Orthorexia Nervosa – A “New” Eating Disorder?

I’m often asked by clients if it’s possible to overeat on raw vegetables. Or some other perceived healthy food- you fill in the blank. Or if it’s possible to drink too much water. Or even if it’s possible to exercise too much.  In short, is there such a thing as too much of a good thing?  It may seem strange, but the answer to the questions is actually “Yes”.

Although I am referring to a rare phenomenon in this blog post, it is actually possible to be “too healthy” with your diet choices.  A relatively “new” type of disordered eating has emerged on the scene of our health-obsessed, thin-obsessed, and diet-obsessed culture, and it is becoming more common.  The formal name for this type of eating disorder is Orthorexia Nervosa.  This term was first coined in 1997 by Steve Bratman, M.D. and has been gaining attention and momentum ever since.

Orthorexia is simply an obsession with avoiding foods that are perceived to be unhealthy.  Those who suffer with this condition are seeking to eat the perfect, pure diet.  They may progressively avoid foods that have any hint of something they believe to be unhealthy.  While other types of eating disorders focus on the quantity of food, orthorexia focuses on the quality. It may start out innocently with trying to improve one’s health and to feel better, but turns into a disordered state when the diet begins to interfere with one’s normal functioning and everyday life.  This can happen when a person becomes chronically concerned and fixated on their food, the preparation of it, planning of meals, etc.  They may be doing this to avoid unpleasant feelings, deal with stress, or avoid situations in their life.  Malnutrition, emaciation, depression, and low self esteem can be the end result.

Now, let me be clear and emphasize an important point again.  A set of behaviors is not a “disorder” unless it has become excessive or an obsession that interferes with normal healthy functioning.  One must be evaluated by a qualified professional who specializes in eating disorders before it can be determined if the individual suffers from an eating disorder of any kind.  Unfortunately, Orthorexia may not be noticed or diagnosed by a physician until it has reached an extreme point with nutrient deficiencies and other physical consequences for the patient.  The American Psychiatric Association does not yet recognize Orthorexia as a mental disorder and it is not included in the Diagnostic and Statistical Manual of Mental Disorders.  Nevertheless, eating disorder specialists and those familiar with eating disorders recognize its dangers and its similarities to Anorexia Nervosa.

Here are some good questions to ask yourself if you suspect you may suffer from Orthorexia.  The first two questions were developed by Steve Bratman, M.D. and the other questions were found on WebMD’s website.  References are below:

  • Do you care more about the virtue of what you eat than the pleasure you receive from eating it?
  • Does your diet socially isolate you?
  • Do you spend more than 3 hours a day thinking about healthy foods?
  • When you eat the way you’re “supposed to”, do you feel in total control?
  • Are you planning tomorrow’s menu today?
  • Has the quality of your life decreased as the quality of your diet increased?
  • Have you become stricter with yourself?
  • Does your self-esteem get a boost from eating healthy?
  • Do you look down on others who don’t eat this way?
  • Do you skip foods you once enjoyed in order to eat the “right” foods?
  • Does your diet make it difficult for you to eat anywhere but at home, distancing you from family and friends?
  • Do you feel guilt or self-loathing when you stray from your diet?

If you answered yes to two or more questions, you may have at least a mild case of Orthorexia.  Please be evaluated by a qualified professional.

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Stacey Wald, LAPC, RD

swald@ growcounseling.com