HEALTHY EATING OR UNHEALTHY OBSESSION?
When does ‘eating clean’ become an eating disorder?”
That was the headline on Broadly writer Claudia McNeilly’s lengthy piece on a little-researched, still disputed medical condition known as “orthorexia.”
Within 24 hours of publication, “orthorexia” was trending on Facebook and the piece had garnered thousands of comments.
Half the responses were ecstatic: “Awesome article,” one person wrote. “(I) would get incredibly anxious in the presence of certain foods such as rice or white potatoes before realizing that I had some kind of problem but couldn’t pinpoint what it was until I finally heard the word ‘orthorexia.’”
The other half were contemptuous: “Since WHEN is eating healthy a terrible thing?” raged one commenter.
The Broadly piece this week was just the latest of many on orthorexia nervosa (literally, “correct appetite disorder”), an illness that has been making the rounds online, though it’s absent from all psychiatric manuals.
Most doctors don’t yet recognize “orthorexia,” at least, not as an official diagnosis.
But people who have spent hours looking at images of food online probably will.
It’s a perfect explanation for the fixation on “clean eating” that exists off-line but can be exacerbated by the food blogs, the anxiety around health that exists just outside the frames of carefully crafted Instagram shots of well-composed plates.
Popular Instagrammer Jordan Younger, known as “The Balanced Blonde,” crashed her website last year when the self-proclaimed vegan announced that she would be easing up on her restrictive-yet-esthetically-pleasing diet because it was making her isolated and ill. Younger identified as orthorexic. “I think the images of all the really beautiful food — the joke for me is the kale smoothie; the endless kale smoothies are very pretty,” Steven Bratman, a doctor who coined the term, told Broadly. “I think this type of media is definitely causing orthorexia to reach a larger audience and a younger audience.”
Bratman didn’t originally intend for orthorexia to become a diagnosis. In 2009, he told the New York Times he used it for patients who kept coming to him with increasingly obsessive concerns about their diets.
“I would tell them, ‘You’re addicted to health food.’ It was my way of having them not take themselves so seriously,” said Bratman, who published a book on the condition.
Orthorexia, as Bratman defines it, is a disorder distinct from anorexia or bulimia. It’s not the diet that’s the problem — it’s the obsession that accompanies it.
Many psychiatrists believe that what some call orthorexia is really a form of anorexia or obsessive compulsive disorder, and studies have found that the symptoms of the former overlap significantly with the latter two.
Like anorexics, people with orthorexia are preoccupied with food and the state of their bodies.
Like people suffering from OCD, they are often searching for control.
And, as with any eating disorder, orthorexia can be isolating and anxiety-inducing and often leads to unhealthy weight loss.
“I don’t think the symptoms are significantly different enough from bulimia or anorexia that it deserves a special diagnostic category,” Angelique A. Sallas, a clinical psychologist in Chicago, told the New York Times.
“It’s an obsessive-compulsive problem. The object of the obsession is less relevant than the fact that they are engaging in obsessive behaviour.”
An unhealthy attachment to “clean eating ” may not signal a new kind of eating disorder so much as a new manifestation of an existing one. Angela Guarda, director of the Johns Hopkins Eating Disorders Program, told the Guardian that eating disorders may appear different depending on the time period, but the root cause is the same.
“Twenty years ago, many of the patients I saw with anorexia were vegetarians,” she said. “Now, they also talk about eating exclusively organic food or say that they are lactose intolerant and allergic to gluten, when their blood tests show that they are not. These explanations are convenient ways to hide their fear of eating high-calorie foods or foods prepared by others which provokes anxiety.”
Orthorexia was considered as a new diagnostic category for the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. But it was ultimately discarded, mostly because there haven’t been enough studies published on the condition.