Is it possible for healthy eating to become an unhealthy obsession?
Orthorexia is a word turning up frequently in the media to describe an excessive focus on healthy eating and dietary restriction. Though the term is not yet an official psychological diagnosis according to the DSM-IV, it is being used by some clinicians to describe patients with eating disorders that resemble obsessive compulsive.
Paradoxically, orthorexics obsessed with health are not healthy and often shun food to the point of emaciation and starvation. But unlike patients with anorexia nervosa, the goal of orthorexics is not to be thin but to be "pure, healthy and natural," according to Dr. Steven Bratman who first described the disorder in 1997. Suffers are frequently associated with a particular eating regimen such as veganism or rawfoodism.
That orthorexia has only recently been identified and characterized may be the best argument yet for Michael Pollan's assertion in The Omnivore's Dilemma that over the past several decades America has undergone "a national eating disorder." Americans spend tens of billions of dollars per year on weight loss and fitness products, with only growing obesity and chronic diseases to show for it. We've shunned fats, sugars, starches and everything in between, and embraced each new diet trend with open arms and wallets. And perhaps not surprisingly, it appears some people are now taking it too far.
The irony is that as a condition like orthorexia has emerged as clinically relevant, we've also seen a notable health food backlash. Google searches for the word "bacon" have increased significantly in the past year, and books are being written from websites like This Is Why You're Fat.
In other words, we have serious issues with food.
It is easy to be sympathetic toward all of these behaviors, even if their extreme forms make us a bit uneasy. For those interested in living healthy and being thin (the chronic dieters), the only guidance is offered by thousands of diet books and companies like Weight Watchers. Each of these systems has its own strict guidelines for success, while unfortunately few (if any) of them encourage us to behave as we would naturally. Thus the dirty little secret of the diet industry is that the vast majority of them are ineffective for long-term weight loss.
This is why we now have a congregation of bacon worshipers. A growing segment of the population is tired of bland food and unsatisfying, ineffective diets. Bacon tastes good, and since we are all clearly dying of heart attacks anyway we may as well live it up. Right?
Even if this attitude is a bit fatalistic, at its core it reflects a desire to enjoy life. And anyone who counts themselves among the human race should acknowledge this as a sentiment that deserves respect.
But striking the perfect balance between health and gluttony is extremely difficult in a food culture where we are allowed to eat in our cars and in front of our televisions. The food industry has made sure that as far as food is concerned, there are no rules. So a bit of obsession seems like a necessity for someone that still holds the desire to eat whole, unprocessed foods from the bottom of the food chain. The healthiest foods, after all, cannot be found at your neighborhood supermarket. For taste, health and the environment, the best stuff is at your local farmers market.
But avoiding the supermarket, isn't that orthorexic?
Not necessarily. Every day we take a little extra time to do things that are necessary and important, things like sleeping, doing laundry and brushing our teeth. We go out of our way to do these things because the alternative is simply unacceptable. Eating quality food isn't an obsession so much as a life maintenance task that -like being clean- is not up for negotiation. Until we have farmers markets on every corner, a little extra effort will be necessary.
But delicious, high-quality food is not only about health. It is also about taste, enjoyment, community and life. Food is something that is worth building your days around, because when approached from this angle food improves your quality of life in every way. Eating like this is not a disorder, it is a culture. And it is something that we desperately need to rediscover.
When proposing the term orthorexia, Bratman suggested framing a diagnosis around two direct questions:
1. Do you care more about the virtue of what you eat than the pleasure you receive from eating it?
2. Does your diet socially isolate you?
In other words, seeking healthy food only becomes unhealthy when it is devoid of enjoyment and social relationships.
Several weeks ago I had the privilege of attending a lecture at UC Berkeley given by Michael Pollan. Near the end of his talk Pollan proposed reestablishing food culture in America as "The Omnivore's Solution," the way to break our habits of both health food obsession and unbridled gluttony. He described health as "a set of relationships," and encouraged his audience to think of food not as a product but as something we do.
Throughout history and around the globe food cultures are what have dictated when, where and how much we should eat, and countries that have worked to preserve their cultures have fared better against obesity and other diseases of civilization. For Americans though, food culture has been replaced by nutritionism and all-you-can-eat buffets.
This kind of thinking is often branded as elitist, but it shouldn't be. Food culture does not cost money, it is a basic tenet of life that extends across class boundaries. It costs time, but is a priority shift worth investing in. According to the latest Nielsen statistics, Americans are watching an average of 5 hours of television per day. Calculate in the cost of high-definition screens and monthly cable bills and your daily food investment will start to be put into perspective.
It is undeniable that food grown locally with care costs more than the subsidized, mass-produced products that fill your favorite supermarket. But despite our reputation, Americans have never been opposed to going out of our way for and spending a little extra money on food that tastes amazing and makes us happy. (If you don't believe me I'll redirect you once again to This Is Why You're Fat.)
Is it such a stretch to say that we should be able to eat healthy and still enjoy our food?
I'd love to know your thoughts.