Orthorexia is not a formal medical disorder. It is a term coined in 1996 by Steven Bratman, MD, author of Health Food Junkies to describe his own experience with food and eating. The word is derived from the Greek ortho meaning “right” or “correct” and orexia meaning “appetite”. Some health professionals say orthorexia does not need its own classification because it is a form of obsessive compulsive disorder (OCD) or anorexia. So, what is orthorexia?
According to Bratman, orthorexia is an “unhealthy obsession with healthy eating.” People with this condition normally start out with the intention of wanting to eat more healthfully, but over time their eating habits get out of control. They become obsessed with the foods they eat, and if they do not stick to their strict diet, they feel bad and will punish themselves with a stricter eating regime, exercise and/or fasts. Eventually, their obsession can interfere with their lives - interests, activities, relationships - and become psychologically and physically unhealthy.
Some people use the word “orthorexia” to indicate a mild obsession and “orthorexia nervosa” to indicate a dangerous obsession. The Greek word nervosa means to be nervous as an implied agitation over something.
The root cause of eating disorders in general is not fully understood. However, scientists believe genetics may play a role, as well as situational factors and/or psychological reasons. According to the National Eating Disorders Association, underlying motivations for orthorexia, besides wanting to be healthy, include “safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.”
There is not a specific diet orthorexics adhere to. Foods commonly avoided include animal and dairy products, those that contain preservatives, artificial colors and flavors, pesticides, unhealthy fat, sugar and salt, and those that are genetically modified. Some people will avoid eating food that they did not buy or prepare. Preparation techniques may also be a concern - for instance, the person may wash their food many times before eating.
Although the focus is not on thinness, some orthorexics will become severely underweight because their choices of food are extremely limited. According to an article that was published in The New York Times (February 25, 2009), an 18 year old female began her struggle with food when she started eliminating “bad” foods from her diet, including meats, carbohydrates, processed foods and refined sugars. Her daily calorie intake was reduced to 500, her weight dropped to 68 pounds and she was repeatedly hospitalized until she restored her weight. Also, Bratman reports on his website ‘Orthorexia Home Page’ that a woman died of heart failure brought on by orthorexia-induced starvation in 2003. She was diagnosed with anorexia, but resisted the diagnosis and recommended treatment because she was not afraid of being fat - she just wanted to eat healthy food.
According to the National Eating Disorders Association, “Orthorexics lose the ability to eat intuitively – to know when they are hungry, how much they need, and when they are full.”
Signs of orthorexia may include:
Thinking about healthy food for more than three hours a day.
Skipping foods that were once enjoyed so the “right” foods can be eaten.
Taking more pleasure from the virtuous aspect of food than its taste.
Continually limiting the number of foods consumed.
Feeling in total control when eating the “right” diet.
Feeling guilt when straying from the “right” diet.
Feeling critical of people who do not eat as well.
Experiencing social isolation because of the time spent on thinking about food and planning meals, and/or because the diet makes it hard to eat anywhere but at home.
If you or someone you know has any of the above signs, you should seek help. While orthorexia is not a condition your health care provider will diagnose, the recovery process can require professional help. Consulting a practitioner who is skilled at treating people with eating disorders is the best choice. Treatment generally involves treating nutritional deficiencies and/or other conditions that may have developed as a result of the diet, and psychological therapy to help address any underlying emotional problems. Another important part of treatment is educating the person about proper nutrition, which people with orthorexia often resist because they believe their diet is already healthy.
A recovered orthorexic will continue to eat healthy, but they will have a different understanding of what healthy eating is, and they will learn that there are other important things in life besides eating healthy foods.
Orthorexia Home Page: https://www.orthorexia.com/
National Eating Disorders Association: https://www.nationaleatingdisorders.org/uploads/file/Orthorexia%20Nervosa.pdf
Timberline Knolls: https://www.timberlineknolls.com/eating-disorder/orthorexia/signs-effects
Palo Alto Medical Foundation: https://www.pamf.org/teen/life/bodyimage/orthorexia.html
The New York Times: https://www.nytimes.com/2009/02/26/health/nutrition/26food.html