Orthorexia nervosa: nosographic category or not?

Area of Science:

• Psychiatry
• Clinical Psychology
• Eating Disorders

Background:

• Orthorexia nervosa is characterized by an obsessive fixation on "healthy" eating.
• Debate exists on classifying orthorexia nervosa as a distinct psychiatric disorder.
• Distinguishing pathological orthorexia from non-pathological healthy eating is complex.

Purpose of the Study:

• To analyze conceptual issues in diagnosing orthorexia nervosa.
• To evaluate proposed diagnostic strategies for orthorexia nervosa.
• To determine if orthorexia nervosa fits current psychiatric nosological categories.

Main Methods:

• Literature review of proposed diagnostic criteria for orthorexia nervosa.
• Analysis of two main diagnostic strategies: physical impairment and psychological distress.
• Conceptual comparison with similar phenomena (e.g., eco-anxiety).

Main Results:

• Using physical impairment (malnutrition) as a criterion requires significant conceptual changes to orthorexia nervosa.
• Using psychological distress risks pathologizing dedicated, non-pathological lifestyles.
• Current diagnostic approaches present substantial problems for classifying orthorexia nervosa.

Conclusions:

• Orthorexia nervosa, as currently conceptualized, faces significant challenges as a plausible psychiatric nosographic category.
• The behavior may represent an adaptive response rather than a mental disorder, similar to eco-anxiety.
• Further conceptual refinement is needed to address diagnostic ambiguities.