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Orthorexia: Obsession With Healthy Eating

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This morning, "Good Morning America" profiled a survivor of "orthorexia." Can you really be too obsessed with eating right?

Obsession With Healthy Eating

Maggie Baumann, MA: Most of us have heard the terms associated with the more common types of eating disorders, such as "anorexia," "bulimia" and "binge-eating disorder."

However, there are other identified disorders that focus on food -- and one of them is called "orthorexia nervosa" -- a term coined by Steven Bratman, MD, in 1997. Bratman described this condition as a "fixation on righteous eating." The term is derived from the Greek word "ortho," which means "correct or right."

Obsessive-Compulsive Driven Disorder
Someone with orthorexia (males and females are equally affected) has taken the obsession with healthy eating to the extreme. Eating foods that are considered "pure" is the motivation of these specific eaters. Certain food groups are often avoided, such as fats, any foods made with preservatives, animal products or any other food considered to be "unhealthy."

Raw foodists and vegans are more likely to become orthorexic. People who have a past history of an eating disorder are also at a higher risk.

Eating healthy is something good for all of us to strive for. It's when eating extremely healthy interferes with a balanced lifestyle -- and you find yourself socially isolating because you fear eating "unacceptable" foods made by others -- that it becomes a problem. Relationships can become impaired and the disorder can negatively affect your whole life.

People who struggle with orthorexia often state that their foods and eating patterns become very ritualistic. For some, it takes days to prepare a meal from homegrown organic products. Others obsessively catalog every food they eat. Life is centered on how pure the food you eat is, and your self-esteem is based on how well you maintain this purist behavior. If you ate pure, you consider yourself a "good person." If you ate the wrong food, you consider yourself a "bad person."

The medical consequences associated with extreme orthorexia can include emaciation, malnutrition and even death by starvation due to severe dietary restrictions.

How Does Orthorexia Differ from Anorexia?
Orthorexia may seem like a sister form of anorexia. The physical consequences of both disorders present the following: extremely low body weight, the risk of developing osteoporosis, an absence of menses for women, low testosterone levels for men and the potential of death from starvation.

However, Bratman says there is a significant psychological difference between the two. Someone with anorexia does not see her/himself as emaciated, but as fat -- whereas someone with orthorexia is aware of their extreme thinness but is fine with it, as long as they feel "pure."

It's important to note that some anorexics may "hide" behind the orthorexic way of living to sustain their low body weight.

Treatment Essential for Return to Wellness
No matter which disorder is at the forefront, treatment is necessary to bring health back to the body. A medical doctor, a dietitian and a therapist experienced in treating all kinds of eating disorders -- including orthorexia -- can help those wanting to regain their health and balanced lifestyle.

The Orthorexia Self-Test
Bratman offers these 10 signs of orthorexia from his book, "Health Food Junkies -- Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating." You could have orthorexia, or be on the way to developing it, if you:

1. Spend more than three hours a day thinking of food.
2. Plan your day's menu more than 24 hours ahead of time.
3. Take more pleasure from the "virtuous" aspect of your food than from actually eating it.
4. Find your quality of life decreasing as the "quality" of your food increases.
5. Are increasingly rigid and self-critical about your eating.
6. Base your self-esteem on eating "healthy" foods, and have a lower opinion of people who do not.
7. Eat "correct" foods to the avoidance of all those that you've always enjoyed.
8. Increasingly limit what you can eat, saying that you dine "correctly" only at home, spending less and less time with friends and family.
9. Feel guilt or self-loathing when you eat "incorrect" foods.
10. Derive a sense of self-control from eating "properly."

If you selected more than four of these signs, you may need to assess whether your behaviors and attitudes toward food are balanced. If all of the signs resonated with you, you are engulfed in this obsessive (and potentially fatal) form of eating. Seek help today!


Do you think orthorexia nervosa should be considered a disorder ... or a lifestyle choice?





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5 comments so far | Post a comment now
Angela March 23, 2010, 1:28 PM

I used to be overweight but over the past year have begun eating cleaner and exercising to change this. I come from a family with a lot of obesity issues and find myself slipping after spending a lot of time at their homes where junk food is rampant. Eating out poses similar problems so I find myself more and more planning social activities that don’t revolve around eating. I do spend a lot of time planning and preparing menus. I admit that feeding my family healthy food makes me feel good about myself. Also I’ve replaced much of the junk food I used to love with healthier options and do take pride in the sense of discipline I’ve acquired.

Clearly I identify with pretty much all of the warning signs, but I don’t see how it causes me any problems. I’m not emaciated and I feel better and more energized than ever. I still consume an appropriate number of calories and very occasionally will treat myself.

Obviously any diet so extreme that it causes emaciation and serious health risks isn’t healthy at all and should be stopped. But is a little obsession over health a bad thing if it actually does improve health and quality of life?

Erica March 23, 2010, 11:45 PM

I never knew there was a term for this. My significant others ex-wife fits this. He said that her behaviors started after their daughter was born and have only become increasingly more obsessive since. We were told that we were bad parents the last time his daughter came to stay because we fed her pork and beef and our vegetables weren’t entirely organic. The little one is 3 and I’m worried that she’s setting her up for ‘food issues’.

I think eating a healthy, well balanced diet is extremely important. I rarely eat junk food (processed snacks, fast food, candy, pop, etc) but I also believe at some point you take it too far and run the risk of setting yourself or your child up for an eating disorder.

Catherine March 24, 2010, 4:21 PM

What bothers me is that we live in a society where consumers should have to scrutinize labels to eat healthy in the first place. When food is loaded with trans fats, high fructose corn syrup, additives, preservatives, pesticides, aspartame, etc., people SHOULD be reading what they’re putting in their bodies. I applaud people for standing up to the food industries by buying only organic, natural foods… and yet, in turn, they get stigmatized with the label of an eating disorder. Awesome.

Why is an obsession with prescription drugs and insulin shots that derive from a poor diet not scrutinized instead? Why do we condone a society where 2/3 of the population is overweight due to poor food choices? What is considered in this country as a “well-balanced diet” is a joke. It’s the people who refuse to buy into a system of animal cruelty and chemical-laced foods that are the pioneers towards a greener, healthier society.

People who suffer from malnutrition and emaciation are anorexic due to a fear of eating, not righteous eating. There are plenty of natural foods that are high-fat, high-calorie.

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