Orthorexia: Can Healthy Go To Far

In a nation full of people stricken with chronic diseases, many linked to lifestyle choices, why would we worry about those engrossed with healthy eating? Because “healthy” can go too far.

You may have heard the term “orthorexia” in the media and even in conversation. Orthorexia nervosa was first termed by Steven Bratman, MD in 1997 in an essay in Yoga Journal. A dissection of the phrase translates to straight or correct (Ortho), desire or appetite (-orexia) and obsession (Nervosa). Dr. Bratman suggests that the term wasn’t one so much of clinical meaning as it was a way of teasing his patients with an unhealthy fixation on their way of “healthy eating.” But, has it become our newest eating disorder? He expands further in his book, Health Food Junkies: Orthorexia Nervosa – the Health Food Eating Disorder, which was published in 2000.

As a nutritionist/dietitian working primarily with persons with eating disorders, I’d have to say there are two sides to this coin. Orthorexia nervosa is not a clinical diagnosis and is not in the current Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-V. Yet this unhealthy obsession of superior or righteous consumption can lead to clinical diagnosis of an eating disorder. Clinical criteria for diagnosing Orthorexia has been proposed.

Time and time again, clients tell me “I just wanted to be healthier… how did I end up here?” “Here” often being severely malnourished, fearful of what we consider normal foods, and paralyzed by the thought of something as simple as eating at a restaurant with friends. When someone can no longer function in a social setting because of these issues, we may be dealing with an eating disorder. Questioning the motivation of the diet regimen may help one determine an eating disorder or orthorexia. Generally, orthorexia isn’t driven by a weight loss goal like the eating disorders, anorexia nervosa and bulimia nervosa. Nutritional purity and health are generally the driving forces behind orthorexia.

Researchers have created questionnaires that may identify those with unhealthy tendencies and possible disordered eating. Some researchers using and evaluating these questionnaires have suggested that health professionals, particularly those in medical, nutrition, and fitness fields may be at greater risk. However, this research may have led to confusion. Dr. Bratman suggests in his blog post Healthy Eating vs. Orthorexia, that “the research test used in Europe for studies of orthorexia, the ORTO-15, needs some further refinement; as currently structured, it seems to identify members of healthy eating subcultures rather than those who truly have orthorexia.”

Italian researchers initially used the self-help questions from Dr. Bratman’s book to expand upon for the development of their questionnaire. The questionnaire was not authorized however, Dr. Bratman recently published a The Bratman Orthorexia Self-Test on his website. You can find it HERE.

According to research noted by the National Eating Disorders Association, more than ten million women and one million men suffer from eating disorders in the US. It is suspected that the actual number of those suffering is much higher. In our diet-crazed society, it’s easy to see how this could happen. When I speak on the topic of eating disorders, I like to say “if you don’t think you’re encountering eating disorders, your eyes are not open.” It is all around us. And, orthorexia may be the newest gateway to a potentially life-threatening eating disorder.

As we continue to learn more about eating healthfully and nutrition research, it’s important that we don’t confuse someone’s theory of healthy eating with orthorexia. Please check out Dr. Bratman’s fantastically informative blog, Orthorexia.com for more information and thoughtful posts on this emerging disorder.