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Eating disorders are one of the most common mental illnesses in the United States, affecting over 30 million Americans and killing at least one person every 62 minutes. Anorexia, or severely restricting food intake, and bulimia, or recurrent binge-eating followed by compensatory actions, are the two most well-known maladies, but recent years have seen a rise in a fairly new condition known as orthorexia.
What is it?
The term “orthorexia” was first introduced by Dr. Steven Bratman in 1997. In his landmark essay, he remarks on the tendency of those who advocate for non-traditional dietary cures to become unhealthily “fixated on on eating proper food.” This results in a day that is primarily dominated by the “planning, purchasing, and eating of meals,” so much so that the very meaning of life itself becomes completely intertwined with food. In the words of Dr. Bratman, anorexia and bulimia involve the quantity of food; orthorexia involves the quality.
While orthorexia is not officially listed in the DSM, a proposed list of formal diagnostic criteria was released in 2016. The first criterion focuses on a patient’s obsessive focus with healthy eating. Unlike anorexia and/or bulimia, weight loss is not necessarily the primary goal. Rather, the patient feels a need to achieve “optimum health,” and does so by following a progressively more restrictive diet associated with anxiety and shame if violated.
The second criterion involves the impairing effects of the compulsive behavior outlined above. Orthorexia may cause physical damage by leading to malnutrition and/or severe weight loss if the diet becomes too restrictive. It also may have far-reaching mental effects by damaging intra-personal relationships, negatively affecting perceptions of self-worth, and inappropriately associating dietary adherence with happiness and joy.
Where does exercise fit in?
Technically, the definition of orthorexia is solely concerned with diet. However, Dr. Bratman notes in a follow-up blog post that orthorexics are often very enthusiastic (sometimes dangerously so) with exercise as well. Given a patient’s preoccupation with health as a whole, as well as society’s gradual transition towards excessive fitness routines and goals, it makes sense that those with orthorexia likely have a misguided relationship with exercise as well.
What to do if you or someone you know might be suffering:
Dr. Bratman has provided an online self-test to help diagnose the presence of orthorexia, which can be found here. Admittedly there is a fine line between orthorexia and a general proclivity towards “healthy eating,” and it can be difficult to convince somebody afflicted with this disorder that they are hurting themselves by continuing down this path. As with other eating disorders, the best way to help is to contact a medical professional. If it’s an emergency, here are some important resources:
Disclaimer: I am not a licensed nutritionist nor a registered dietician. The opinions expressed in this article are my own, and each individual is ultimately responsible for his/her dietary and nutrition practices. Please consult a physician before starting a new dietary program.