What are People’s Experiences of Orthorexia Nervosa, as Described in Online Blogs?

Abstract

Orthorexia Nervosa (ON) is the term for a proposed new eating disorder, used to describe a pathological obsession with healthy or ‘clean’ eating. For individuals with ON, the obsession with eating ‘healthy’ foods, and the elimination of foods considered ‘unhealthy’ or ‘impure’, results in impairment to social, physical, occupational and/or other areas of functioning. Whilst there is still debate as to whether ON describes a distinct eating disorder, and there is no consensus around diagnostic criteria as yet, ON is an emerging topic for research, with more cases coming to light both clinically, and in the media. Although some quantitative research has been carried out in ON, particularly focusing on the measurement and prevalence rates of this proposed disorder, no qualitative studies have been published to date to explore individuals’ personal experiences of ON. Thus, for this project, 40 pre-existing blog entries describing first-person experiences of ON from fifteen women bloggers were analysed using thematic analysis. Five key themes were identified: 1) confusion around diagnosis, 2) initial motivations for a healthier lifestyle, 3) fuelling the problem- social influences, 4) when healthy becomes unhealthy…, and 5) avoidance, isolation and compensation. The clinical implications of these findings were explored, particularly focusing on the social context of ON, diagnostic crossover between ON and other eating disorders, and the role of fear, perfectionism and perceived control. Whilst the debate around the diagnosis of ON continues, these bloggers’ accounts suggest that ON is experienced as a legitimate and debilitating disorder, worthy of clinical and research investigation in its own right.