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The Mask of Orthorexia – Two Cases from Medical Practice

Darina Hristova, Dimitar Marinov


Introduction: Eating disorders (EDs) are common, often chronic, and potentially life-threatening conditions affecting predominantly adolescents and young people. An especially common problem in the latest years is orthorexia nervosa (ON). Often the symptoms of ON are well disguised and the condition is not included in the differential diagnosis of most medical professionals.

Materials and Methods: Two case studies are presented from the practice of a medical specialist in nutrition and dietetics: women with ON. Both patients received nutritional training and specific nutritional instructions. The motivation to change their dietary habits and create new ones was maintained through regular communication with the physician, and in some cases - through regular meetings with a clinical psychologist. Both women were encouraged to participate in group psychotherapy sessions under the guidance of a clinical psychologist.

Interpretation: These clinical cases demonstrate that when diagnosing ON there are not always large deviations in the clinical and laboratory indicators. Only the careful recording of the anamnesis and the in-depth conversation with the patient allows the correct diagnosis to be made. Insufficient awareness among medical staff (including doctors and nurses) about symptoms and diagnosis of eating disorders requires further training on this issue.


orthorexia nervosa, eating disorders, diagnosis, treatment

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