Why Is Orthorexia Still Not Classified as an Eating Disorder?

There’s a point where healthy eating becomes an obsession, and more officially, an eating disorder—but despite the growing realization that healthy eating can turn psychologically and physically unhealthy, there’s still no official diagnosis for the condition. A new Fast Company article breaks down why it’s important to define orthorexia in the DSM as a form of “disordered eating.”

For one, not officially identifying orthorexia makes it harder to diagnose and get treatment, since the DSM (the APA’s Diagnostic and Statistical Manual of Mental Disorders) is the go-to source for doctors. While the term has technically been around for almost two decades, Fast Company points out that hasn’t been a huge amount of medical awareness around it.

As Heather Hansman explains, “It’s been lumped in with other eating disorders, like avoidant/restrictive food intake disorder, or considered a form of OCD.” Figuring out what actually qualifies as orthorexia is the hard part—there are social factors that complicate it—so imagine the confusion when you’re trying to get treated. Here’s a simple explanation:

Unlike anorexia, which addresses how much you eat, orthorexia is about what you eat. And nutritionists and psychologists say that they’re seeing it more often, especially in the face of restrictive food trends, like gluten free, and growing information about where food comes from, and how it’s grown and processed.

Hansman references Jordan Younger, a vegan food blogger who revealed last year that her experience with orthorexia and her “hyper-restrictive diet” led to panic attacks and hormonal imbalances:

No two eating disorder cases are alike, but Younger is somewhat typical of what’s seen as orthorexia. She says she has an “all or nothing” personality that made her prone to compulsive healthy eating, and that her heavy digital involvement made it even harder to break off. She said she became even more compulsive because posting everything she was eating, and comparing herself to other people’s Instagrams.

Younger self-diagnosed after being called out by a friend who had similar unhealthy habits, but it’s complicated to diagnose and treat eating disorders when they’re not clearly defined, which is why there’s a current push to get orthorexia officially designated as an eating disorder.

Orthorexia was left out of the most recent 2013 DSM edition because, according to Hansman, “when they did a literature review in 2009, there wasn’t enough published about orthorexia to warrant a change, even though people were talking about it.” Now, people are talking about it at least a little bit more.