The difference between orthorexia and anorexia

Eating a healthy, nutritious, balanced diet can help protect against many chronic diseases including heart disease, diabetes, and obesity. But in some cases, healthy eating can become harmful when it’s taken to the extreme.

Orthorexia is considered an emerging eating disorder in which people become hyper focused on consuming healthy food. They may worry obsessively about only eating “pure” foods and spend a significant amount of time reading food labels and researching ingredients.

While orthorexia and anorexia are both serious mental health conditions that share an obsessive focus on food, the two conditions also differ. Those with anorexia are preoccupied with food quantity and have an intense fear of gaining weight. In contrast, people with orthorexia are fixated on the quality and purity of food they consume.

Understanding the differences between anorexia and orthorexia is important, especially when considering symptoms, treatment approaches, and diagnosis. 

What is anorexia?

Anorexia is an eating disorder that involves restrictive eating and a fear of gaining weight. People with anorexia may have a distorted perception of their body, believing they’re overweight, despite often being underweight. This condition is frequently accompanied by low self-esteem and a negative perception of their physical appearance.

While people of all genders and ages can be diagnosed with anorexia, it’s more common in young women. While teen girls between the ages of 13–19 and women in their early 20s are most at risk, one study showed that 13% of women older than 50 had an eating disorder.  

Symptoms of anorexia include:

• Extremely restricted eating
• Extreme thinness
• Intense fear of gaining weight                
• Distorted body image, denial of the seriousness of being underweight
• Unwillingness to maintain a healthy or normal weight

What is orthorexia?

Orthorexia is an eating disorder defined by an intense obsession with consuming only healthy or “pure” foods. This fixation can become so extreme that it leads to restrictive eating habits, which can result in malnutrition, strained relationships, and a diminished quality of life.

Orthorexia affects both women and men and has been found to be more common in college students and athletes.

According to the National Eating Disorders Association (NEDA), the signs and symptoms of orthorexia include:

• Compulsively checking nutrition labels
• An increased concern about the health of ingredients
• Eliminating an increasing number of food groups (all dairy, all carbs, all meat, etc)
• High level of perfectionism
• Excessively following food and “healthy lifestyle” blogs on social media

Research has shown orthorexia is on the rise and that athletes and fitness practitioners are at an increased risk of developing the eating disorder.

Anorexia vs. orthorexia

In some cases, anorexia and orthorexia can coexist, and it’s also possible for orthorexia to lead to anorexia. Over time, orthorexia can evolve into anorexia, where someone not only restricts food intake but also develops an intense fear of gaining weight.

If someone with anorexia shifts from restricting calories for weight loss, to restricting what they eat to only healthy foods, they may believe they’re making better choices, yet their anxiety and compulsion over food choices remains the same.

Find healing with orthorexia and anorexia treatment

Although treatment for both anorexia and orthorexia involves addressing unhealthy thoughts and behaviors around food and body image, there are slight differences.

Anorexia treatment focuses on body image issues and fears of gaining weight, while orthorexia treatment focuses on obsessive behaviors related to food purity.

Several different types of therapy are available that can help you learn self-care strategies, manage your symptoms, and create goals that help you achieve optimal health. These can include: 

• Cognitive behavioral therapy (CBT) helps those with anorexia and orthorexia by challenging their distorted beliefs about healthy foods and body image.
• Acceptance and commitment therapy (ACT) encourages those with orthorexia to focus on values rather than food and health.
• By working with a dietician, nutrition counseling can help those with anorexia and orthorexia to build a balanced relationship with food.
• Family therapy can benefit the person with anorexia or orthorexia, especially minors, while teaching their family how to support their recovery and encourage balanced meals.
• Dialectical behavior therapy (DBT) can teach those with anorexia skills for managing emotions and learning healthy coping strategies.

Find care with Rula

If you’re living with anorexia or orthorexia, it’s important to know you aren’t alone. Approximately 28.8 million Americans live with eating disorders. If thoughts about the food you eat, your body image, and your weight are interfering with your happiness or daily life, treatment is available.

At Rula, we can help you find the right therapist who accepts your insurance and has experience with your unique needs. And, with our extensive network of therapists, you can schedule your first appointment as soon as tomorrow and meet with your therapist in a convenient online appointment.

Find a therapist with Rula