Orthorexia: The Road to Health is Paved with Good Intentions

December 14, 2008 by Be Nourished

"Many of the most unbalanced people I have ever met are those who have devoted themselves to healthy eating."
- Dr. Steven Bratman

We all know someone like this -- someone who obsessively eats so healthfully that you find yourself unable to relax in her presence at the dinner table. Perhaps you know several people like this, but in a few examples, you actually worry about whether or not someone is getting enough to eat to be healthy.

Maybe you've also noticed that she seems to medicate herself with food, believing that a chronic illness or pain is managed by their diet and, not only that, that this friend of yours talks about it quite a bit.

When you've found yourself worrying about this person, you likely reassure yourself by the fact that this person is knowledgeable about nutrition and, if anyone is eating well, it's this person, so you may dismiss your concerns.

Well, you might need to rethink that belief, according to Dr. Steven Bratman, who has coined the term "orthorexia nervosa" recently to refer to what he deems "a pathological fixation on eating proper food."

According to Bratman, orthorexia begins as a desire to overcome chronic illness or to improve general health but, because it depends on an iron will to change habits ingrained in childhood and reinforced by a fast-food-driven culture, some people find themselves obsessing about their dietary choices, ironically, to the detriment of their own health.

Like obsessive-compulsive disorder or, its close relation, anorexia nervosa, orthorexia quickly becomes a vicious cyle. When the orthorexic individual doesn't meet his own high standards of dietary perfection by indulging in ice cream or fettucine alfredo in a "moment of weakness," he will often respond by putting himself on even stricter diets and/or an exhausting exercise regimen, perpetuating the downward spiral.

According to Bratman:

"Orthorexia begins, innocently enough, as a desire to overcome chronic illness or to improve general health. But because it requires considerable willpower to adopt a diet that differs radically from the food habits of childhood and the surrounding culture, few accomplish the change gracefully. Most must resort to an iron self-discipline bolstered by a hefty dose of superiority over those who eat junk food. Over time, what to eat, how much, and the consequences of dietary indiscretion come to occupy a greater and greater proportion of the orthorexic's day."

One study on food preoccupation showed that people with no disorder spend 15-20 percent of their day thinking about food, while dieters, 20-65 percent; people with bulimia, 70-90%; and those who struggle with anorexia, 90-110 percent (Healthy Weight Journal, 1998).

Bratman warns on his website that the motivation behind the disorder "is a health food theory, such as rawfoodism, macrobiotics, veganism (and) that, in most cases, the underlying diet is reasonably healthy (if unreasonably specific). It's in the obsessive approach to diet taken by an orthorexic that the disorder lies."  He describes how for the orthorexic eating healthy food is not unlike a religion and "begins to carry pseudospiritual connotations." This dogmatic approach can extend to the processes of planning and purchasing meals, dominating their lives, making their self-esteem dependent on their incredibly high dietary standards, and infusing them with a sense of superiority over others with what they deem unhealthy eating habits.  One may question if someone can truly pursue "health" at the expense of their emotional wellness.

Like people with anorexia and bulimia, orthorexics give food a sense of disproportionate priority, and the yard stick by which they measure "healthy" eating habits varies depending on the individual. Bratman says there was a time when he wouldn't eat a vegetable if it had spent more than 15 minutes outside the garden, insisted on chewing each mouthful of food 50 times, would only eat alone and always left his stomach partially empty at the end of a meal. He also habitually lectured his friends and family about the perils of processed foods and the dangers of pesticides and fertilizers.

While their eating habits in and of themselves may not jeopardize their well being, people with orthorexia suffer from their tendency to alienate themselves socially and the stress they inflict on themselves from pursuing impossible eating and, in some cases, exercise regimens. Like other eating-disordered people, moreover, those with orthorexia do, in severe cases, run the risk of depriving themselves of the calories and nutrients required in a given day, endangering the health and their lives.

Even food politics leader Michael Pollan, in his well-regarded book In Defense of Food: An Eater's Manifesto, mentions orthorexia, describing America in general as "becoming a nation of orthorexics." While acknowledging that orthorexia is not yet formally recognized by the DSM IV, Pollan notes that "academic investigation is under way."

More information about this intriguing disorder is available at www.orthorexia.com, and Bratman has written a book on the subject, Health Food Junkies: Orthorexia Nervosa - the Health Food Eating Disorder

In: orthorexia eating disorders 

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