Orthorexia: an unhealthy preoccupation with healthy food
In recent weeks, I have seen some discussions on television and read some blogs about a condition called ‘orthorexia’.
It’s not described in any textbook of psychiatry or psychology, but the phenomenon is one that many people will identify with; not necessarily because of any personal affliction but because of the behaviours of others that we observe when we’re grocery shopping.
Have you observed the amount of time some shoppers spend examining the packaging of their foods — particularly the part where calories and nutrients are listed?
The vegetable counters, notably the organic sections, are magnets for this group of people.
Steve Bateman, a Colorado doctor and alternative therapist, described these as “Health Food Junkies” and gave his book, written in 1997, the same title.
In the book, he described a condition called orthorexia or orthorexia nervosa.
The name derives from the Greek ‘ortho’, meaning straight or correct, and ‘rexia’, meaning appetite, and is defined as a preoccupation with healthy eating. Bateman has since developed more precise criteria that must be met in order to diagnose it.
It’s a not a term I have used in my out-patient clinic, although I am familiar with the behaviour it describes and most mental health professionals would simply see it as a variant of anorexia nervosa — however, this is probably an inaccurate understanding of what underlies it.
Orthorexia differs from anorexia in that the latter is concerned with restricting food intake so as to lose weight and achieve a particular body image.
Meanwhile, in orthorexia, food intake is restricted so as to ensure that only high-quality food is consumed and that one’s health is pristine.
‘Cleanliness’, ‘detoxification’, ‘purity’, ‘organic’, ‘wholesome’ are the terms that spring to mind when considering the motivation driving the orthorexic behaviour.
In essence, it is an extreme form of food faddism that takes on a life of its own.
It is largely a culturally driven condition. At a time when obesity in the Western world is increasing, when there is a health-food (and smoothie bar) industry in the wings waiting to capitalise on this and when there is an approved route into this in the form of ethical veganism and other very narrow diets, Bateman believes this sets the scene for some people to be seduced.
Celebrity endorsements for these faddy diets also contribute. As well as the backlash against unhealthy food, there are the health gurus who encourage people to embark on particular diets with simple cliché’s such as “you are what you eat”.
Beguilingly naive, it carries a very powerful message of empowerment and mastery.
This also has a ring of virtue and wholesomeness about it: sparing the animal world (the suffering of being milked with electronic devices), not eating the flesh of slaughtered animals or choosing only the healthy, insecticide and antibiotic-free grains and vegetables of our ancestors, taps into our moral identity.
And who could object to such goodness? Of course nobody does, within reason.
But when food idealism transforms into food extremism, there may be unforeseen dangers to health if food constituents, considered to be unhealthy, are excluded.
When only one domain is eliminated — for example, fat — the risk may not be significant, but when multiple components are avoided, such as fat and carbohydrates, then the danger of physical complications is significantly increased.
The profile of those affected by orthorexia differs from other eating disorders in that the age group affected is much older.
This difference is hardly surprising in light of the preoccupations of these different groups, with younger women mainly concerned with appearance, while with increasing age, the focus is on health.
In light of the high cost of organic and ‘health’ foods, it is hardly surprising that this condition is largely found in those who are middle class. And as with other eating disorders, lapses in diet are associated with guilt and feelings of weakness.
Ultimately, the drive behind diets is to achieve an ideal image of what we should be.
For most of us, this is healthy and our image is a proportionate, healthy one.
For those with anorexia nervosa, it is a caricatured image of a slim young woman; for the orthorexic, it is of a silk-haired, glowing nymph-like creature, protected from illness.
Both are wrong-headed and a danger to health.
Health & Living