Physician Steven Bratman coined the term “orthorexia nervosa” and wrote about it in his 1997 article “Health Food Eating Disorder.” See if this sounds at all familiar:
Orthorexia begins innocently enough, as a desire to overcome chronic illness or to improve general health. But because it requires considerable willpower to adopt a diet which differs radically from the food habits of childhood and the surrounding culture, few accomplish the change gracefully. Most must resort to an iron self-discipline bolstered by a hefty sense of superiority over those who eat junk food. Over time, what they eat, how much, and the consequences of dietary indiscretion come to occupy a greater and greater proportion of the orthorexic’s day. …
Orthorexia eventually reaches a point where the sufferer spends most of his time planning, purchasing and eating meals. The orthorexic’s inner life becomes dominated by efforts to resist temptation, self-condemnation for lapses, self-praise for success at complying with the self-chosen regime, and feelings of superiority over others less pure in their dietary habits.
It is this transference of all life’s value into the act of eating which makes orthorexia a true disorder. …
As often happens, my sensitivity to the problem of orthorexia comes through personal experience. I myself passed through a phase of extreme dietary purity when I lived at the commune. …
After a year or so of this self imposed regime, I felt light, clear headed, energetic, strong and self-righteous. I regarded the wretched, debauched souls about me downing their chocolate chip cookies and fries as mere animals reduced to satisfying gustatory lusts. But I wasn’t complacent in my virtue. Feeling an obligation to enlighten my weaker brethren, I continuously lectured friends and family on the evils of refined, processed food and the dangers of pesticides and artificial fertilizers. …
But even when I became aware that my scrabbling in the dirt after raw vegetables and wild plants had become an obsession, I found it terribly difficult to free myself. I had been seduced by righteous eating. The problem of my life’s meaning had been transferred inexorably to food, and I could not reclaim it.
I am certainly not advocating that folks stop eating healthy foods or in a healthy manner. But if you’re one of those folks who are struggling to stay a hardcore “clean” eater — no matter whether that’s low-fat or low-carb or paleo or vegan — it may be prudent to consider NEDA’s Do I Have Orthorexia? questions:
- Do you wish that occasionally you could just eat and not worry about food quality?
- Do you ever wish you could spend less time on food and more time living and loving?
- Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
- Are you constantly looking for ways foods are unhealthy for you?
- Do love, joy, play and creativity take a back seat to following the perfect diet?
- Do you feel guilt or self-loathing when you stray from your diet?
- Do you feel in control when you stick to the “correct” diet?
- Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?
If you have found a diet that addresses a specific health complaint, that’s a different kettle of fish. No one is suggesting celiac folks eat wheat to be sociable. And if your restrictive diet isn’t a challenge for you, that’s great (as I’ve said, I envy folks who are strongly committed to their WOE).
But ultimately, what’s really important is finding the right diet for a lifetime. Or as Yoni Freedhoff says, find the diet you can enjoy, not the one you can tolerate. It may be that your internal compass is different from your favorite guru’s!
Speaking of which, Bratman also made a couple of other points in his 16-year-old piece that seem curiously relevant re dietary programs and/or dogma today:
It often surprises me how blissfully unaware proponents of nutritional medicine remain of the propensity for their technique to create an obsession. …
Like all other medical interventions — like all other solutions to difficult problems – dietary medicine dwells in a grey zone of unclarity and imperfection. It’s neither a simple, ideal treatment, as some of its proponents believe, nor the complete waste of time conventional medicine has too long presumed it to be. Diet is an ambiguous and powerful tool, too unclear and emotionally charged for comfort, too powerful to ignore.
Sigh … it’s still a grey zone and too powerful to ignore!
HT Evelyn.
Weight Maven is written by Beth Mazur. Beth believes that obesity is more symptom than cause and that the real problem is our Western diet -- especially sugar, refined grains, and industrial oils. Beth writes about nutrition, ancestral health, & food policy. And cats! 
I can say that if I run across a food that lights up the old emotional/binge tendencies, I can feel it within about half an hour or so. It’s so not good. I lived so long in that numb/foggy/haze that I’d run not walk if someone “lovingly” put a grain, processed sugar or frosting in front of my face and told me I must eat it. “It’s made with love, just for you”. Yeah, right…..
I lived 40 years, now about 1.5- 2 years in what I call recovery. The next 40 years is on my terms.
Interesting post, Beth. I do enjoy the new diet and food sobriety. Gotta do what works.
Absolutely Karen. I think you’re in the crowd of folks who are committed to your way of eating, not the crowd who would like to have a piece of grandma’s pie at Thanksgiving, but who fears the guilt for eating grains or carbs. Those are the folks who are turning up in cheat threads on Paleo Hacks or are finding relief at groups like Eat the Food on Facebook.
“Gotta do what works” should be the mantra for us all!
Nice article, Beth.
This is definitely a difficult topic as most “diets” restrict SOMEthing, whether it is calories, fat, grains, or whatever. It’s hard to find the line in the sand between a healthy weight-loss diet and orthorexia, but those questions from NEDA really seem to put things into perspective.
-Bill
Bill, I think there’s restriction and then there’s more extreme restriction. Vegan diets, Ornish type LF diets, ketogenic LC diets, “true” paleo diets that eliminate all grains, legumes, and dairy are the types of diets that are more than “restrictive.” They clearly work well for some folks, but they also seem to be the diets that are associated with this more obsessive diet behavior.
I do think the NEDA questions are helpful to tease out whether any given WOE is net positive for an individual.
In a way, I felt like this when I went on Weight Watchers back during the days of weighing and measuring. It wasn’t orthorexia nervosa; however, I felt like I was focused on food more than I should have been. Even now, the points system doesn’t appeal to me. I’m not criticizing the Weight Watchers method. There is a variety of food available; however, the methodology is something I can’t do again.