Exploring scientific legitimacy of orthorexia nervosa: A newly emerging eating disorder
DOI:
https://doi.org/10.4100/jhse.2013.84.14Keywords:
Orthorexia nervosa, Eating disorderAbstract
Eating disorders are a range maladaptive eating behaviours characterized by highly restrictive and unhealthy food intake patterns that lead to variety of psychiatric, physiological and health complications such as depression, anxiety, and personality disorders etc. Many of these psychological eating disorders such as anorexia nervosa or bulimia nervosa have been recognized as disease by the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) of American psychiatric association. However there are many newly identified eating disorders which are yet to be recognized as disease by American psychiatric association. Orthorexia nervosa (ON) is one such unrecognized psychological eating disorder in which the person becomes obsessed with eating pure, healthy and right kinds of foods to improve health. There are no standard diagnostic criteria for ON and in recent times different researchers used different questionnaire to assess the presence of orthorexic characters. Many researchers have raised questions about the validity of ON as a unique disorder and many of them preferred to describe ON as a variant of existing eating or anxiety disorder. On the other hand many researchers believe that ON is an unique eating disorder different from other recognized eating disorders and it should be recognized as a disease in the planned fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM 5), due to be published in 2013. The review aims to highlight the present understanding about ON including its character, physiological and psychological consequences and different diagnostic features used by different researchers to evaluate ON. The review will compare ON with other recognized eating disorders, and assess the scientific validity of ON to be considered as a valid psychological eating disorder by American Psychiatric Association's (APA).
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Martina M., Cartwright, MM. Eating disorder emergencies: Understanding the medical complexities of the hospitalized eating disordered patient. Critical Care Nursing Clinics of North America 2004;16(4):515-530. https://doi.org/10.1016/S0899-5885(04)00071-1
Becker AE, Grinspoon SK, Klibanski A, Herzog DB. Eating disorders. N Engl J Med 1999;340(14):1092– 8. https://doi.org/10.1056/NEJM199904083401407
Kaye WH, Klump KL, Frank GK, Strober M.. Anorexia and bulimia nervosa. Annu Rev Med 2000;51:299– 313. https://doi.org/10.1146/annurev.med.51.1.299
Keel PK, Klump KL, Leon GR, Fulkerson JA. Disordered eating in adolescent males from a school- based sample. Int J Eat Disord 1998;23(2):125– 32. https://doi.org/10.1002/(SICI)1098-108X(199803)23:2<125::AID-EAT2>3.0.CO;2-M
Bratman S, Knight D. Health Food Junkies: Orthorexia Nervosa – Overcoming the Obsession with Healthful Eating. New York: Broadway Books, 2000.
Catalina Zamora ML, Bote Bonaechea B, García Sánchez F, Ríos Rial B. Orthorexia nervosa: A new eating behavior disorder? Actas Esp Psiquiatr 2005;33(1):66-8.
Bartrina JA. Orthorexia or when a healthy diet becomes an obsession. Arch Latinoam Nutr 2007;57(4):313-5.
Nymah H. A direct question: is orthorexia a correct word for a wrong concept? Lakartdningen 2002;99:433- 434.
Bosi ATB, Camur D, Güler C. Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine. Appetite 2007;49(3): 661-666. https://doi.org/10.1016/j.appet.2007.04.007
Mathieu J. What is orthorexia? Journal of the American Dietetic Association 2005; 105(10):1510-1512. https://doi.org/10.1016/j.jada.2005.08.021
Getz L. Orthorexia: When Eating Healthy Becomes an Unhealthy Obsession. Today's Dietitian. 2009;11(6):40.
Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C. Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord 2004;9(2):151-7. https://doi.org/10.1007/BF03325060
Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C. Orthorexia nervosa: Validation of a diagnosis questionnaire. Eating Weight Disord 2005;10(2):e28-32. https://doi.org/10.1007/BF03327537
Korinth A, Schiess S, Westenhoefer J. Eating behaviour and eating disorders in students of nutrition sciences. Public Health Nutrition 2009;13(1):32–37. https://doi.org/10.1017/S1368980009005709
Kinzl JF, Hauer K, Traweger C, Kiefer I. Orthorexia nervosa: eine ha¨ufige Esssto¨rung bei Dia¨tassistentinnen? (Orthorexia nervosa: a frequent eating disorder in dieticians?) Erna hrungs-Umschau 2005;52:436–439.
Aksoydan E, Camci N. Prevalence of orthorexia nervosa among Turkish performance artists. Eating and Weight Disorders 2009;14(1):33-37. https://doi.org/10.1007/BF03327792
Fidan T, Ertekin V, Işikay S, Kirpinar I. Prevalence of orthorexia among medical students in Erzurum, Turkey. Compr Psychiatry. 2010; 51 : 49-54. https://doi.org/10.1016/j.comppsych.2009.03.001
Segura-García C, Papaianni MC, Caglioti F, Procopio L, Nisticò CG, Bombardiere L, Ammendolia A, De Fazio P, Capranica L. Orthorexia Nervosa: A frequent eating disordered behavior in athletes. Eat Weight Disord 2012; 21. [Epub ahead of print] Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV TR). 4th ed. American Psychiatric Association; Arlington, VA: 2000. American Psychiatric Association. Diagnostic and statistical manual for mental disorders. 4th edition (DSM IV). Washington DC: American Psychiatric Press, 1994.
Mehler PS, Krantz M. Anorexia nervosa medical issues. J Womens Health (Larchmt) 2003;12(4):331 –40. https://doi.org/10.1089/154099903765448844
American Psychiatric Association Work Group on Eating Disorders. Practice guidelines for the treatment of patients with eating disorders. Am J Psychol 2000;157(1 Suppl):1– 39.
Lilenfeld LRR, Wonderlich S, Riso LP, Crosby R, Mitchell J. Eating disorders and personality: A methodological and empirical review. Clinical Psychology Review 2006;26(3):299-320. https://doi.org/10.1016/j.cpr.2005.10.003
Affenito SG, Dohm FA, Crawford PB, Daniels SR, Striegel-Moore R H. Macronutrient intake in anorexia nervosa: The national heart, lung, and blood institute growth and health study. Journal of Pediatrics 2002;141(5):701-705. https://doi.org/10.1067/mpd.2002.129840
Fernstrom MH, Weltzin TE, Neuberger S, Srinivasagam N, Kaye WH. Twenty-four hour food intake in patients with anorexia nervosa and in healthy control subjects. Biological Psychiatry 1994; 36(10): 696-702. https://doi.org/10.1016/0006-3223(94)91179-7
Kummer A, Dias FM, Teixeira AL. On the concept of orthorexia nervosa. Scandinavian Journal of Medicine & Science in Sports 2008;18(3):395-396. https://doi.org/10.1111/j.1600-0838.2008.00809.x
Misra M, Tsai P, Anderson EJ, Hubbard JL, Gallagher K, Soyka LA, Klibanski A. Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents. American Journal of Clinical Nutrition 2006;84(4):698-706.
Joiner TE Jr, Heatherton TF, Keel PK. Ten year stability and predictive validity of five bulimia-related indicators. American Journal of Psychiatry 1997;154(8):1133-1138. https://doi.org/10.1176/ajp.154.8.1133
Lilenfeld LRR, Wonderlich S, Riso LP, Crosby R, Mitchell J. Eating disorders and personality: A methodological and empirical review. Clinical Psychology Reviewb 2006;26(3):299-320. https://doi.org/10.1016/j.cpr.2005.10.003
Shafran R, Cooper Z, Fairburn CG. Clinical perfectionism: A cognitive behavioural analysis. Behaviour Research Therapy 2002;40(7):773-791. https://doi.org/10.1016/S0005-7967(01)00059-6
Mac Evilly C. The price of perfection. Nutrition Bulletin 2001;26(4):275-276. https://doi.org/10.1046/j.1467-3010.2001.00182.x
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