What is neurological orthodontics?

What is neurological orthodontics?

The term “neurological orthodontics” describes an obsession with healthy, “pure” or “clean” diets. It was created as an analogy with anorexia nervosa: “ortho” means correct; “anorexia” means hunger; and “nervosa” means stubbornness or obsession.

Orthodontics is not recognized Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) As an official eating disorder. It is still a proposed diagnosis, attracting increasing interest from researchers, therapists, bloggers, and the public, especially as the craving for healthy food becomes more mainstream.

Dr. Stephen Bratman first coined the term in 1997 to describe the obsession with healthy eating he saw in several patients. Although he did not take this diagnosis seriously at first, he later discovered that people suffered serious health consequences from this condition.


Orthorexia is more than just vegetarianism, a gluten-free diet, or the general appreciation of healthy eating. As long as the diet provides adequate nutrition, it is possible to adhere to a healthy diet plan without eating disorders.

Orthodontics usually begins with a “strong” interest in healthy eating, which gradually escalates over time, becoming unhealthy and even destructive.

Symptoms of the disease include:

  • Compulsively following a diet plan: what was it in the first place A choice Becoming a kind of obsessive-compulsive disorder, individuals can no longer choose to relax their own rules.
  • Eat only healthy food. People with this symptom restrict foods that are considered unhealthy, and according to their belief system of healthy foods, accept certain “superfoods” that are considered to provide special health benefits. These restrictions often result in the elimination of entire food groups and/or increased purification, fasting, and detoxification.
  • Shame and guilt: A person’s self-esteem is closely related to their adherence to the chosen diet. Therefore, any deviation from diet usually leads to extreme guilt and shame as well as anxiety.
  • Negative effects on normal functioning: Eventually, the person’s restrictive diet begins to have a negative impact on his health and social and professional functions; eating the right foods becomes more and more important and excludes other pursuits.


In 2016 journal papers Eating behavior, Dr. Bratman and his co-author Thom Dunn proposed the following diagnostic criteria:

Standard A

All of the following:

  1. Compulsive behavior and/or full attention to restrictive diets to promote optimal health
  2. Violation of self-imposed dietary rules can lead to excessive fear of illness, personal uncleanness and/or negative physical feelings, anxiety and shame
  3. Dietary restrictions increase over time and may include eliminating food groups and cleaning.Weight loss often happens, but the desire to lose weight is not the point

Standard B

Any of the following:

  1. Other medical consequences caused by malnutrition, severe weight loss, or restricted diet
  2. Inner pain or impaired social, academic, or professional functions due to beliefs or behaviors about healthy eating
  3. Self-worth, identity, and body image are overly dependent on adherence to a “healthy” diet

A 2018 study estimated that the prevalence of normal eating disorders is between 6% and 90% due to the inability to distinguish between a healthy diet and a more pathologically healthy diet.of

Research is needed to refine the diagnosis, determine prevalence, identify risk factors, and develop treatments. An important first step is the development of evaluation tools; a 100-question survey is under development to evaluate and diagnose orthodontics. Researchers are currently proposing the use of the diagnostic tool ORTO-R, which contains six items from ORTO-15, which have been identified as the best markers for neurological orthodontics.


There are few studies on the causes of neurological orthodontics, but many different factors are likely to be involved. Dr. Bratman described several risk factors that he believes lead to orthodontics:

  • Adopt a highly restrictive diet theory
  • Childhood diseases involving diet and/or digestive problems
  • Fear of disease
  • Medical problems that cannot be solved by medicine
  • Parents who pay too much attention to healthy food
  • Characteristics of perfectionism, obsessive-compulsive disorder (OCD) and extremism

Research also shows that people in certain occupations, especially health-related occupations, may be more likely to suffer from orthodontics.

Other risks

Dr. Bratman reported that it has shown signs of evolution since he first thought about the beginning of orthodontics.He pointed out that compared with the 1990s, exercise is now more commonly part of it. He also reported that adding low-calorie foods has also become an important part of a healthy diet related to orthodontics.

In the case of individuals pursuing both purity and slimness, there may be overlap between anorexia nervosa and anorexia nervosa.

Sometimes, eclipse can also be a disguise for anorexia, because people show a more socially acceptable way to stay slim. Orthodontics may also cross over with bulimia nervosa and avoidance/restrictive food intake disorder (ARFID).

Because it can cause malnutrition, anorexia nervosa may cause any medical problems associated with anorexia nervosa, including menstrual reduction, osteoporosis, and heart failure.

Orthodox belief system

Although the behaviors (eating restriction) and consequences (weight loss, malnutrition, binge eating, and/or elimination) associated with anorexia nervosa may look similar to anorexia nervosa or bulimia nervosa, the main difference is The content of the belief system.


  • focus on health

  • Do not hide their behavior

  • Usually don’t skip meals

  • May resist treatment deemed unhealthy


  • Focus on weight loss

  • Shame, guilt, and attempts to hide yourself

  • Skip eating, avoid eating

  • May refuse treatment for fear of weight gain

The main considerations of normal eaters are ideal health, purity of the body, strengthening of the physique and avoidance of diseases. In contrast, people with anorexia consciously focus on weight and restrict food mainly based on calories.

People usually feel ashamed of their anorexia and try to hide it, but people with anorexia may actively try to persuade others to follow the same health beliefs.

People with anorexia nervosa often skip meals; people with orthodontics usually do not (unless they deliberately “clean”).

Finally, when patients with anorexia are treated, apart from calories, they are not particularly opposed to feeding products such as Assurance or Boost, and patients with anorexia are opposed to the chemicals in these supplements.

These differences in beliefs may be important. Misunderstandings by treatment professionals about the concerns of orthodontic patients may lead to treatment failure.


Although the treatment method has not been specifically validated for orthodontics, clinicians report that treatment methods that challenge diet theory and establish a more flexible diet have been successfully used to treat orthodontics.

If you or your loved one shows signs of loss of appetite, please seek help from an eating disorder treatment specialist. As with other eating disorders, early intervention increases the chances of a full recovery and minimizes negative effects.

Consultation is the main method of treatment. Some treatments that may be recommended include cognitive behavior therapy and dialectical behavior therapy. Medications such as antidepressants and anti-anxiety drugs may also help.

If you do not have a doctor who specializes in treating eating disorders, please consult your primary care professional first-they will most likely refer you to a specialist. Be sure to discuss behavior, daily issues, and any other matters related to your diet and health with your doctor.

Orthodontic Discussion Guide

Get our printable guide to make an appointment for your next doctor to help you ask the right questions.

Usually, people with eating disorders cannot recognize the impact of the condition on them. In fact, people with orthodontics still believe that everything they do is for health, and they don’t think it’s a problem. They may not even want to talk to the doctor at all.

If your current thoughts and/or behaviors surrounding food are causing distress and/or affecting your daily functions, it is recommended to seek professional help.


In addition to getting help from qualified professionals, you can also use self-help strategies to help you manage your daily life according to your condition.​​ Some of them include:

  • Join a support group: Find a support group online for people with orthodontic symptoms. It can be helpful to connect with people who have similar experiences. You can also find advice and tips on how to deal with symptoms of the condition.
  • Set limits: If you find that exercising, planning meals, or buying healthy foods takes up most of your time, limit the amount of time you can devote to these habits each day. It may be difficult to stick to your limits at first, but you may find that as time and practice progress, you will improve.
  • Start slowly: Normal eating usually involves very strict eating patterns, so break these habits very slowly. Try to add new foods to your diet. Trying new recipes or restaurants can be a fun way to incorporate different nutritious foods into your diet plan.
  • Talk to a dietitian: It can be helpful to talk to someone who has been specifically trained to help you develop a healthy diet plan. Talk about your past eating habits, develop a less restrictive nutrition plan, and make regular appointments to track your progress.