Researchers at York University’s Faculty of Health say those who have a
history of an eating disorder, obsessive-compulsive traits, dieting, poor body
image, and a drive for thinness are more likely to develop a pathological
obsession with healthy eating or consuming only healthy food, known as
orthorexia nervosa (ON). Although eating healthy is an important part of a
healthy lifestyle, for some people this preoccupation with healthy eating can
become physically and socially impairing.
In the first exhaustive review of the psychosocial risk factors associated
with orthorexia nervosa, York University psychology researchers examined all
studies published up until the end of 2018 in two popular databases. They
looked at studies that examined how orthorexia nervosa is related to
psychosocial risk factors that predisposed or made an individual vulnerable to
or more likely to develop the condition. They then amalgamated all available
findings for each risk factor to reach conclusions about which psychosocial
factors were most reliably associated with the condition.
“The long-term impact of these findings is that they will lead to better
recognition among healthcare providers as well as members of the public that
so-called healthy eating can, in fact, be unhealthy. It can lead to
malnourishment or make it very difficult to socialize with people in settings
that involve eating. It can also be expensive and time-consuming,” says
Jennifer Mills, associate professor in the Department of Psychology and senior
author on the study.
“When taken to the extreme, an obsession with clean eating can be a sign
that the person is struggling to manage their mental health.”
Previous research has shown that unlike individuals with anorexia nervosa
who restrict calories to maintain very low body weight, people who have the
condition have a fixation with the quality of food eaten and its preparation
rather than the number of calories. Over time, they spend increasing amounts of
time and effort purchasing, planning, and preparing pure and healthy meals,
which eventually becomes an all-consuming obsession that interferes with other
areas of life and results in weight loss.
One of the main reasons for conducting this study was that current research
on the condition is limited. Unlike other eating disorders, such as anorexia,
bulimia, orthorexia is not recognized in standard psychiatric manuals for
healthcare providers.
“It was surprising to me that the overwhelming majority of the articles in
this field were of neutral-poor quality, indicating that the results of these
studies must be interpreted with caution,” says Sarah McComb, a Master’s
student in Mills’ lab and first author of the study. “It really suggests a call
for more valid measurement tools of orthorexia, so that more reliable
conclusions can be drawn about the true prevalence of orthorexia in the
population and which psychosocial factors really put a person at risk for
developing orthorexia nervosa.”
Researchers found the literature consistently showed that those who have
obsessive-compulsive traits, depression and a previous eating disorder, and/or
are preoccupied with their appearance and body image, are more likely to be at
risk for developing the condition. Other eating habits such as being a
vegetarian or vegan also put individuals at higher risk for developing
orthorexia nervosa. Lacto-vegetarians were at highest risk for the condition
and people who are on a strict eating schedule, spending large amounts of time
preparing meals, were also at greater risk.
“In our research, we found equal rates of men and women who struggle with
symptoms of orthorexia nervosa,” said Mills. “We still think of eating
disorders as being a problem that affects mostly young women. Because of that
assumption, the symptoms and negative consequences of orthorexia nervosa can
fly under the radar and not be noticed or taken seriously.”
Researchers say developing a consistent definition of orthorexia nervosa
will make it easier for health researchers to develop reliable measures and
provide better diagnosis and treatment of the condition.
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