There’s a lot of talk today about this phenomenon called “orthorexia”, and most people are flinging the word around without knowing what it means, whom it implicates, and why they’re using it.
So it’s time to clear the air.
First and foremost, a definition:
Orthorexia is a play on words. It uses the same Greek origins as the word anorexia, where an- means “lack” and -orexis means “appetite”. “Ortho” means “right” or “proper”, so the term “orthorexia” means “right appetite”.
Second, the origins:
According to Dr. Steven Bratman, the man who coined the term, orthorexia was something of a lark, even though it had its roots in something very serious. As a young man living on a spiritual commune in the 70s, he became obsessed with “right” nutrition—just as many of us do. Anything that was natural, clean, or pure was considered “right,” and anything that was dirty, impure, or a guilty pleasure was considered off limits.
By the time he realized that maybe he had a problem with his relationship to food, he was an alternative medicine practitioner, and he began to see the resonances of his own disordered relationship with food in his clients.
In order to help people better understand their rigidity around food, he tried to use humor to broach the topic and diffuse the situation. And thus, orthorexia was born.
Here’s the thing about orthorexia: it usually starts as a fear of malnutrition—you know, a lack of nutrients in the diet. Many people who come to healthier eating from what we call the “SAD” or “Standard American Diet” recognize the lack of nutrient density in our previous way of eating. We’re told that only clean, natural, and organic foods can make up a healthy diet, so clean eating helps us diversify our diet while also avoiding the effects of malnutrition.
However, orthorexia takes it a step further from the recognition that it’s better to partake of a diet that features more kale and grass-fed beef than Big Macs and fries.
Orthorexia has a religious dogma behind it (and even if you don’t practice a religion, if you’re a regular maker of “appeals to nature,” then you’re probably praying at the Church of the Healthy).
Orthorexia features an obsessive focus on purity and cleanliness (and cleanliness is next to godliness!)—so that you’re not just avoiding malnutrition, but MALnutrition—mal, meaning “bad”, “evil”, or “wrong”.
Orthorexics believe that the right foods are the key to salvation—salvation meaning, in this case, eternal life and perfect health. There’s a demonization of non-natural ingredients, and a constant focus on cleansing.
Any slips in the religious practice of eating clean are immediately shamed; orthorexia creates a feeling of intense guilt for both indulging or even wanting to indulge.
Self-flagellation is regularly practiced in the case of eating something considered impure, and often practiced in the form of ever tightening restrictions on the diet—like, say, a 21-Day Sugar Detox every time you look cross-eyed at a Paleo treat.
Orthorexics begin to place their food quality ahead of their quality of life. Gatherings with friends and family who don’t pray at the same Church of the Healthy are regularly avoided, and food fear becomes the source of cancelled plans and increased isolation.
Orthorexia is not just caring about food quality—it’s about placing food quality on the same plane with godliness and experiencing extreme fear or anxiety when unable to access that feeling.
While orthorexia may not be an actual clinical diagnosis for an eating disorder (at least according to the DSM-V, which is the current bible of “mental illnesses for which your doctor can bill insurance”), it closely mirrors many of the behaviors that once made up what was classified as EDNOS, or Eating Disorder Not Otherwise Specified (which has been discontinued in the DSM in favor of the diagnosis “Other Specified Feeding or Eating Disorder.” Orthorexia would probably most qualify for the OSFED Atypical Anorexia Nervosa diagnosis)
For some orthorexics, the rigidity and religious devotion stops before the level of eating disorder (even though it is certainly disordered eating when it becomes a disruption to your quality of life), but for many, orthorexia is just a way to cover up an eating disorder.
Food purity is often tied to weight loss, at least in our over-marketed first world. And eating disorders are closely tied to an intense fear of gaining weight and a distorted body image. So eating “clean” not only brings you closer to God, but it also feeds the desire for weightlessness.
And because eating clean is so worshipped—everywhere from the government recommendations to the morning news to Sally from accounting who’s doing a 30 day cleanse—it’s easy to get away with disordered behaviors.
I can’t tell you how many times people told me how good I looked or how they wished they could be as disciplined—or “good”—as I was around food back when I was clean eating myself into a suicidal depression and an anorexia diagnosis. My fear of “bad” food—and of the impurity, ill-health, and promised weight gain that came along with it—was so all-encompassing that I lost out on friendships, relationships, and my life’s passion. I almost lost everything, including, ironically, my health.
Orthorexia is not just a healthy concern for eating mostly “good” food whenever possible; it’s an unhealthy obsession with the power of the “goodness” of your food that increasingly restricts the goodness of your life. Even if you’re not using it for weight loss (although, let’s face it, who isn’t eating “clean” and not at least slightly convinced that it’ll affect their weight?), extremely clean eating is a dangerous thing when it begins to impinge upon your mental and emotional health.
I know that people like to generalize about orthorexia and call anyone who doesn’t eat oreos at every meal an orthorexic, but casually flinging the word at anyone who likes kale is just as dangerous as using the word “anorexic” to describe anyone who, in your opinion, “needs to eat a hamburger.”
No, your therapist can’t bill insurance if you have orthorexia, but that doesn’t make it any less dire or worth treatment—and we have to take it seriously if we want to avoid destroying our lives and our health.
That’s why I’m so excited and honored to have had the chance to bring Dr. Steven Bratman himself onto today’s podcast. I read his book, Health Food Junkies, back in 2010, and it was the first resource that helped me at least understand that I had a problem. This was such an incredible interview—I really hope you listen, and then share what you learn with others. This is such an important topic, and I just want you to know that your food does not have to be your prison, your penance, or your punishment. That’s why you should: