“Eat healthy!” is a trope we’re all used to hearing -- and with good reason. Obesity has reached epidemic levels in the United States, we are consistently inundated with ads for overly-processed junk foods and busy schedules push people towards stopping off at McDonalds instead of cooking a meal at home. But what about the other side of the spectrum? Can you have too much of a good (eating) thing?
In some cases, the answer seems to be yes. Orthorexia -- or an obsession with healthy eating -- is a term that was coined by Steven Bratman, M.D. (a specialist in alternative medicine) in 1997 and has received an increasing amount of media (and scientific) attention over the last few years. Most recently, the TODAY show's Savannah Guthrie sat down with resident nutritionist Madelyn Fernstrom and psychotherapist Robi Ludwig to discuss the issue.
Orthorexia is not a clinical term, and it has not been officially defined as a mental disorder or been given a place in the American Psychiatric Association’s DSM-IV. This, coupled with the lack of clinical studies that have been conducted on the subject (we could only find two) make orthorexia a difficult subject to address with any sort of certainty. A couple of the nutritionists that we reached out to had never encountered this type of disordered behavior and remarked that most of their clients had the opposite issue. However, a growing number of nutritionists, dietitians and psychologists are acknowledging that a focus on healthy food does have the potential to cross the line into obsessive -- and unhealthy -- behavior. “We have no specific criteria [for orthorexia], but we know it when we see it,” registered dietitian and co-founder of AppforHealth.com, Julie Upton, told The Huffington Post.
Dr. Bratman, who published a book on the subject in 2004, entitled “Health Food Junkies,” explained the definition to WebMD as such: “The whole issue is obsession. This is about the obsession with eating to improve your health.” It is this obsession that marks the distinction between making well-informed, careful, healthy decisions and engaging in potentially harmful behavior.
Upton, who works predominantly with an athletic population, says that she sees individuals on a consistent basis who cross the line into health-food obsession. In her experience, athletes tend to be natural candidates for orthorexia as they are involved in industries that are inherently body and food-conscious. Some typical “red flags” that Upton encounters include: spending all day planning out meals, never eating food served at parties and other social events, and targeting very specific ingredients in foods -- regardless of the portion size of the ingredient and whether said ingredient has a real effect on the overall diet. Orthorexia is often characterized by a rigid restriction of some sort, although the type of restriction varies widely person-to-person.
And while education about nutrition is unquestionably a positive, it may be this very environment that encourages the development of disordered behavior in individuals predisposed to these type of conditions. “Within our environment today, we have the opportunity to know so much about the food that we get,” says Roberta Larson Duyff, registered dietitian and author of the “American Dietetic Association Complete Food and Nutrition Guide.” “There’s enough editorial copy out there that the environment can feed on that kind of obsession for those who … do not have a more rounded, realistic view of food.”
While most cases of obsessive behavior regarding healthy food lead to more psychological stress than physical -- namely social isolation and a loss of the joy traditionally associated with eating -- individuals who take orthorexic behaviors to an extreme may end up harming their bodies as well as their minds. “Once you start eliminating food groups and large categories of food, you run the risk of losing out on essential vitamins and minerals,” says Katherine Brooking, registered dietitian and co-founder of AppForHealth.com. She also spoke to the seeming contradiction between a culture of obesity and a culture of health food obsession. “There’s a whole contingent of the population who is paying very little attention to the quality of their food … [but] you also see [people] starving themselves,” she told The Huffington Post. “Our society is very prone to those kind of extremes.”
Ultimately, orthorexia is an issue that seems to merit further research and discussion. However, in the process, Duyff cautions that we shouldn’t be too quick to label or demonize people. “We need to be careful to look at where there is compulsive behavior, and when there is a genuine interest in food and trying to make … strides toward healthy eating.”
Brooking says that for her the bottom line is that making healthy choices should be simple -- not anxiety-producing: “If people feel that they are experiencing anxiety, obsession or stress [over healthy eating], that is something that should be addressed with a health care professional.”
WebMD provides a comprehensive list of 10 questions that individuals should ask themselves when trying to identify orthorexic behavior. A few of them are listed below:
1. Are you spending more than three hours a day thinking about healthy food?
2. Do you skip foods you once enjoyed in order to eat the “right” foods?
3. Is the virtue you feel about what you eat more important than the pleasure you receive from eating it?
4. Do you feel guilt or self-loathing when you stray from your diet?