Orthorexia vs. Anorexia

Orthorexia and anorexia both include extreme food restriction, but each one has some important differences. Learn the differences here.

Healthy eating is more popular than ever, and many people are focusing on eating well and avoiding unhealthy or processed foods to improve their overall health.

While eating a healthy and balanced diet has many benefits, it can sometimes be hard to draw the line between healthy eating behaviors anddisordered eating. Healthy eating is often accompanied by messages of “clean eating” and “avoiding toxins.” These messages can add moral value to foods, classifying some as “good and clean” and others as “bad and harmful.”

The obsession with healthy eating is known asorthorexia, and people who suffer from it show many signs of disordered eating.Orthorexia and anorexiahave many similarities, but there are some key differences in their underlying factors, symptoms, and types of treatment.

What Is Orthorexia?

Orthorexiais an approach to eating thatextends beyond a healthy approachto a balanced diet. It involves obsessing about the nutrient quality or “purity” of foods and only eating kinds deemed to be good or safe.

Although it is not yet included in the Diagnostic and Statistical Manual for Mental Disorders,orthorexiashares many signs andsymptomswithdiagnosable eating disorders. For example, someone withsymptoms of orthorexiamay:

• Obsessively check food labels
• Limit foods or food groups that they may deem “dirty” or “unclean,” such as meat, dairy, carbohydrates, etc.
• Spend significant time and energy anticipating upcoming meals
• Experience significant distress if they don’t have access to “safe” foods
• Feel guilt or shame for eating “impure” foods
• Not function normally in social, academic or work situations

Orthorexia is also often linked with concerns about body appearance or focus on weight loss. While they may fit the criteria of “eating healthy,” these behaviors are extreme and can be all-consuming as well as very distressing.

Interestingly, social media use — particularlysites like Instagram— can increase the risk of orthorexia. Contrary to the actual goals of healthy eating, obsessing about healthy eating can actually decrease overall health and wellbeing.

Characteristics of Anorexia

Anorexiais a serious eating disorder characterized by intense fear of weight gain and severe restriction of food. For a clinical diagnosis of anorexia, a person must meetcriteria that include:

• Low body weight or body mass index
• Restriction of energy intake
• Persistent behavior to avoid gaining weight
• Abnormal perception of body size and shape, and an unusual amount of self-identity tied to body and appearance

Thesesymptoms and characteristics of anorexiacan be linked with serious short- and long-term health consequences and people who suffer from anorexia can have difficulty functioning in their normal daily lives.

Related Topic:Atypical anorexia

Similarities in Presentation

Since orthorexia and anorexiashare similar signs and symptoms, it can sometimes be difficult to distinguish between the two. Both disorders include anexcessive focus on dietand food while exerting extreme control over what is eaten.

In general, people with both conditions tend to categorize foods as “good” or “bad.” In addition, the thought of having to deviate from strict food rules is incredibly distressing. People with either condition are usually very focused on losing or maintainingweight loss.

Populations Affected

Orthorexia and anorexia are commonly seen in similar groups of people. The groupswho are affected by eating disordersare normally people whose body shape, size or function are closely scrutinized. This can include groups like adolescent females, dancers or athletes. Anorexia andorthorexia statisticscan help show just how many people are affected.

The lifetimeprevalence of anorexia nervosaamong adults in the U.S. is estimated to be0.88%. The exactprevalence of orthorexiais more difficult to track since it is not yet an officially recognized psychiatric disorder. However, estimates suggest that between6.9% to 57.6%of the general population areaffected by orthorexia. Rates might be even higher in certain groups, such as medical students or athletes.

Women make up the majority of thepopulation affected by anorexia,but it’s not yet known whether men or women are more commonlyaffected by orthorexia. However,eating disorders can certainly affect menand people of all ages. Orthorexia can also be influenced by social media use, which can promote messages regarding the purity of certain foods. Importantly, people with anorexia are also atincreased riskof displaying symptoms of orthorexia, even after treatment.

Differences in Motivation: Quality vs. Quantity

The signs and behaviors of orthorexia and anorexia are quite similar. What distinguishes these two conditions is theunderlying motivationrelated to anunhealthy relationship with food.

More specifically, theprimary motivator oforthorexia nervosarelates to a desire to be pure, good, clean or healthy. In contrast,anorexiais causedby a drive for thinness and extreme fear of weight gain. While orthorexia can include foods deemed “clean” and healthy, a person with anorexia often aims to avoid or restrict food of any kind.

The motivating factors andcauses of orthorexia and anorexiaare quite different, but both can lead to extremeobsessions with foodand an inability to participate normally in social settings.

Treatment Strategies

Treatments for eating disorderscan include a combination of psychological, behavioral and nutritional counseling. There are manytreatment strategies for eating disorders, and patients with both anorexia and orthorexia may benefit from one or multiple treatments, including:

• Medication
• Cognitive-behavioral therapy
• Behavioral and food-based interventions (i.e., broadening the range of “acceptable” foods)
• Psychoeducation to unpack beliefs about food

The success oftreatment for orthorexiaand anorexiamay differ based on the type of eating disorder. For example, medication may be more successful in anorexia, but might be considered “unnatural” or inappropriate by someone with orthorexia. For this reason, it is important to discuss the range of treatment options with a professional.

Key Differences Between Orthorexia and Anorexia

Bothorthorexia and anorexiainclude disordered eating behaviors and an obsession with food and appearance, and both are disruptive to a person’s ability to function optimally. Although they share many similarities, there are several keydifferences between orthorexia and anorexia.

Some of these differences include:

• Anorexia is a recognized psychological condition, whereas orthorexia is not yet recognized in the DSM-5
• Orthorexia is motivated by a desire to be pure; anorexia is driven by a desire for thinness
• People with orthorexia are not always underweight or driven to be extremely thin, and anorexia is characterized by severely low weight or significant weight loss
• Treatment strategies may differ, based on differences in underlying beliefs about food

Although the two disorders may appear to be similar, these key differences can impact eating disorder prognosis and treatment. Discussion with a professional can help to differentiate between anorexia and orthorexia and find the most appropriate course of treatment.

If you or someone you care about is experiencing symptoms of anorexia or orthorexia and a co-occurring substance use disorder, contactThe Recovery Villagetoday to discuss treatment options. We have facilities located throughout the U.S., and we can help you find a treatment plan that works well for your situation.