Mary Anne Cohen
Many people eat rigidly and with restriction, constantly obsessed about getting thinner. Their eating is all about control. Others overeat or binge regardless of whether they are hungry or full. Their eating is all about losing control. Still others yo-yo back and forth between these two extremes.
And then there are the orthorexics, who devote their lives to eating healthy and have been described as “health food junkies.” Sounds good, right? After all, in this day and age when Americans are suffering from an obesity epidemic, high cholesterol, diabetes, and other health/weight related issues, doctors constantly recommend eating well and exercising more.
Yet, sometimes healthy eating can spiral out of control and take on a dangerous life of its own. In the 1990’s, Dr. Steven Bratman coined the term “orthorexia” to describe people who are fixated on righteous eating, who become preoccupied with avoiding foods they believe to be unhealthy or impure. Orthorexics usually begin by cutting out certain foods: meat, sugar, flour, dairy, carbs, processed foods, salt and/or fat. Often they become devotees of macrobiotics, vegetarianism, vegan, organic, or raw food diets. Although there may be nothing wrong with any of these diets, the orthorexic fears that even these restrictions are not sufficient enough to satisfy their need for a purer health regime. They continue to whittle away more and more categories of food which they will permit themselves to eat. This preoccupation can become so excessive that they risk becoming malnourished which can sometimes lead to death. This is an ironic twist for someone who started out with the goal of health!
Although orthorexia sounds a lot like anorexia, it is different. While anorexics cut down on the quantity of food they eat because of their fear of being fat, orthorexics are exclusively concerned with the quality of the food they eat and continue to refine and restrict their food choices according to their personal beliefs as to which foods they consider virtuous. They are not necessarily invested in weight loss like the anorexic.
Orthorexia is a progressive disorder where the sufferer spirals into a prison of distorted thoughts and destructive behaviors. Because an orthorexic may need increasing time to plot his or her eating, social isolation can be another sign of this disorder.
Why does someone develop orthorexia?
• Bio-chemical vulnerability. Orthorexia is a form of obsessive compulsive disorder that can be caused by a biological chemical imbalance related to anxiety, depression, or posttraumatic stress.
• Personality vulnerability. One of the key characteristics of orthorexics is perfectionism where they see their eating as either all good or all bad, black or white. Either their food is pure or impure; they are a success or a failure based on how “clean” their eating is. Self-esteem becomes connected with the purity of their diet.
• Psychological issues. Orthorexics often suffer from deep guilt over what they consider to be their inner badness. The purer the foods they eat, the more they hope their badness will be healed. Their attempt to “clean up their act” by cleaning up their food is almost like an attempt at spiritual redemption.
“Sometimes I really don’t like my children (or my mother, or my husband). I must be a bad person.”
“Sometimes I wish I was pregnant and not my sister. I must be a bad person.”
“Sometimes I secretly resent my husband for not making enough money. I must be a bad person.”
Horrified by their own “evil” thoughts, an orthorexic may not distinguish between a mean-spirited notion in the privacy of her head and the actual committing of a destructive act. Feelings are not facts! Nobody in the above scenarios was putting children up for adoption or getting divorced. The guilty orthorexic needs to learn that you don’t need to “purify” yourself with your food so much as embrace self-compassion. Having a variety of selfish thoughts and feelings at times is not a crime! It’s just human nature.
In my next article, I will discuss the treatment of orthorexia.
Mary Anne Cohen is Director of The New York Center for Eating Disorders in Brooklyn, NY.
