Emerging Eating Disorder
When we hear the word eating disorder, we think of anorexia and bulimia, disorders in which slim people are afraid to be fat and will adopt unhealthy habits in order to maintain their weight or, more commonly, slim down. People suffering from anorexia nervosa or bulimia strive to control the quantity of food that they eat so that they can, ultimately, control their body weight.
However, there is newly emerging eating disorder called orthorexia that causes an unhealthy focus or obsession on the quality of food ingested, rather than the quantity. The term orthorexia has been around since 1996; Steven Bratman, MD is credited with coining the phrase and is the author of the book “Health Food Junkies”. Bratman’s experienced with diet-obsessed patients led him to begin researching the issue. Although the mainstream medical community has not adopted the term, or acknowledged the existence of a separate eating disorder apart from anorexia, many have found the classification useful in defining this unique disorder.
Noble Beginnings of Orthorexia
Orthorexia begins in a rather unremarkable way, with the person wishing to eat healthier and avoid foods that are deemed “bad” for them. While the motivation for healthier eating can come from a variety of places, the mainstream media’s increasing focus on weight and food safety provide plenty of reasons for people to worry about what they are putting in their mouths.
What starts out as avoidance of preservatives, high-fructose corn syrup, and artificial flavorings often leads pre-orthorexics down the path of veganism, vegetarianism, or raw food diets. Many try to avoid animal products – the foods that provide protein and fat. However, the human body needs protein and fatty acids to maintain muscle mass, brain tissue, and nerves. Followers of these more extreme diets often fail to obtain the nutrients essential in keeping the body healthy. Although orthorexics often eat a normal amount of food, they can become malnourished, emaciated, and can die due to their obsession with healthy eating.
Admittedly, not all people who eat healthy develop orthorexia; many can successfully avoid unhealthy foods and still ensure that they are eating what their bodies need to thrive. However, in orthorexics, what started as healthy eating turns into a type of obsessive-compulsive disorder (OCD), with many suffers choosing not to eat at all rather than eating something that is bad for them. One example of a progression from normal eating to orthorexia is strict adherence to the government food pyramid, followed by elimination of processed foods, then eating only whole foods, next eating only organic foods and, eventually, eating only raw foods such as uncooked vegetables.
Progression of Orthorexia
Orthorexia affects more than just the person’s weight and health. As eating is a traditionally social behavior, this seemingly bizarre focus on obsessively healthy eating can actually turn others off, leading to problems in personal relationships. Further, orthorexics will withdraw from social relationships and isolate themselves, hoping to avoid probing questions about eating habits and lectures about maintaining a healthy weight.
People suffering with orthorexia often refuse to eat in restaurants, obsess about what they will have for their next meal, and spend a significant amount of time reading nutritional labels while shopping.
Like all eating disorders, orthorexia is a type of disorder that is based on a behavior that cannot be avoided. Unlike alcoholism, where ingesting alcohol is not a necessity of life, eating disorders are more difficult to treat as the patient must still eat to survive; one cannot completely eliminate the problematic behavior in order to control the disease. With orthorexia, not only will eating continue to play an important role in the lives of orthorexics, but society’s increasing focus on eating healthier foods can only add to the pressure these people feel to eat healthier foods.
It would be erroneous to consider orthorexia a version of anorexia because the motivations are entirely different – healthiness vs. thinness. There is a movement for orthorexia to have its own entry in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The lack of an exact DSM diagnosis makes it difficult for patients to get treatment paid for by insurance; it also makes it hard to obtain grant funding for research. Sadly, orthorexia has not made it into the first draft of the new DSM; those involved with the DSM process cite lack of scientific knowledge about and broad clinical acceptance of orthorexia.
As orthorexia has strong obsessive-compulsive characteristics, cognitive behavioral therapy (CBT) has shown to be useful in replacing obsessive thoughts about food safety.