Issue link: https://www.massageandbodyworkdigital.com/i/530196
46 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 5 A pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. 5 This description includes aspects of both anorexia and OCD. Indeed, as scientists look more closely at orthorexia, the areas of overlap with these other disorders, along with the areas where they defi nitely do not overlap, yield some fascinating information. The following diagram is a simplifi ed version of a chart found in the cited articles that highlight the relationships between orthorexia and similar conditions (see below). It is clear that areas of overlap are substantial, but one of the most important distinctions is in the sense of motivation behind these behaviors. People with orthorexia are not trying to be thin or fi t, nor are they motivated by physical appearance; they are simply trying to be healthy. This may also speak to why people involved in health care seem to be more vulnerable than many other populations: we are all trying to be healthy for our own sakes, but also as examples for our clients and patients. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the reference most commonly used in the United States to categorize mental disorders. The fi fth edition was recently published, and it lists a new heading under eating disorders: avoidant/restrictive food intake disorder, or ARFID. Orthorexia may fi t under this heading, and in subsequent editions this condition may appear as an ARFID subtype. THE CONTROVERSY At this point some readers may be experiencing signs of hypertension. Maybe your stomach is roiling, and your teeth are grinding, as you draft your letter to the editor. "Are you seriously suggesting that it's an illness for people to be concerned about food safety?" Or, "Really, Massage & Bodywork? Now we are pathologizing the idea of healthy eating? I expected better." No one is making the argument that most Americans are trying too hard to eat healthily. But for some, the goal of eating right actually creates disease. Patients can become so consumed with "doing it right" that the variety of foods they fi nd acceptable becomes narrower and narrower. Any deviation leads to guilt, self-loathing, and compensatory activities OVERL AP Preoccupation with weight loss Obsession with food quantity Body image disturbance Intense fear of obesity 90% are women ANOREXIA ORTHOREXIA Preoccupation with purity of food Obsession with food quality No interest in appearance No fear of being obese No predictable gender prevalence Preoccupation with food in general Restrictive diet Eating is primary focus Magical beliefs about the power of food Exaggerated need for self-care Sense of superiority for eating choices Need for control Chronic, long-term nature Health-related consequences: malnutrition, isolation Adapted from Brytek-Matera, 2015 Adapted from Koven & Abry, 2014