Orthorexia

A couple of media outlets have contacted me recently to talk about orthorexia, and I'd like you all to weigh in. The term "orthorexia" was coined by Steven Bratman , a physician specializing in alternative medicine, in 1997. Orthorexia is understood to be an unhealthy fixation with eating healthy foods (often accompanied by a righteous, holier-than-thou attitude), to the point where either important nutrients are often omitted (like fat) and/or the person becomes emaciated because quality foods are not available enough. This isn't just healthy eating.



Bratman asks the following questions in order to diagnose orthorexia:

Do you wish that occasionally you could just eat, and not think about whether it’s good for you? Has your diet made you socially isolated? Is it impossible to imagine going through a whole day without paying attention to your diet, and just living and loving? Does it sound beyond your ability to eat a meal prepared with love by your mother – one single meal – and not try to control what she serves you? Do you have trouble remembering that love, and joy, and play and creativity are more important than food? Have you gotten your weight so low that people think you may have anorexia?



If you recognize yourself in these questions, you might have orthorexia.

As opposed to anorexia, the goal of orthorexia is not weight management/loss, but health, and therefore, the emphasis is not on the quantity of food consumed, but the quality. As with any psychiatric diagnosis, orthorexia is understood to impair daily functioning, to impact work/school, family, and friends because of the time and effort devoted to meal planning and consumption.



But , orthorexia is not a psychiatric diagnosis. There is a dearth of research on orthorexia, particularly quality, peer-reviewed research. Many folks in the e.d. community don't see orthorexia as significantly different from anorexia (or from an anxiety disorder, such as obsessive-compulsive disorder). I'm able to describe the condition as the lay community has described it, and I realize that some people may meet the criteria proposed above, but I, too, am not sure that it differs enough from anorexia or OCD (w/food behavior being the obsession and compulsion used to manage anxiety) in order to warrant a freestanding diagnosis. I think some folks struggling with bona fide e.d.'s may play the "health card" in order to avoid suspicion. In this way, they may present with orthorexia when the main motivation is weight control, therefore indicating anorexia.



Do you struggle with orthorexia or know anyone who does? Can you say that it is significantly different from these other disorders? Please help!