Orthorexia Nervosa Treatment: Here’s What One Can Expect During Treatment

In this post, we will discuss getting help for orthorexia nervosa. We will review signs of orthorexia and how you can get orthorexia nervosa treatment..

What is Orthorexia Nervosa?

Orthorexia nervosa is characterized by a person having an “unhealthy obsession” with healthy eating or eating the “right way.”. When we think of healthy eating, ideas of a balanced diet come to mind: fresh fruits and vegetables, whole grains, limiting our processed foods, and avoiding chemical additives when possible. This is not what happens with Orthorexia Nervosa.

Some people however, take this idea of eating healthy to the extreme. This is called orthorexia nervosa. Orthorexia nervosa was named by Steven Bratman, MD in 1977. From the Greek term “orthorexia” nervosa means “correct diet.” How can a “correct diet” be harmful? It can be harmful for individuals who start obsessing over consuming “pure” food, an obsession that causes major disruptions to a person’s well-being and social life. Because this interest in eating the right way becomes pathological,  a person with orthorexia nervosa experiences malnutrition, heart issues, and other physical problems from not getting the necessary nutrition associated with a balanced diet. In addition, social isolation may occur when a person with orthorexia starts looking down on those who don’t follow the same strict diet and lifestyle. People with orthorexia are very rigid about their food rules to the point of not being able to eat out in restaurants or join in on family dinners or celebrations. 

It is important to note that individuals with this disorder do not actually eat in a healthy way.  It may start out that way but it becomes so rigid and so restrictive that they wind up malnourished and obsessive.  Orthorexia nervosa can be severe even if the person is not extremely underweight or seeking to lose weight.  

Is Orthorexia an Eating Disorder?

While orthorexia nervosa is not classified officially as a category of an eating disorder according to the DSM-5, it should not be confused with Avoidant/Restrictive Food Intake Disorder, otherwise known as ARFID. Learn more about ARFID treatment here. If this way of eating is causing a functional, emotional, or physical impairment, it can be formally diagnosed as either Other Specified Eating Disorder or Unspecified Eating Disorder depending on the specific presentation of the case.

Orthorexia Nervosa Symptoms

Those suffering from orthorexia nervosa may:

• Severely restrict the types of food they consume because they feel it’s unacceptable to their diet
• Overuse probiotics, herbal remedies, and other supplements
• Have strong overreactions when they eat food that they perceive to not be clean, healthy, and pure. 
• Have feelings of guilt when consuming foods that they don’t consider healthy and pure
• Think excessively about food and consuming food
• Regularly plan meals and have feelings of displeasure if meals are not planned in advance
• Critically judge others who don’t follow their strict diet
• Avoid eating food away from home or food that is not prepared in their home kitchen
• Avoid food bought or made by others
• Create distance between themselves and their loved ones
• Have feelings of shame, anxiety, depression, and/or mood swings
• Isolate themselves socially

Do I have Orthorexia Nervosa?

If you suspect you may have orthorexia nervosa, answer the questions below. If you answer “yes” to any of the following, it may be a good idea to speak with a professional.

1. Are you feel guilty or put yourself down when you don’t stick to your diet?
2. Do you long to spend less time thinking about food?
3. Do you neglect areas of life such as love, joy, creativity, and fun to follow the perfect diet?
4. Do you feel a sense of control when you stick to your strict diet?
5. Are you looking for ways foods are unhealthy for you?
6. Do you avoid food made for you by others?
7. Do you find yourself overusing “healthy” probiotics, herbal remedies, and other supplements? 
8. Do you judge others because they aren’t following the same diet you are?
9. Do you avoid eating food away from your home? 
10. Do your friends or loved ones express annoyance or frustration over the fact that you will not eat the same foods as them?
11. Have people close to you stopped inviting you to meals and celebrations because they know you will not partake in the meal?
12. Are your food rules and eating behaviors alienating those close to you?

It is not unusual for a person who has partially recovered from another eating disorder, such as anorexia nervosa or bulimia nervosa, to think that they can maintain a very clean or pure diet as a part of their long term recovery.  This is extremely problematic and an indication that the recovery is not complete.  For this reason, it is essential that individuals seeking treatment work with an experienced clinician who recognizes that orthorexia is not a reasonable outcome for recovery.

Levels of Care for Orthorexia Nervosa That Turns into Anorexia

In extreme cases, orthorexia nervosa can turn into anorexia nervosa. In some cases, individuals with orthorexia become so compromised by their lack of proper nutrition that they do not recognize they are in a physically unhealthy state.  In this situation, orthorexia and anorexia nervosa are nearly indistinguishable.  Below are the levels of care for a person with anorexia nervosa:

Inpatient

The highest and most comprehensive level of care for anorexia nervosa treatment. This is a hospital setting or a treatment center that is also licensed as a hospital.  They can see the most acute patients who are at extremely low body weights.  They also have the highest level of medical support and therefore can administer IV’s and tube feeding when necessary.  Intensive therapy and nutritional therapy is also provided on a daily basis.

Residential

This is a step down from inpatient and anorexia nervosa treatment is generally provided in a residential treatment center. While residential centers can also see patients who are very low weight and medically compromised, they have some limitations to what they can properly treat. Clients stay at the facility and receive round the clock care.  These centers provide medical and nursing care along with significant therapeutic services and monitoring.

Partial Hospitalization (PHP)

Clients do not sleep at the treatment center though they spend 6-8 hours per day at the center receiving therapeutic services. Clients at this level of care are medically stable and have some ability to manage their symptoms on their own, without full time supervision or support.

Intensive Outpatient (IOP)

As in PHP, clients at this level of care must be medically stable and demonstrate fair to good motivation for recovery. Clients typically spend about 3 hours a day at the treatment center and are beginning to reintegrate back into their lives. IOP is most helpful when someone has successfully completed higher levels of care and still benefits from some additional structure and accountability. When someone is getting treatment for the first time and struggling to manage their symptoms on a daily basis, generally it is not helpful to start at the IOP level of care because it does not provide enough support throughout the day.

Outpatient

This level of anorexia nervosa treatment is appropriate for clients who are medically stable, mostly weight restored, and who are willing manage their eating disorder symptoms by talking about them. Clients are this level of care are mostly or completely weight restored and show an ability to feed themselves consistently and appropriately.  The only exception to this rule is clients who elect to do Family-Based Therapy (FBT).

Recovering from Orthorexia Nervosa

While there are no official treatments designed specifically for someone with orthorexia nervosa, mental health care professionals often treat the condition like they would anorexia or obsessive-compulsive disorder.

One common form of treatment is psychotherapy, which can help change obsessive thought patterns about food someone with orthorexia may be experiencing. In addition, psychotherapy will help someone with other mental health conditions often associated with orthorexia such as depression, anxiety, panic disorders, and stress. 

Get Treatment for Orthorexia Nervosa in Miami, FL

A full recovery is within your grasp.  orthorexia nervosa is a serious eating disorder that requires immediate help from a knowledgeable professional. Fortunately there is hope!

I’m Dr. Amy Boyers, a Clinical Psychologist in Miami who specializes in the treatment of eating disorders (all types) and other serious, long-term mental health conditions, including addictions, bipolar disorder treatment, and OCD. I offer personalized and sophisticated eating disorder treatment services, individual and family psychotherapy, family member support and education, in-home meal support, coordination of a treatment service, and much more.

Have you asked “Do I have orthorexia nervosa? I’d be happy to help you answer that question. Simply reach out to me and I’ll be sure to answer anything you want to know.

I look forward to helping you obtain a brighter tomorrow.