There is often a desire to eat healthier in the beginning," says Thomas Huber of the Bad Oeynhausen Clinic, which specializes in eating disorders.

"People with orthorexia determine for themselves what is healthy and what is not. These rules become stricter over time and more food is removed from the diet, ”Huber explains. "More and more of this is getting a stamp - unhealthy."

"For example, someone wants to lose weight and therefore change their diet. Someone else starts paying more attention to food because of frequent food scandals, ”explains Frederike Bartels of the University of Düsseldorf, who has been researching the behavior of orthorexists for years.

"Over time, it can take on obsessive traits, and the focus on healthy eating becomes the burden that everything revolves around," Bartels says.

The official term orthorexia nervosa was coined by American physician Steven Bratman in 1997. "Bratmann identified the disorder himself and wrote down what he noticed, convinced that his preoccupation with healthy eating had gone beyond normal," Huber explains. His records are still used as a basis for evaluating orthorexia.

Expert circles have debated whether orthorexia is an eating disorder like anorexia or bulimia - or whether addiction to healthy foods should be classified as an obsessive-compulsive disorder.

"The truth is somewhere in the middle," Huber says, "there's definitely something compulsive about it, and there are many parallels to classic eating disorders."

But there are differences. These are explored by Frederick Bartels. "Many are weight loss, weight loss and weight loss programs. At first, orthorexia was thought to have nothing to do with it, but in all my studies, I see an association with the alleged weight and lineage issues. "

Healthy is not always healthy

The focus on supposedly healthy foods can be counterintuitive and lead to unhealthy diets. Because that supposedly healthy diet can be too one sided. Deficiency of vitamins and minerals leads to typical malnutrition or some diseases.

"It can happen that someone is pathologically thin. The result can be a dangerous reduction in body fat and even muscle mass. Malnutrition can lead to hair loss and, if advanced, can lead to organ damage, ”Huber explains.

Huber recalls a young woman who came to the clinic: “She wanted to eat healthier, did not gain weight, and was actually happy with her body. But motivated by a friend, she gave up candy. She searched all over the internet for a healthy diet, learned many half-truths and developed more and more fears about different foods. "

"She started avoiding preservatives first, then fat and carbohydrate foods and was extremely lean at the end. When she came to us, she was about 40 pounds, "Huber summarizes.

Some people do not shy away from eating the food they think is healthy and getting it expensive.

"Bratmann has set himself the rule that vegetables must be eaten within fifteen minutes of harvesting. As an organic food farmer, he could simply go to the garden and immediately eat fruits or vegetables or process them directly, ”Huber says.

About nutrition fanatics, Bratmann later said, "Instead of life, they just have a diet plan."

People who overly restrict their food choices often have environmental problems. Community meals have a great social significance, however, people with orthorexia often refuse invitations to joint meals. Behind this is the fear of dealing with unhealthy foods.

When nutrition fanatics try to persuade people around them that they should not continue to feed as before, an almost missionary fervor is often observed: "They make them feel guilty," Huber says.

It should be said that this disorder exists primarily in rich countries and regions.

There are scarcely cases of eating disorders in developing countries. "Nobody comes up with the idea of reducing food quantity and choice unnecessarily," concludes Frederike Bartels of the University of Düsseldorf.