it is suggested that some elements of eating disorder treatment can be applied to orthorexia. Already now, the first thing to do is really to engage in what is called psychoeducation. That is, to stimulate the awareness of patients: yes, healthy eating, even if we are told that we can do it, becomes pathological at a certain point. Then, if the symptoms are really knocking the person out, you need to rework the beliefs behind them: if you’re not eating healthy all the time, it’s not so bad… flexibility in your diet.

These are the first clues that we have in terms of care, and this also includes training for healthcare professionals. Again, this is not often recognized by psychologists, psychiatrists, or general practitioners. What kind of doctor would say to his patient: “Be careful, you eat too healthy! »

As for the treatment of orthorexia, we do not yet have enough prospects. If we look at previous studies that have studied this issue, then, unfortunately, they were often carried out on the so-called “all comers”, that is, on ordinary people. We do not yet have enough insights into the management of people hospitalized for orthorexia.

Some resources if you have an eating disorder

Read also:

When Sexual Assault Causes an Eating Disorder

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