Researcher’s review of Swedish agency report on orthorexia shows unclear evidence base

Eva-Carin Lindgren, Professor of Sport Science with a specialisation in Health Promotion at Halmstad University, has reviewed a report by the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) on the current state of knowledge regarding orthorexia nervosa. The review shows that the research field is still characterised by considerable uncertainty in terms of definition, diagnosis and treatment.

Orthorexia nervosa is described in the international literature as an unhealthy fixation on eating food perceived as “clean” and healthy. Over time, this may restrict an individual’s everyday life. In its report, SBU emphasises that excessive exercise is not included in the concept of orthorexia nervosa.

“It is important to underline that orthorexia nervosa concerns a compulsive focus on healthy eating, not excessive exercise”, says Eva-Carin Lindgren, one of two experts who reviewed the SBU report.

SBU further concludes that there are no consistent criteria for assessing orthorexia nervosa, that the behaviour is not an established psychiatric diagnosis, and that there are overlaps with conditions such as obsessive-compulsive disorder and anorexia nervosa. In addition, there is a lack of reliable measurement instruments and scientific evidence for preventive and therapeutic interventions.

“Overall, the evidence base for orthorexia nervosa remains unclear”, concludes Eva-Carin Lindgren.

Leading several projects on orthorexia nervosa

Eva-Carin Lindgren is leading several research projects aimed at increasing the understanding of orthorexia nervosa.

In one project, funded by the Swedish Research Council, Eva-Carin Lindgren and her colleagues are investigating how health-related school subjects may influence the development of orthorexic behaviours among pupils. One aim of the project is to develop a self-assessment instrument to identify such behaviours.

Another project, funded by the Swedish Research Council for Sport Science, focuses on elite sport and elite coaches’ perspectives on orthorexia nervosa, intending to increase awareness and contribute to more sustainable training environments for young elite athletes.

“Hopefully, our projects can contribute new insights in an area where knowledge is currently limited, as demonstrated by the review of the SBU report”, says Eva-Carin Lindgren.

Text: Hilda Liberg, Lena Lundén

Photo: iStock, Magnus Karlsson