Orthorexia nervosa: A lifestyle phenomenon or the emergence of a new eating disorder?

Background: Several studies have provided evidence on orthorexia nervosa, a syndrome characterized by an extreme and drastic healthy eating pattern, which has been the focus of growing interest. However, there is a scientific debate as to whether it is simply a behavioural phenomenon, a lifestyle or a mental disorder. Objective: A descriptive analysis of the evidence about orthorexia nervosa: epidemiological, nosological, clinical and therapeutic aspects were discussed. Method: A narrative qualitative bibliographic search on orthorexia nervosa and other eating disorders was carried out using Medline/ PubMed, SciELO databases and specialized texts. Results: It is controversial whether orthorexia nervosa is a unique eating disorder or a consequence of its outcome or an obsessive-compulsive process. It can precede, occur, or coexist along with eating disorders and also may affect eating habits. A history of eating disorder is a significant predictive factor for the development of orthorexia nervosa. Some authors have differentiated between an orthorexia oriented towards the interest in a healthy diet (healthy orthorexia) and another related to a pathological concern about eating healthy (orthorexia nervosa). Conclusions: Many psychological and behavioural features of eating disorders are shared by orthorexics. Future longitudinal research is needed to analyse the temporal relationship between these and other issues to include orthorexia nervosa within the spectrum of eating disorders.