Orthorexia: Obsessed with Healthy Food
Katherine Hepburn said, “If you obey all the rules, you miss all the fun.” Orthorexia doesn’t sound like fun. It is about eating cleaner than it needs to be.
"Orthorexia nervosa" is the informal name of an eating disorder – more precisely, an aberrant eating pattern – defined by an extreme obsession with healthy eating food. According to an article in The Guardian, the term was coined by Steven Bratman, MD in 1997. He combined the Greek “ortho” - straight and correct - with the medical prefix “orexia’ - appetite - to describe a “pathological fixation on proper eating”.
People with orthorexia may feel virtuous about their “good” food choices, but vile and self-loathing if they should stray. They may spend hours and hours planning what to eat, and opt for nothing if the right food is not available. The Guardian says the pattern is typically seen in “well-educated, middle class, adults over 30”…who have rigid rules about which foods are pure and good. The pattern may start with food allergies and diets where foods are systematically eliminated until only a small number remain. It is also seen in bodybuilders during the competition season followed by an all out binge later on.
Healthy eating: another ED?
When does a tight grip on eating turn into a problem? Many doctors don't accept orthorexia nervosa as a legitimate diagnosis. They say aggressive cases may be obsessive compulsive disorder (OCD), an anxiety disorder characterized by fear, intrusive thoughts and repetitive behaviors, with food as the obsession. And at times, "orthorexic" individuals may meet the diagnostic criteria for anorexia nervosa when amenorrhea, emaciation and a pathological fear of becoming fat coexist.
In his book, Health Food Junkies: Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating, Dr. Bratman uses this screening tool for orthorexia that has not been validated but may be useful for identifying issues in need of deeper review. If you answer "yes" to two or three of these questions, then you may need to loosen your grip on food.
- Are you spending more than three hours a day thinking about healthy food?
- Do you always skip foods you once enjoyed in order to only eat the "right" foods?
- Does your diet make it difficult for you to eat anywhere but at home, distancing you from friends and family?
- Do you look down on others who don't eat your way?
- Does your self-esteem get a boost from eating healthy?
- When you eat the way you're supposed to, do you feel in total control?
- Do you feel guilt or self-loathing when you stray from your diet?
- Is the virtue you feel about what you eat more important than the pleasure you receive from eating it?
- Has the quality of your life decreased as the quality of your diet increased?
The Bottom Line: One of the hardest parts about dieting is learning where to draw the line between the rules and the fun. At one end is a careless diet of highly processed, non-nutritive foods and at the other end is clean eating to the point of social isolation and malnutrition. While it is important to plan and practice a new eating style when starting to make basic diet changes, one should not be fixated on healthy eating or on looking a certain way.
Where do you draw the line? Do you know anyone with orthorexia?