Should an Obsession with Healthy Eating be Classified as a Disease?

Scientific review published in Advances in Nutrition notes “great caution should be exercised in extending the label of illness to the phenomenon of orthorexia nervosa”

A healthy diet is positively
linked to a higher life expectancy and a lower probability of developing
chronic disease.  But what happens when
healthy eating is put to the extreme?  When
does a behavior with seemingly positive health effects turn unhealthy?  Could an overly strong fixation on healthy
eating become a mental illness?  This
phenomenon has been termed “orthorexia nervosa” to describe a pathological
fixation on healthy eating.

The Orthorexia Nervosa Task
Force described the main diagnostic criteria for orthorexia nervosa as “a
pathological preoccupation with healthy eating; the emotional consequences,
such as stress or anxiety, of noncompliance with self-imposed dietary rules;
and psychosocial restrictions in significant areas of life, malnutrition, and
weight loss.”  Despite much research and
debate, orthorexia nervosa is generally not recognized as a distinct mental
illness.  It is not, for example, included
in either the fifth edition of the Diagnostic and Statistical Manual of
Mental Disorders published in May 2013 or in the 11th version of the International
Statistical Classification of Diseases and Related Health Problems adopted
in May 2019.

Published in Advances in Nutrition, the international review journal of the American Society for Nutrition, “Classifying Orthorexia Nervosa as a New Mental Illness—Much Discussion, Little Evidence” sheds new light on the current debate over orthorexia nervosa as a distinct mental illness by examining the current body of research and identifying knowledge gaps.

The authors did note the
difficulty in conducting their narrative review “due to the use in previous
research of nonuniform criteria to diagnose orthorexia nervosa, a multitude of
diagnostic methods, and instruments revealed to have poor psychometric quality.”
In addition, many of the study sample populations have been “convenience
samples” whose results cannot be generalized.  The authors therefore state, “great caution
should be exercised in extending the label of illness to the phenomenon of orthorexia
nervosa.  More studies are needed to
investigate the sole contribution of orthorexia nervosa to pathology before we
can reach a conclusion about its significance as a distinct illness.”

In addition, researchers
and clinicians must be wary of being ethnocentric.  What may be considered pathological eating
behaviors in one context may not be in another. 
“Cross-cultural studies and the development of culturally sensitive
diagnostic procedures are highly warranted, given the general assumption of the
considerable influence of Western culture by many health professionals and some
evidence from scientific reports.”

Whether or not orthorexia nervosa can be classified as a distinct mental illness remains debatable; however, it is clear that many people suffer distress in their efforts to adhere to healthy eating patterns.  If you believe that you may suffer from orthorexia nervosa, a discussion with a mental healthcare provider or your general healthcare provider is in order.

References Jana Strahler, Rudolf Stark, Perspective: Classifying Orthorexia Nervosa as a New Mental Illness—Much Discussion, Little Evidence. Advances in Nutrition, DOI: https://doi.org/10.1093/advances/nmaa012.

Images credit: canva.com

The post Should an Obsession with Healthy Eating be Classified as a Disease? appeared first on American Society for Nutrition.

Source link