In my opinion, the criteria for orthorexia in criterion A does not set a good boundary for mental illness or healthy eating because there is no time frame to define when this would be normal or out of control. For example, if someone is insecure about their weight or health and they undergo a cleansing diet for a few weeks or a month, there is a possibility that after changing drastically from an unhealthy diet to a cleansing diet, the symptoms noted in criterion A are likely to come up. However, if someone continues to feel these obsessive compulsives and anxiety from eating, there is a possibility for a mental illness diagnosis. The people who wrote the concepts for criteria A should include a time frame for when the anxious feelings actually turn into a serious mental illness. I believe that if these thoughts and beliefs cause a weight loss and continue to escalate in six months to a year, there should be a check up for orthorexia.
In Criterion B, I think the criteria listed are acceptable to distinguish the boundary between orthorexia and healthy eating. Someone who is malnourished from severe weight loss would have started struggling with the compulsive behaviors and mental complications for a long period of time and should cause serious concern, especially if these actions are caused by a lack of body image, self-worth, identity, or satisfaction. I believe that in order to diagnose someone with orthorexia, these criteria have to be met.
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I appreciate your thought on the importance of a time frame for these symptoms. This is something that is often included in diagnostic criteria because the duration of maladaptive behaviors is often a good indication of how much of a problem it is.
I also agree that criterion B sounds more credible. Lack of nourishment, distress, and the weak self-image are all maladaptive and can quickly become harmful to a person’s physical and mental well-being. When these symptoms begin to impede on a person’s daily life and cause disruptions, a diagnosis may be appropriate.