The troubled world of eating disorders just became a little bit broader. The term orthorexia is being used more and more frequently to describe the unhealthy obsession with eating healthy food; a self righteous verging on spiritual component accompanies the strong desire to limit foods considered bad or "dirty," meaning not organically grown.
The term, over a decade old, was coined by Steven Bratman, M.D. who wrote the book Health Food Junkies to describe how a healthy lifestyle shifts from being a choice and becomes so overwhelming that it pushes other activities and interests to the periphery and interferes with relationships. It can also, quite ironically, lead to unhealthy consequences like malnutrition.
There have been skeptics to Bratman's theories since so many Americans seem to interact with food in quite the opposite manner, by making themselves ill by not paying attention to what they eat or eating healthy food. We seem to be a society of extremes, especially when it comes to food intake. Bratman's ideas, however, are gaining more traction and it has not become uncommon to hear of someone in the spotlight taking on an extremely healthy yet restrictive diet. This is not to say that vegetarians or vegans who restrict what they eat have this eating disorder. To see the diagnostic questions used to define this eating disorder, read more.
- Are you spending more than three hours a day thinking about healthy food?
- Are you planning tomorrow's menu today?
- Is the virtue you feel about what you eat more important than the pleasure you receive from eating it?
- 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 friends and family.
- Do you feel guilt or self-loathing when you stray from your diet?
- When you eat the way you're supposed to, do you feel in total control?
According to Bratman, answering yes to two or three of these questions suggests that you have a mild case of orthorexia. If you answered yes to four or more questions then you could be entering a downward spiral of healthy food obsession. If all of your responses were positive you have become obsessed with food. Personally, I think the second question is a little misplaced. I am always planning meals ahead. Some mental health professionals classify orthorexia as an obsessive compulsive disorder.
Regardless, the specificity of the problem intrigues me. Is this an upper class problem afflicting those who can afford to fixate on health food? Do you know anyone who you fear has this problem? Are you skeptical that this is really a problem? Share your views in the comments section below.

Buti
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BDL by Ben de Lisi
I do like to think of meals ahead of time if I have some free time. I also feel better by eating healthier now by choosing organic fruits and veggies and not eating red meat. Also, I do skip foods I once enjoyed but I don't miss it. I think this is something that is really common and think that one would only have this "disorder" if they answered almost all right not more than two...Some may be more intense than others such as thinking about healthy food for a few hours or isolating yourself when eating. I don't do those!
1I know someone like this. Emalove are we on the same page with this one?
2The first time I read this, I thought it said "otherexia", like "just another -exia". (Not to make fun - I'm sure this disordered behavior is no picnic. In fact, my sister does a lot of these things, and I'm tired of her organic/local food rants that are followed by trips to taco bell.)
3I answered yes to two - planning menus and becoming stricter about my diet. I agree with sohoshopper, I think that answering yes to a few of these doesn't imply a problem, but if you answer yes to all I can see how that could be a problem.
4Wow, this is so me hahaha.
5It's interesting that this is a disorder. I suppose just because of the health-affecting nature of a strict diet and the obsessive tendencies.
6Yeah...a lot of these apply to me. I'm going to blame my obsession on my thyroid problems. I simply can't eat as much as most people my age if I want to maintain my weight, and I guess that has translated into orthorexia for me. But like other people have said, I don't think meal planning should necessarily be included. There are multiple reasons why you could be planning meals in advance.
7It is interesting how some of those questions are tied to control and self-esteem. I do plan ahead, think about foods, and I prefer to eat at home but that is food allergy based. Luckily I still get a whole lot of pleasure from the food itself when the dish comes out great. My quality of life is increased by the quality of my diet. I was almost concerned for a second as I read the questions.
8I don't think planning meals should be considered a "symptom" of a disorder. It's a good idea, especially when you want to avoid not knowing what to eat and you want avoid eating whatever you grab first since it might be junk that offers little nutrition.
9Whoa!! This is an actual disorder??? I answered yes to every question except the one about a decrease in the quality of my life. I feel that since I began watching my diet and really examining the unnecessary things that I was eating, I feel 100% better than before. I now follow one rule, I only eat things that will benefit my body in some way. I feel more energized when I eat natural and healthy foods and I think more people should realize the benefits of a nutritious meal. Yes, I do restrict a lot of foods I used to enjoy but when I do splurge and eat them, I realize that they just aren't as good anymore...
10"Yes, I do restrict a lot of foods I used to enjoy but when I do splurge and eat them, I realize that they just aren't as good anymore..."
Me too actually. Somethings like ice cream make my stomach hurt when I haven't had some for awhile or even when I have it more frequently and some processed sweets just seem mediocre to me now so it seems kind of pointless to ever have it. I enjoy having dark (low in sugar) chocolate instead because it's better and I don't feel icky after eating it.
11i was in ED treatment with some orthorexics. i believe in this disorder completely. it's not just about eating healthy, it's where it's taken over your life, it's all you think about, and it's having a negative impact on you and your environment. it's an obsession, and it's a maladaptive coping mechanism.
12"Orthorexia" is not a disorder that's classified in the DSM-IV. Furthermore, if you are doing these overly healthy behaviors to lose weight, that disqualifies you. It's not about weight loss from what i've read. Again, this is not an actual disorder.
13I think this is stupid. With all the crap there is in food in the US, any healthy eater is bound to get more paranoid! I agree that eating healthy shoulnd't "decrease your quality of life", but gioving up junk food only feels like a sacrifice at first - when you start eating clean you realize most junk food tastes horrible!
14A lot of disorders aren't classified in the DSM-IV.
only Anorexia Nervosa, Bulimia Nervosa & Eating Disorder - Not Otherwise Specified (ED-NOS) are there as criteria.
Binge-Eating Disorder is VERY common and yet it doesn't have it's own criteria yet- there are "proposed" criteria, but at the moment it falls under ED-NOS as does "Purging Disorder" (where people don't binge- they eat small or 'normal' amounts of food, then purge). Diabulimia is becoming common- an eating disorder in which Type 1 diabetes sufferers skip their insulin injections for the purpose of weight loss. but it isn't in the DSM. It is however mentioned in the
ICD-10 criteria for Bulimia Nervosa under "b"
Eating Disorders DON'T have to be soley about weight loss OR food. The issue lies MUCH deeper than that. You don't "fix/cure" an Eating Disorder by making them eat more, eat less, gain weight, lose weight, etc (depending on their specific issues- they are a spectrum and come in ALL shapes and sizes).
OCD is commonly seen in Eating Disordered people. And with Orthorexia I think the two go very much hand-in-hand. It isn't necessarily about the "weight loss" but in reality thats not the 'goal' of any Eating Disorder- there is typically something else going on. And THAT is what needs to be dealt with. Often issues with "control" and "perfectionism" are seen in Eating Disordered people. That can go very much with Orthorexia as well.
If anyone is looking for support for Orthorexia (or other Eating Disorders, www.weightofillusion.com is a support forum for people with Eating Disorders - with a board specific FOR Orthorexia (we have 130 boards- including boards for men with Eating Disorders, Parents struggling with Eating Disorders, and people of all ages! You DON'T have to struggle alone!
15whatever some call it orthorexia, others the mothers syndrome
16I agree with Hipmom completely. Also who *doesn't* this statement apply to?; Do you skip foods you once enjoyed in order to eat the "right" foods? Hasn't this applied to everyone at some point?
I know a *LOT* of people think I have an ED because I choose to be vegan (and because I'm small) and it's been implied plenty. But no one has ever implied that in the 'organic' aspect. Interesting....
17A good example of this to me was reading about Mariah Carey's diet in Us Weekly when she lost 20 lbs. As if she even needed to lose that much weight! She probably went from about 120 to 100. She pretty much eats nothing and works out for 2 or 3 hours a day. And her "nutritionist" says shes being healthy. I think its obsessive. Same goes for any of those celeb diets!
As for the organic food obsession, I think people take it to the extreme. Those who can afford to only eat organic become elitist about it. It's all about power, control, and self esteem.
18Totally me... yikes!
19Anyone can 'read into' a lot of questions or criteria for various illnesses/disorders and be like "I have that"- but with Orthorexia, it is when this is taken to an EXTREME that it becomes a problem.
People DO die from Orthorexia- because they are so focused on right/correct/pure foods that they eliminate SO many things from their diets they end up with vitamin/mineral deficiencies which can be fatal.
SomethingFishy has a good summary of these: http://www.something-fishy.org/dangers/vitamins.php
There is a difference between being a 'healthy' vegetarian/vegan and/or organic food eater, and someone who is just SO 'obsessed' with eating the 'correct' foods that it controls their life, their thoughts, and everything they do.
For instance, it wouldn't take a normal person on a vegetarian/vegan diet or that ate organic several hours IN the grocery store (esp. like Whole foods or a Coop) to choice only a couple items. It would for someone with Orthorexia because they are too busy reading labels (even if they did the week before- because 'ingredients may change') and eliminating ALL the bad choices and may leave after several hours with practically nothing. THAT is an obsession/Eating Disorder. Simply being Vegetarian, Vegan, eating Organic and making healthy choices with a good BALANCE is perfectly 'normal' behavior.
20it's not about just being "paranoid" about healthy eating... people with this disorder will refuse to eat fruit and veggies that have been out of the ground for more than a few hours, fearing nutrient loss, and thus deeming the food pointless to eat.... many end up starving to death because of the difficulty in acquiring "worthy" foods.... this is ABSOLUTELY a serious eating disorder. and to all the people saying "this is me, this is me!".. you would KNOW if this was you because you would be living a miserable life that was completely controlled by food.
21I don't buy it. I mean, I'm a vegan, I think about/plan my meals ahead of time, and it does affect my family time/social outings - but I don't think that means I have a disorder - it means that I don't want to eat a leg of a cow when I go to my aunt's house, so I bring some fruit or a salad to share.
Also, if my family is going to a buffet that I know will not serve anything that I want to eat, and the entrance fee is $30, of COURSE I'm not going to go, instead I'll join up with them afterwards and spend time with them then. Eating differently DOES change social situations, but it just takes a little flexability.
Putting these labels and criteria up just make ONE MORE excuse for people to eat very unhealthily - "Well, I don't want to be orthorexic, so i'll just take some extra insulin and eat cake next weekend."
22i'm congused
i answered yes to at least 5 questions (another 2 or so i pondered about and decided to answer no)
ummmm i don't think there's anything wrong with eating healthy..
in order to do it you need to be strict with yourself coz a piece of cake it yummier than ummm.. sorbet for example.
i have exuces to the others too...
mm oh well
23I had a vegan friend who would only eat organic, and had a very, very limited repertoire of food she ate. The way she controlled her intake and her obsession with food made it unhealthy, not the food itself (which was organic produce, mostly). Let's just say that for someone who was so health-conscious (she didn't drink or smoke or do any drugs) she was emaciated and looked about 10 years older. Very unhealthy, psychologically and physically. So I believe it exists.
24I know several people who are orthorexic. And they don't look any skinnier or any younger/more vibrant than the rest of us. It makes that person isolated and can be damaging to their personality and their social life.
25btw gumdrop, I saw that US Weekly as well and I think she was lying about her weight and the amount of weight she lost. She is definitely not a size 2 (not that there's anything wrong with the way she looks). She probably was a size 8 and lost about 10 lbs and is now a size 6.
26Like anything, this is all about going to the extreme. I "had" orthorexia (had is in quotes since it isn't technically classifiable yet). It almost ruined my life. I became isolated. Food absolutely ruled my life. I lost a ton of weight & my period. It was a terrible time in my life.
In my opinion, there is only one question that matters: Given the choice between eating an "unhealthy" food or starving, which do you choose? Normal people would choose to eat, if they were hungry enough. There was a time when I chose starvation.
PS> It's not all about organics - how healthy is defined is individual. And it's not necessarily "self-righteous or spiritual" I never looked down on anyone who didn't eat like I did. I envied their freedom. I knew I had a problem.
27sorry but it is a joke that this is not being considered a disorder. Put together a list of anything these days and you can call it a dysfunction or disorder. Come on!
28Eek. Answered 'yes' to everything except the quality of life question, which I can't honestly agree with since I feel a lot better about myself after losing 20kg. I suppose I would agree to some extent that it is a valid disorder, though. I'm aware that I've got a little obsessive about food to the point where I do find it difficult to eat out, yet I definitely wouldn't call myself anorexic since I can't imagine not eating at all. The point was to lose weight, yes, but also to get healthy. Unfortunately it seems that I find it almost impossible to put new focus on eating healthy and exercising without getting slightly fixated about it all.
29Are you spending more than three hours a day thinking about healthy food? Usually, yes.
Are you planning tomorrow's menu today? Everdya I do.
Is the virtue you feel about what you eat more important than the pleasure you receive from eating it? yes.
Has the quality of your life decreased as the quality of your diet increased? i don't think so...
Have you become stricter with yourself? very much so.
Does your self-esteem get a boost from eating healthy? Do you look down on others who don't eat this way? all the time. when i eat healthy i feel better about what ia m doing for my body.
Do you skip foods you once enjoyed in order to eat the "right" foods? all the time.
Does your diet make it difficult for you to eat anywhere but at home, distancing you from friends and family. no.
Do you feel guilt or self-loathing when you stray from your diet? YES!
When you eat the way you're supposed to, do you feel in total control? yes!
30I'm not sure I agree with these criteria, but I definitely agree that there are people who take their healthy eating to unhealthy extremes. Obsessing about anything is not particularly healthy. When Fit posts about splurging on an unhealthy meal, some of the comments make me cringe. Short of serious medical conditions, it's just not healthy to be so militant about anything.
31Oh yeah, Aimeeb, my first thought too!
32Oh yeah... total orthorexic.
I'm not particularly ashamed of it though.
33I try to eat healthy. Well-balanced is different thing than über-healthy.
I met a new friend in college last year. Her mother has an orthorexia and in many ways had her habits gotten to her daughter also. Some of the stories of her mother were just crazy!
For example my friend had never drank soda, eaten candy etc before she turned 15. My mother was rather strict also (partly due to my granpa's diabetes - we all had to eat healthy, same food for all), but we learned moderation and were able to eat junk sometimes.
It was funny when my friend was making chocolate-milk, she put two spoons of chocolate-powder and glanced at me winking:"my mom will never know, it's good thing she lives 200km away."
My family almost only eat dark bread, but I don't get guilt if I sometimes eat wheat-bread. I do sports so that I feel good, but I don't go running with taste of blood in my mouth when it is pouring rain.
34those of you who don't believe in it are lucky. this isn't eating healthily. This isn't just trying to eat healthy. This is an obsession with eating healthy foods that is so obsessive it becomes unhealthy.
and I read a couple comments about not being anorexic because you can't imagine not eating at all - that's not it at all. Anorexics usually eat, they just don't usually eat enough to survive, they eat below the level of starvation.
35Oh god, my mom is totally like that.
36Ok.. I don't think it's horrible to be mindful of your diet. Heart disease runs in my family so I am VERY aware of what and when I eat. I think this article is dumb.
37Given that the government and the media are always talking about how you should completely avoid trans-fats, HFCS, etc., it's no wonder that there are more and more people out there that try to eat ONLY the "right" foods. I believe that I am borderline orthorexic because I am very choosy about what I will and will not eat. I think the difference between an orthorexic and someone who just eats healthy is the whole "rule your life" aspect. Sometimes, food does rule my life. If I'm going somewhere where there is no healthy food, I bring my own or I avoid eating. I also have OCD, so maybe that is tied into it. I like the feeling of control I get from monitoring my food closely, so maybe that's similar to the anorexic mindset. I don't think orthorexia is really a disorder though; not unless it REALLY overtakes your life...like people who won't eat anything that's not 100% organic and more than 2 days old or whatever.
38Fiona Apple had orthorexia:
"I definitely had an eating disorder. What was really frustrating for me was that everyone though I was anorexic, and I wasn't. I was really depressed and self-loathing. For me, it wasn't about being thin, it was about getting rid of the bait attached to my body. A lot of it came from the self-loathing that came from being raped at the point of developing my voluptuousness. I just thought that if you had a body and if you had anything on you that would be grabbed, it would be grabbed. So I did purposely get rid of it."
(from http://self-injury.net/doyousi/famous/)
Definitely not fun and definitely nothing to do with eating right.
39Sorry for double-posting, but my previous comment is incomplete.
Orthorexia isn't about eating right, but eating how you think is right, it's a mental disease, and when you're mentally ill, what you think is right is often not.
Fiona, for example, would spend an hour wondering which apple she could eat. "I couldn't eat things that I felt clashed with what I was wearing (...) and I was so afraid of doing the wrong thing. If I ate something, I felt like I was doing it because I don't want to be crazy. 'I'm going to eat that apple right now, even though I am wearing a yellow dress'".
Now that's more what orthorexia looks like.
40ummm, i answered yes to 7 of these. But I'm much happier and healthier than I used to be, and I don't really see many of these things as a problem.... in fact, I'm proud to answer yes to some of these questions. I worked hard to stop eating so unhealthily.
It doesn't consume my life, but it is important to me.
41Hmm, I seem to have answered in the affirmative to a lot of those. I definitely don't think my quality of life or my fun quota has gone down any, but I definitely think about my quality of food intake a lot more than i used to. And yes, I do sometimes feel really bad if I'm eating not so healthy food. But, I think I'm happier like this. And definitely healthier!
42I have orthorexia. Ive said it now...
Its not just an obsession with eating the right foods. Its a obsessive yet unconcious desire to be pure. I was abused and orthorexia is a way of making your body so that its like everybody else's. Am I making sense? Its that you dont want to stand out from the crowd, because if you do, then you can be hurt. Blending into the background is the most important thing.
I guess its a way of getting rid of the soul inside you, just concentrating on the shell- you feel sick every time you eat something you dont know the nutritional information for, and on the plane last week I was sobbing for an hour and a half because I'd eaten half a cheese and onion wrap that was wrapped in plastic and had been mass-produced. Ive lost four stone since I became orthorexic but i've only just started to notice my problem. I am thin, but its never good enough, because you just dont want to BE anything.
My point has been, its not a 'wishy-washy' eating disorder that is just the result of good eating. It controls your whole life... you become almost afraid of food, but if you stop eating altogether, then people will notice (which is the last thing you want, to be noticed.) So you carry on, doing it the same, but every day you get that bit more afraid of eating at all. It really scares me sometimes, what started out to be a way to control what happens to my body. Its completely controlling, and terrifying.
And I'm 15.
43Amy xx
"There have been skeptics to Bratman's theories since so many Americans seem to interact with food in quite the opposite manner, by making themselves ill by not paying attention to what they eat or eating healthy food."
Not true. This isn't an either-or situation. Most people who become ill do so because human beings are mortal, and because it's simply their time to be ill. Human beings are healthier now, and living longer and more actively, than at any time in human history. Believing that all, or even most, illnesses are under human control is part of the disease of orthorexia. Get real data. Demand double-blind studies. Stop assuming anyone ill is guilty. Stop assuming anyone not the "right" size, weight, shape, or degree of ability is guilty of nutritional or lifestyle "crimes". Everyone is going to die, sometime -- even people who think they're not "guilty".
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