A woman is preparing to get married and as is not unusual, decides to try to lose weight for the wedding. Having been a dancer she was surrounded by others who suffered from eating disorders and while she hadn’t she did restrict her diet during those years to 400-500 calories a day. When she quit the ballet and no longer had to look at herself in the mirror all the time she began to eat junk food which caused problems at home as her mother was a health food advocate and stocked the house only with what she considered “healthy foods”. When the daughter told her mother about her desire to lose weight her mother was ecstatic and offered to help. She herself, was quite thin due to the limitations she placed on what she ate and began making suggestions to her daughter about what to cut out of her diet.
First, she encouraged her to become a vegetarian then a vegan. The daughter noticed that she began having cravings but as the pounds began dropping off she ignored these desires. As the wedding got closer the daughter began to direct her own eating become more obsessed with healthy foods until even her mother was concerned. She researched every food she ate for nutritional value before she’d consume it. Finding negative press on almost every food group she stopped eating anything with gluten, then all the possible substitutes including flour made from spelt, rice, bean, sorghum and potato as well as any type of starch. When her mother pointed out she didn’t have a gluten allergy and asked about the other types of flour and starch she refused to eat, the daughter became hysterical claiming they were all toxic and would kill you if you ate even a little regularly.
She then began to eat only raw foods refusing anything that was processed. By then she’d dropped 50 pounds and while happy with the decrease she still wasn’t satisfied though her primary focus was on how healthy her meals were. She began to obsess, spending much of her day worrying about having possibly eaten something she wasn’t aware was unhealthy, planning her meals though by then there were few foods she considered healthy and would eat. She dropped another 10 pounds and her mother became frightened, approaching her again about her eating habits.
Ignoring her mother's concerns, she began refusing to go out with friends or make plans to eat out even with her fiancé, having decided there was no way to avoid poisons if she couldn’t completely control what she ate. Eventually, after almost dying from lack of sufficient nutrients and what the doctor stated was “starvation” resulting in multiple organ failure, she was hospitalized and placed in a program which specialized in eating disorders She continued to refute this diagnosis, insisting the doctor was wrong about what had caused her “illness”, since she ate in a healthy manner – the complete opposite of what defined a eating disorder.
What Is Orthorexia Nervosa?
While it’s normal for people to change their eating habits to improve their health, due to an illness or to lose weight, usually once they are used to these new habits they stop focusing on them and they become a normal part of their life. However, some remain obsessed with everything they eat, continuously worrying about how healthy the ingredients are to the point it turns into an eating related syndrome which has been termed Orthorexia Nervosa.
According to Steven Bratman, the individual who first coined the term Orthorexia, the disorder is about being obsessed with eating healthy due to the spiritual nature of it when someone with the disorder “falls of the wagon” which may be as minor as eating a single raisin, they feel they must take on penitent acts which, similar to anorexics, involves stricter diets with less types of foods allowed (Bratman & Knight, 2001).
The Course of Orthorexia
The disorder, which is currently not included as an official diagnosis in the DSM-IV-TR, often begins from a sense of spirituality. Individuals believe they are doing something good for their bodies, that they are cleansing them of toxins and maintaining a state of purity. In addition, given that it’s a difficult thing to maintain, many feel that’s an indication of virtuosity (Davis, 2000).
Eventually, orthorexics normal lifestyle is eclipsed by planning, purchasing and eating their meals. Bratman states in an article published on Health and Beyond Online, that when individuals transfer all of life’s meaning and significance to the quality of food and the process of eating they should be considered to be suffering from a psychological disorder. He goes on to add that this transference alters the orthorexic’s inner life as it 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.”
The Controversy Over the Existence of Orthorexia
Despite the seriousness of the behavior and outcomes seen in individuals who have been classified as having this syndrome, including dangerously low weight, organ failure and death, many fail to consider Orthorexia a disorder in it’s own right, instead simply calling it a “health phenomena”, (EatingDisordersOnline.com). While other experts consider it a genuine concern, the fail to view it as clinically useful in terms of a diagnoses, and Douglas Bunnell, president of the National Eating Disorders Association stated that while for lay people the term may be important for descriptive purposes and understanding, it is largely irrelevant for treatment implications as he believes it to differ from anorexia on only a few fine points (Strand, 2004).
Others point out that while the disorder does focus on food and the rigid rules created to define what is consumed, with the anorexic patient the focus is on calories and how likely it is the food will add weight while for the orthorexia the focus is exclusively on how healthy they believe the food to be (Eating Disorders Help Guide).
Summary and Concluding Remarks
The term “Orthorexia Nervosa” was first used by Dr. Steven Bratman, M.D. to describe individuals suffering from an obsession to eating only healthy foods, which becomes stricter over time until what the individual defines as “healthy” is so limited that their health is or is likely to become compromised. Despite the controversy over whether this cluster of symptoms is really a subcategory of Anorexia it differs significantly enough from this disorders that it appears to warrant its own diagnosis which would lead to valuable research and hopefully, implications for treatment to address it’s unique symptoms.
Sources
- Bratman, S. Orthorexia Nervosa: The Health Food Eating Disorder. Health and Beyond Online. Retrieved 1/16/2012.
- Bratman, S., & Knight, D., (2001). Health Food Junkies: Orthorexia Nervosa: Overcoming the Obsession With Healthful Eating. Broadway Books: New York, NY.
- Davis, J. L., (2000, November, 17). Orthorexia: Good Diets Gone Bad. WebMD. Retrieved 1/16/2012.
- Eating Disorders Help Guide. Orthorexia – A Different Kind of Eating Disorder. Retrieved, 1/16/2012.
- EatingDisordersOnline.com. Orthorexia. Retrieved 1/16/2012.
- Strand, E., (2004, September 1). Orthorexia: Too Healthy? Psychology Today. Retrieved 1/16/2012.
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