正食症（Orthorexia）与厌食症（Anorexia Nervosa）虽然都涉及对饮食的极端关注，但二者在核心动机、表现形式和心理机制上存在显著差异。正食症并非正式列入精神疾病诊断手册（如DSM-5）的临床诊断，但它指的是一种对“健康饮食”的强迫性追求。患者极度关注食物的“纯净度”或“健康程度”，例如只吃有机、无添加、天然食材，甚至发展到拒绝社交聚餐、因饮食限制而营养不良。其驱动力主要来自对健康的焦虑，而非体重控制。相比之下，厌食症是一种被广泛认可的进食障碍，核心特征是对体重增加的强烈恐惧和对体型、体重的扭曲认知。患者通常通过极端节食、过度运动等方式刻意减重，即使已明显消瘦仍认为自己“太胖”。厌食症常伴随严重的生理后果，如闭经、骨质疏松、心律失常，甚至危及生命。简言之，正食症关注的是“吃什么才健康”，而厌食症关注的是“吃多少才不会胖”。尽管两者都可能导致营养不良和社交隔离，但治疗重点不同：正食症需调整对“健康”的执念，而厌食症则需重建对身体形象的认知并恢复体重。理解这些区别有助于更精准地识别问题并提供适当支持。
Although orthorexia and anorexia nervosa both involve extreme preoccupation with food, they differ significantly in core motivations, behavioral patterns, and underlying psychological mechanisms.Orthorexia, not yet formally recognized as a clinical diagnosis in manuals like the DSM-5, refers to an obsessive focus on eating ‘healthy’ or ‘pure’ foods. Individuals with orthorexia may rigidly consume only organic, additive-free, or natural ingredients, often to the point of social isolation or malnutrition. Their driving force is anxiety about health—not weight control.In contrast, anorexia nervosa is a well-established eating disorder characterized by an intense fear of gaining weight and a distorted perception of body shape and size. Patients typically engage in severe calorie restriction, excessive exercise, or other weight-loss behaviors, often remaining convinced they are overweight even when dangerously underweight. Anorexia can lead to serious medical complications such as amenorrhea, osteoporosis, cardiac arrhythmias, and even death.In short, orthorexia centers on ‘what is healthy to eat,’ while anorexia focuses on ‘how little one can eat to avoid gaining weight.’ Although both conditions can result in malnutrition and social withdrawal, treatment approaches differ: orthorexia requires addressing rigid beliefs about ‘healthy’ eating, whereas anorexia demands restoring body weight and correcting distorted body image. Understanding these distinctions is crucial for accurate identification and appropriate support.
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