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Suchttherapie 2019; 20(01): 24-34
DOI: 10.1055/a-0707-7722
Schwerpunktthema
© Georg Thieme Verlag KG Stuttgart · New York

Orthorexia nervosa: Verhaltensauffälligkeit oder neue Störungskategorie?

Orthorexia Nervosa: A Behavioral Condition or a New Mental Disorder?
Jana Strahler
1   Psychotherapie und Systemneurowissenschaften, Justus-Liebig-Universität Gießen, Gießen
,
Rudolf Stark
1   Psychotherapie und Systemneurowissenschaften, Justus-Liebig-Universität Gießen, Gießen
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Publication History

Publication Date:
11 September 2018 (online)

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Zusammenfassung

Zahlreiche epidemiologische Studien zeigen, dass es sich bei Orthorexia nervosa, der zwanghaften Fixierung auf gesundes Essen, um ein bekanntes und verbreitetes Phänomen in verschiedenen Ländern und Kulturen handelt (Prävalenzen zwischen 1 und 7% in der deutschen Allgemeinbevölkerung). Die Diskussion, ob es sich dabei jedoch lediglich um ein gesellschaftliches Phänomen bzw. Verhaltensauffälligkeit handelt, eine (subklinische) Essstörung oder eine Zwangsstörung, oder ob man dieses Verhalten zur Gruppe der Verhaltenssüchte zählen sollte, steht dabei ganz am Anfang. Nur wenige Studien beschäftigen sich mit dieser differenzialdiagnostischen Abgrenzung. Unter Beachtung der Uneinigkeit in Bezug auf die Definition des Phänomens legen aktuelle Studien am ehesten eine Klassifizierung im Rahmen der Essstörungen nahe. Zweifel entstehen v. a. aus dem deutlichen Überlappungsgrad zu anderen Lebensstilmerkmalen. Ähnlich rar sind Studien, die die klinische Relevanz eines orthorektischen Essverhaltens nachzeichnen sowie mögliche Entstehungsmechanismen thematisieren. Alter und Geschlecht spielen nach aktuellen Erkenntnissen eine eher untergeordnete Rolle. Studien zum Einfluss von Bildung und Gewicht deuten auf einen schwachen bis moderaten U-förmigen Zusammenhang mit orthorektischen Verhaltensweisen. Ebenso werden Aspekte wie Schönheitsideal, Perfektionismus sowie Fitness- und Gesundheitsorientierung immer wieder als relevant beschrieben. Studien zu neuropsychologischen und biologischen Korrelaten fehlen fast komplett. Der vorliegende Artikel gibt einen Überblick über den aktuellen Forschungsstand, zeigt verschiedene Erklärungsansätze und reflektiert kritisch über den aktuellen Wissensstand.

Abstract

Numerous studies show that Orthorexia nervosa, the manic obsession with healthy nutrition, is of epidemiological relevance across different countries and cultures (prevalence rate 1 to 7% among German general population samples). However, scientific debate about considering this phenomenon merely a socio-cultural phenomenon and behavioral problem, a (subclinical) eating disorder or obsessive-compulsive disorder, or whether criteria for a behavioral addiction are met, is only just beginning. Only few studies exist that differentiate orthorexic eating behaviors from other diagnostic categories. Keeping unclear diagnostic criteria in mind, the current literature favours a classification linked to common eating disorders. In particular, overlaps with other lifestyle behaviors raise doubts about this phenomenon’s independency. Likewise, studies that address this phenomenon’s clinical relevance and pathogenesis are scarce. Age and gender seem to be of minor importance. Studies on education, socio-economic status and weight indicate a small to moderate U-shaped relationship with orthorexic tendencies. The aspects of the ideal of beauty, perfectionism, and a strong focus on fitness and health are often reported associated factors. Studies on underlying neuropsychological and biological mechanisms are almost completely missing. This article provides an overview of the current state of research, summarizes explanatory approaches and critically reflects the current scientific evidence.

Schlüsselwörter

Orthorexia nervosa - Lebensstil - Essstörung - Zwang - Verhaltenssucht

Key words

orthorexia nervosa - lifestyle - eating disorder - obsessive-compulsive disorder - behavioral addiction
 

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