Orthorexia nervosa is an eating disorder characterized by an ongoing preoccupation with the “quality” of food, resulting in severely restricted diets and a strong need to maintain the “perfect” diet. The term was first coined in 1996 by the doctor Steven Bratman. Unlike anorexia nervosa, restriction is not a motivational factor, but a consequence of obsession with the perceived health effects of various foods.
Aside from the physical health issues, including low body mass index, malnutrition, and heart complications, orthorexia also affects mental health. Orthorexic people feel good when following strict diets, but feel excessive guilt when they fail. Coupled with repeated avoidance of social gatherings for fear of not being able to adhere to their strict diets, this can lead to feelings of isolation, depression, and anxiety. Orthorexia is also often associated with obsessive-compulsive disorder. Sam (alias) shared such a story on Reddit:
“I think my best friend’s sister did [orthorexia]even though I never had a name other than “OCD”. She buys groceries, brings them home, and goes through every item down to the smallest detail. For a couple of small bags, it can literally take 12 hours and it is entirely possible that she will not eat what she bought. She usually can’t cook or eat because [her] Obsession. It just takes too long or everything is “contaminated” or “spoiled”. There are a couple of expensive organic restaurants she trusts so she usually only eats one meal a day from one of them … To look at her you would think she is anorexic but she doesn’t mind much more to eat when she didn’t go to the best of his ability to make her food “healthy” first. “
Jennifer Mills, an associate professor at York University studying body image and eating disorders, spoke to the Trauma and Mental Health Report about how a person can develop orthorexia:
“There are likely genetic factors that put an individual at risk for general obsessive-compulsive tendencies. If these persist in weight loss and low-calorie eating, the person may develop anorexia nervosa. For example, if they engage with concerns about germs, the person may develop an obsessive-compulsive disorder related to contamination anxiety. And if they stick to a healthy diet and are concerned that certain types of foods are toxic or dangerous, the person may develop signs of orthorexia nervosa. “
When looking at personal accounts of orthorexic individuals, a cross-generational pattern emerges. This was true of Roxy (pseudonym), who shared on Reddit:
“My father suffered from orthorexia all his life, always fasted and only ate fruit. It looks like me [got] it from him. “
Taylor (pseudonym) noted that her disrupted diet was likely due to the inability to learn healthy eating habits from caregivers who themselves suffered from eating disorders.
Despite increasing scientific knowledge, not all researchers are convinced that orthorexia is a disorder in its own right and has not yet been officially recognized as an eating disorder by the American Psychiatric Association. In the absence of an appropriate diagnostic guide, many people, especially those following specific diets like veganism and zero carbohydrates, have criticized Bratman’s definition of orthorexia, claiming it pathologizes normal human behavior.
Mills explained the difference between a healthy diet and a disturbed diet:
“There will always be trends that will come and go … I want to point to the vast majority of the results of good scientific studies that show that moderation is key and that restrictive diets, such as no carbohydrates or very low fat diets, do more harm to us Health longer than good in the longer term or when it is taken to extremes. Experts all agree that something doesn’t work when people feel like they are spending too much time thinking about food or preparing it. Or when people avoid eating in social situations, which is often expressed by people with eating disorders, something is not working. Just as it is important not to pathologize healthy eating, it is important not to normalize extreme diets or eating disorders. “
This Medium article states, “Orthorexia nervosa has nothing to do with dietary restrictions itself. It has to do with the individual’s behavior while sticking to the particular diet. “
To correctly identify orthorexia and differentiate it from a normal diet, it is important to remember the four Ds of the abnormality recognized by many in the psychiatric community: abnormality, dysfunction, stress, and danger.
– Rupkatha Basu, contributing writer
Feature: Wikimedia Commons at Wikimedia, Creative Commons
First: Darren Tunnicliff on Flickr, Creative Commons
Second: Mary Lock on Flickr, Creative Commons