Learning About Orthorexia

June 5th, 2011

OrthorexiaTherapistSanFrancisco

I’ve been hearing a lot about orthorexia, a term developed by Steven Bratman, MD, to identify an unhealthy obsession with eating healthy food. Orthorexia is not a recognized mental or medical disorder, but it identifies a phenomenon that Bratman sees in his practice and has experienced personally. The quest for good nutrition and healthy eating seems like a positive goal, but the unhealthy obsessiveness seriously complicates the picture.

The term itself comes from the Greek: ortho meaning “right” or “correct” and orexis meaning “appetite.” It is intended to parallel anorexia nervosa and indicates a link to anxiety and/or obsessive thinking and behavior. In his original essay on orthorexia, published in Yoga Journal in 1997, Bratman writes:

Orthorexia begins innocently enough, as a desire to overcome chronic illness or to improve general health. But because it requires considerable willpower to adopt a diet which differs radically from the food habits of childhood and the surrounding culture, few accomplish the change gracefully. Most must resort to an iron self-discipline bolstered by a hefty sense of superiority over those who eat junk food. Over time, what they eat, how much, and the consequences of dietary indiscretion come to occupy a greater and greater proportion of the orthorexic’s day.

The act of eating pure food begins to carry pseudo-spiritual connotations. As orthorexia progresses, a day filled with sprouts, umeboshi plums and amaranth biscuits comes to feel as holy as one spent serving the poor and homeless. When an orthorexic slips up, (which, depending on the pertinent theory, may involve anything from devouring a single raisin in violation of the law to consuming a gallon of Haagen Daz ice cream and a supreme pizza), he experiences a fall from grace, and must take on numerous acts of penitence. These usually involve ever stricter diets and fasts.

Over time, this “kitchen spirituality” begins to override other sources of meaning. An orthorexic will be plunged into gloom by eating a hot dog, even if his team has just won the world series. Conversely, he can redeem any disappointment by extra efforts at dietary purity.

Orthorexia eventually reaches a point where the sufferer spends most of his time planning, purchasing and eating meals. The orthorexic’s inner life becomes dominated by efforts to resist temptation, self-condemnation for lapses, self-praise for success at complying with the self-chosen regime, and feelings of superiority over others less pure in their dietary habits.

Pretty interesting. Here in the Bay Area, we hear a lot about dietary nutrition and eating heathy, local, organic, etc. It’s useful to identify when the focus on food and nutrition is accompanied by an unhealthy obsession or by a kind of spiritual materialism, when the pursuit becomes an ego-building endeavor.

These distinctions can be explored in a non-judgmental, curious and empathic atmosphere, whether with a counselor or a good friend. Tom Billings of BeyondVeg.com has a useful article called “Clarifying Orthorexia” on identifying a middle ground of moderation and how to tell the difference. Michael Pollan, author of In Defense of Food and Omnivore’s Dilemma, also writes about nutrition and orthorexia in our culture— a short take of his views are available on his website.

If you have questions or comments on orthorexia, I’d be happy to hear from you. Here are some other resources for learning more:

Steven Bratman’s website on orthorexia

the Something Fishy eating disorders website on Orthorexia Nervosa

“Orthorexia: Can Healthy Eating Be a Disorder?” in Time magazine

Orthorexia nervosa on Wikipedia

You might also be interested in another blog post I wrote, Intuitive Eating, which introduces the ten principles of intuitive eating and some practices for making peace with food.

Send a message with your comments and questions.