“Orthorexia Nervosa” is an obsession with eating the “right” foods or the “healthiest” food for the purpose of optimal health. It begins with an enthusiastic interest in following a stringent dietary practice, such as vegetarianism or raw food veganism. It is not that these diets cause orthorexia. Rather, when these practices are taken to extremes, disordered eating, eating disorders and other psychological or physical problems can occur.
Steven Bratman, the physician who coined the term “orthorexia nervosa,” was practicing alternative medicine in the 1990’s when the trend was to try and improve health through various diets in place of using medication. His patients would frequently ask him what foods they should eliminate and they would try theories like the Macrobiotic, Candida or Blood Type diets, which did nothing to make them any healthier.
Dr. Bratman was aware of the dangers of trying to eat too healthy based on his own experience with orthorexia while living on an organic farm in the 1970’s. He knew some of his patients were going to extremes and that it was more important for them to relax the constraints they were putting on their eating because their health was suffering from trying to be too healthy.
Because of the restrictive eating patterns, orthorexia nervosa can look like the eating disorder, anorexia nervosa, but there are some distinct differences:
- In anorexia, the focus is on the quantity of food eaten; in orthorexia, the focus is on the quality of food eaten;
- Anorexia is about the fear of being or becoming fat and wanting to lose weight; orthorexia is an obsessive focus on eating for ideal health;
- Anorexia is an exaggerated fear of being fat; orthorexia is an exaggerated fear of disease, personal impurity and/or negative sensations if dietary rules are violated.
Much like millions of people diet, but only those with genetic vulnerabilities develop an eating disorder as a result of dieting, there are people who can follow even extreme or irrational dietary practices, but only those with vulnerabilities will develop orthorexia.
Anorexia and orthorexia can co-exist and are a dangerous combination of disorders to have. Someone with anorexia can also develop extreme beliefs about what they can or cannot eat in order to prevent cancer or heart disease, for example, even though they are already underweight and think they are fat. Conversely, someone with orthorexia may get so restrictive with what they eat in their quest for optimal health that their weight drops significantly and they develop fears of eating and gaining back to a normal weight.
Those at risk of developing orthorexia are those who:
- Adopt a restrictive dietary practice with the intention of improving their health;
- Are afraid of developing health problems or a disease so want to get healthier;
- Place undue importance on food beyond its normal nutritional value;
- Want to use “natural” interventions to manage health;
- Have perfectionistic, obsessive compulsive or extremist patterns;
- Self-diagnose their own digestive problems, irritable bowel, food allergies, food intolerances, and/or dietary sensitivities.
If you recognize any of the risk factors or the following signs in yourself or someone you know, getting an eating disorders assessment will determine whether the intention to be the healthiest is leading down the opposite path:
- Idealizing the benefits of “superfoods” (like kale, goji berries, chia seeds, kefir, hemp seeds, etc.) while demonizing regular foods;
- Becoming progressively stricter with food choices;
- Extolling the virtues of their dietary practices;
- Having increased focus on food, planning meals, preparing and consuming food, or only shopping at certain “acceptable” food stores;
- Believing that including or eliminating certain types of or specific foods will prevent disease, cure disease or affect wellness;
- Making moral judgments about oneself or others based on what or how they eat;
- Ongoing belief that eating for optimal health is necessary despite evidence of malnutrition or other nutrition-related health problems;
- Wanting to increase food variety and choices but unable to do so due to fear of impurity, disease or shame;
- Experiencing other problems like fatigue, sleep problems, poor concentration, dizziness, low heart rate, hair loss, weakness, anxiety, depression, OCD, eating disorders.
Orthorexia is a treatable condition. Make sure the clinician is an eating disorders expert. Always investigate the credentials of someone who claims to treat eating disorders. Don’t just take their word for it – your life may depend on it!
To learn more, watch this woman’s story about developing orthorexia:
Bratman, S., Setnick, J., & Mellowspring, A. (2016, February). Orthorexia Comes of Age: Past, Present and Future of the Most Controversial Eating Disorder. International Association of Eating Disorder Professionals Symposium: Amelia Island, FL.
Check out the video link on the homepage or ‘LeesPsychological’ Youtube channel for “Mental Health Minute” videos on this and other related topics.
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