Table 5.

Participant quotes.

Reference	Quote	Reference	Quote
1	Expatriate psychologist: [...] considering the flow in the work now, it is becoming a more prominent issue I believe, because I realize in my personal life and I am encountering with other people deeply, there is an issue like this [...] toxicity in eating or eating organic food or like purification of the body becoming a really kind of health-related content for all the talks around me.	11	Expatriate psychologist: I would go for eating disorders not otherwise specified. Because, for now, for what I know already, and because this is so brand new. It feels like, more, the safe side. Because then, if it’s an eating disorder, which seems to be somehow an eating situation here … At least you’re under the relevant category.
2	Expatriate psychologist: Young, highly educated woman I have with my experience in mind.	12	Expatriate psychologist: [...] the more training programs we have […] if we have a diagnosis for it we can have a facility for it and we can have specialists for it.
3	Dutch psychologist: Perfectionist, rigid, in need for control.	13	Dutch psychologist: [...] she (the patient) had to be hospitalized, which had to be done through her health insurance and otherwise her treatment would not have been reimbursed. [...]She does suffer from what we call Orthorexia, but that is not included (in the DSM) [...] so in terms of that her diagnosis will be adapted.
4	Expatriate psychologist: So they’re pretty aware, actually, of different things. And can also know, that it’s imbalanced, what they’re doing, but they’re just not able to stop it.	14	Expatriate psychologist: And it’s an advantage for us as […] psychologists, that work with treating it. To be able to communicate and convey it in a different way, more clear.
5	Expatriate psychologist: Now because the control is really really important […] obsessive-compulsive disorder.	15	Expatriate psychologist: [...] our current diagnostic statistical manual is updated all the time with what happens around. And [...] it would give, like, the scientific community an idea that, okay, we are, we are not an outdated system here, but we really, we really listen to what happens around, and we try to incorporate that, in the way we work.
6	Dutch psychologist: I would now be inclined to classify it under Anxiety Disorders, possibly under OCD and related disorders.	16	Dutch psychologist: Yes a disadvantage could be, but to be honest I don’t really think so, that a vast amount of diagnoses arise. You could also say that [...] this is covered by restricting type of eating disorder. [...] Then you don’t get a jumble of diagnoses.
7	Dutch psychologist: It could also fit with someone with autism who has a rigid idea about what’s healthy food and can’t think flexible anymore.	17	Dutch psychologist: If you call everyone who stops eating gluten orthorexic, then we have a problem.
8	Dutch psychiatrist: […] anorexia nervosa in the DSM also includes severity categories, and a mild form of Anorexia Nervosa really resembles this.	18	Expatriate psychologist: So if this social influence we get on eating healthily and all that, comes from a social influence perspective. By highlighting, not that, but highlighting the people who have the disorder, it’s more distracting everyone from what is the actual root of the problem.
9	Dutch psychologist: See when you look at the process of determining a new classification [...] that is a very lengthy process, and the outcomes of that process have to meet certain criteria.	19	Expatriate psychologist: Normally dsm is very specific. […] Compulsive behavior is very good, and maybe more examples would be needed here. Normally dsm gives examples on those.
10	Expatriate psychologist: No, I would use this one (ON diagnosis) for sure, because this can help, also, the patient to see more clear, in which way this is impairing their everyday life. Quality of well-being actually.	20	Dutch psychologist: I find the medical complications somewhat general. [...] It is described in anorexia [...]. And things like loss of hair, and yeah, disturbed menstruation, stomach and bowel issues, that kind of stuff. So it could be a bit more extensive.