Orthorexia Vs. Anorexia: Similarities, Differences, & Treatment

What Is Orthorexia?

Orthorexia is a form of disordered eating that includes an obsession with healthy eating, so much so that it interferes with someone’s day-to-day activities. Those with this condition put a lot of thought behind planning healthy meals and spending more money than they have to achieve this goal. They use food to feel better about themselves under the guise of healthy eating.

Orthorexia is not currently a diagnosable condition. There are some behaviors that can appear innocent in nature, like reading nutrition labels. This may be overlooked because society tends to encourage mindful food choices. Orthorexia certainly is related to shame about food habits, eating, and one’s weight or body image issues. It could also be a response to trauma in the form of needing control.¹

Some common signs of orthorexia include:²

• Elimination of entire food groups, deeming them “unhealthy”
• Excessive talk about nutrition, food ingredients, etc.
• Obsession about certain brands, ingredients for meals
• Refusing to eat anything different than what they consider healthy
• Expressing stress when unable to control the food options
• Avoiding social interactions based around food

What Is Anorexia Nervosa?

Anorexia is an eating disorder involving a fear of gaining weight, with someone drastically limiting their food intake. This is a diagnosable condition, and those with this condition tend to feel incredibly insecure about their bodies. Unfortunately, this opens a person up to short-term and long-term physical effects such as organ failure, weakness, and hair loss, among other ailments. Someone with anorexia may also engage in purging behaviors such as laxative abuse, calorie counting, and compulsive exercise.³

Some common signs of anorexia include:⁴

• Extreme food restriction
• Severe weight loss
• Avoidance behaviors around social gatherings involving food
• Body dysmorphia

Similarities Between Anorexia & Orthorexia

There is overlap between anorexia and orthorexia. Both conditions deal with disordered eating, and oftentimes weight loss. People will view food as either good or bad, using specific, rigid criteria to determine what foods will qualify for their diet. Criteria for such can include nutrition facts such as calories, fiber, fats, carbs, sodium, and other nutrients. “Good” foods will likely have low calories, fats, and carbs, whereas “bad” foods will not.⁵

Similar characteristics of anorexia and orthorexia include:⁵

• Creating false “allergies” or aversions to foods to avoid consumption
• Strict food rituals
• Calorie counting
• Lying about satiation
• Relying on diet culture to help explain the food fixations

Key Differences Between Anorexia & Orthorexia

Those with orthorexia engage in very different eating disorder compensatory behaviors than those with anorexia. They will typically focus on only eating healthy foods, not engaging in calorie restriction. A person with anorexia is generally very underweight and engages in severe calorie restriction, sometimes coupled with binge or purging behaviors. Someone with orthorexia may not engage in these behaviors and may view these behaviors as disordered—they may use this difference to further validate their behaviors as healthy.⁶

Differences between anorexia and orthorexia include:⁶

• Anorexia is recognized by the DSM-5, while orthorexia is not
• Anorexia focuses on weight loss and thinness, while orthorexia does not
• Orthorexia leans on a healthy diet mindset, while anorexia does not (people with anorexia may eat foods that are considered “unhealthy”)
• People who deal with orthorexia are not necessarily physically underweight, while those who deal with anorexia are
• Motivation is likely different: Being “healthy” for those with orthorexia, and being “skinny” for those with anorexia

Who Do Orthorexia & Anorexia Affect?

There are many eating disorder statistics available for those with anorexia, though it’s important to recognize that more females are impacted by this disorder. Many who struggle with eating disorders or distorted eating beliefs have been body-shamed in some kind of way. They may either be labeled too thin or too fat, and may receive criticism for their bodies. While a small population may experience anorexia, orthorexia is believed to impact half of those with anorexia. It’s important to note that orthorexia, though not an official diagnosis, can help to identify those on the verge of anorexia.⁷

How Are Anorexia & Orthorexia Treated?

Treatment may be the same or different for these disorders, as it depends on the individual’s symptoms and beliefs about their disordered eating, but therapy is a front line treatment for eating disorders. Certain medications can be used to treat comorbid conditions such as depression, substance use disorder, and anxiety. This can be helpful for someone with disordered eating, as these symptoms commonly occur concurrently with depression or anxiety.

To find the right therapist, you may want to search an online therapist directory and check your insurance to find one who is in-network. Depending on your physical health, it may be beneficial to reach out to your physician for a referral, so they are aware of the treatment you are receiving. You can also use an online program like Equip Health or Within Health. Leaning on friends and family for support as you pursue treatment can really help in the healing process, as well.⁸

Treatment options for anorexia and orthorexia may include:

• Exposure therapy: Exposure therapy involves exposing someone to something they fear in an attempt to help desensitize them. It can be helpful to work through fears around body image, weight gain, food quality, etc.
• Enhanced cognitive behavioral therapy (CBT-E): CBT-E is an approach that helps people understand how their thoughts create actions, and the impact their thoughts have on their behaviors. This can be helpful, because it can show us our patterns of distorted thinking and learn ways to combat them.
• Group therapy: Eating disorder group therapy involves a therapist who facilitates healing conversations among a group of people dealing with the same condition. It shows people ways to cope; learn that they are not alone; recognize the ways in which their disorder impacts their social life and relationships; and learn to correct ourselves.

How to Help a Loved One With an Eating Disorder

If your loved one is struggling with an eating disorder, it can be hard to know how to support them. However, remember that you are not alone. There are ways to help your loved one feel supported without feeling ambushed. You can ask your loved one what their needs are and how you can support them. Make yourself available to help them with meal prep or at meal times as they try to work through their disordered eating. Being available to simply listen to them also goes a long way.

Here are some ways to help a loved one with an eating disorder:

• Be patient: Nothing will be fixed overnight, so being patient with your loved one is important. This is their process, and they will need time to cope.
• Offer support: Support of any kind can go a long way. It can be silent presence, listening, or offering to help with meals. Whatever support is needed, offer that and show up consistently.
• Encourage treatment: Professional treatment is so important for someone struggling with disordered eating. Going with them to therapy or offering support to them as they attend treatment can be helpful in their recovery.
• Validate their feelings: Someone with an eating disorder can struggle with understanding that their needs and emotions are valid. Validating their experience is very encouraging.
• Educate yourself: It can be hard for someone to explain what their eating disorder means to them and how it impacts them. So, researching out and educating yourself on the topic can be helpful.