Orthorexia: Obsessed with healthy eating

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SALT LAKE CITY -- What some call a new type of eating disorder is showing up across the country. It happens when healthy eating crosses the line.

It's called orthorexia, a term coined in 1997 by Dr. Steve Bratman, author of the book "Health Food Junkies."

Registered dietician Jennie Twitchell told KSL orthorexia is an unhealthy obsession with eating what is perceived as "healthy food." The obsession is psychologically and sometimes physically unhealthy.

It is not an officially recognized disorder and is not recognized as a mental disorder by the American Psychiatric Association.

Bratman says it's different from other disorders, including anorexia, but some doctors disagree. Time magazine reports organizations like the Eating Disorders Coalition want orthorexia to have a separate entry in the Diagnostic and Statistical Manual of Mental Disorders (DSM). But that is not planned and many doctors think a separate diagnosis is unwarranted.

Twitchell says the criteria for this disorder are not clear, but it appears to have elements of obsessive compulsive disorder (OCD) and anorexia nervosa. In some people it manifests simply as a misinformed view of what healthy is; in others it begins as a restrictive diet. It becomes a problem when the worry about eating "clean," "pure," "healthy," and "natural" foods escalates and the person becomes obsessed with finding more and more foods that are not acceptable for consumption.

How is it different from OCD or anorexia?

Twitchell says OCD and anorexia are related disorders. Anorexia is basically an obsession with being thin and a compulsion to burn calories without replenishing them. Orthorexia is an obsession with healthy food and a compulsion to eat only "safe" foods that have been prepared in a specific way.

The emphasis is not on being thin; however, some people get to the point where they are restricting so many foods they do become dangerously underweight. This has been termed anorexic orthorexia.

If it's not physically unhealthy, why is orthorexia a problem?

When someone becomes so mentally worried about eating "healthy" foods they may become malnourished, but most people will maintain a low-normal weight. If their rituals interfere with their personal and social lives, it becomes a problem, Twitchell says.

People with orthorexia usually develop a routine around food including planning, purchasing, and preparation. With really restrictive diets, this can take nearly an entire day. They often criticize the way friends and family eat, or refuse to visit them because they don't have control over the food available when they leave home.

They are typically not pleasant to be around and only want to talk about "healthy" food or their diet. A mother may be so concerned about helping her children be "as healthy as they can be" that she neglects everything else, like cleaning the house, bathing the children, and getting them to bed on time, because she is preoccupied with her food routine and researching new foods to exclude.

Risk factors include:

  • A genetic tendency toward OCD behaviors
  • A history of other psychological or eating disorders
  • Following a very restrictive diet

Some people adopt extreme eating behaviors for health reasons, others to maximize their energy and spiritual connection. But it's not about the actual reasons for choosing or avoiding a food. Twitchell says. It's the obsession with continually finding new foods to exclude and the negative impact it has on life.

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