When Healthy Eating Isn't A Good Thing

September 4th 2015

Laura Donovan

Many are aware of anorexia nervosa, an eating disorder characterized by maintaining a low body weight, along with "intense fear of gaining weight and a distorted perception of body weight," according to Mayo Clinic.

However, there's a lesser-known eating disorder called orthorexia nervosa, which revolves around excessive healthy eating. (It has yet to be officially recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).)

What is orthorexia?

Though the disorder has not been officially recognized, the term has been around for nearly 20 years. Dr. Steven Bratman defined orthorexia as "an unhealthy obsession with eating healthy food," back in 1997. The word comes from the Greek “orthos,” which means “right” or “correct,” and parallels anorexia nervosa, according to Dr. Bratman, who first came up with the term to poke fun at some of his excessively healthy patients. It stopped being a laughing matter when he realized the severity of this food-restrictive condition, which in certain cases can result in death due to malnutrition.

"I originally invented the word as a kind of 'tease therapy' for my overly diet-obsessed patients," he wrote on his website. "Over time, however, I came to understand that the term identifies a genuine eating disorder ... For people with orthorexia, eating healthily has become an extreme, obsessive, psychologically limiting, and sometimes physically dangerous disorder, related to but quite distinct from anorexia ... It is most often only a psychological problem in which food concerns become so dominant that other dimensions of life suffer neglect."

In the above video, ABC News interviews orthorexia sufferer Jenny Victor of Santa Monica, California. Victor says she's very meticulous about everything she eats and that her diet dictates everything in her life.

"If something doesn't come out the way I want it to, I will just throw it away," she says in the clip. "Orthorexia has taken a huge toll on my body. I recently found out I have adrenal fatigue, and an under active thyroid, and I haven't had a period in almost a year. When you have orthorexia, every single day is full of anxiety over food. I'm scared of gluten, I'm scared of grains, even eating like a sweet potato for breakfast, I wonder how much sugar is in it."

Despite not being recognized by the DSM, nutritionists and psychologists says more and more people seem to have orthorexia, particularly among those who choose restrictive diets and lifestyles. For example, gluten-free lifestyles and obsessively educating oneself about where one's food comes from can result in orthorexia, according to a Fast Company piece published earlier this year.

How is orthorexia different from bulimia and anorexia?

For many suffering from orthorexia, the mission is not to be thin. Orthorexia victims tend to have an obsession with "clean" foods and wellness. Dr. Bratman wrote on his site:

"Some people with orthorexia may in fact additionally have anorexia, either overtly or covertly (using pure food as a socially acceptable way of reducing weight). But orthorexia is usually not very much like typical OCD or typical anorexia. It has an aspirational, idealistic, spiritual component which allows it to become deeply rooted in a person’s identity ... The primary feature distinguishing orthorexia from anorexia is that while a person with anorexia focuses on weight, a person with orthorexia obsesses about purity. People with anorexia possess a distorted body image in which they see themselves as fat regardless of how thin they really are, whereas those with orthorexia constantly struggle against feelings of being unclean or polluted by what they have eaten, no matter how carefully they monitor their diet."

Dr. Bratman wrote that it's possible to "graduate" from anorexia to orthorexia, shifting their focus from weight control to purity and cleanliness.

Health risks of orthorexia.

Jordan Younger, a vegan and popular New York food blogger, is a well-known sufferer of orthorexia, and it has greatly impacted her life. With more than 7,000 Facebook fans, a clothing line dedicated to healthy eating, and 120,000 Instagram followers, Younger is well-known in the food blogging community, but she told The Independent in a recent interview that she knew she had a problem with restrictive eating when, like Jenny Victor, her menstrual cycle stopped. This can happen when a person loses a certain amount of body fat. She also became very tired and would panic about eating a meal she hadn't previously planned out.

“I had developed many fears surrounding food,” Younger told the publication. “I was becoming more and more limited in what I was comfortable eating. I even joked about it with friends, calling certain foods, like eggs, ‘fear foods’ because I had stayed away from them for so long. It was easy to hide behind the shield of veganism when I was at a restaurant with friends or even grocery shopping for myself. Anything not clean, oil-free, sugar-free, gluten-free and plant-based I dismissed because it wasn’t within my dietary label.”

Younger ultimately started going to therapy, changed her eating habits, and renamed her blog from The Blonde Vegan to The Balanced Blonde. Not everyone, however, goes into recovery or seeks help for this condition.

Unfortunately, there aren't any specific figures on how many people suffer from orthorexia. Unlike anorexia and other officially recognized eating disorders, there also isn't data on how many people die from orthorexia per year, but Bratman wrote on his website that he knew of one woman who died from orthorexia after first suffering from anorexia. For the most part, orthorexia, though is not fatal and "merely creates psychological distress and impairs various life dimensions, but does not present a physical danger," he wrote on his site.

"Whatever the motivation, there’s nothing healthy and natural about starving yourself to death," he continued. "If you’re obsessed with healthy diet, and yet people tell you that you are seriously underweight, please take [her] story to heart."

If you are suffering from an eating disorder, you can call the National Eating Disorders Association (NEDA) confidential helpline at 1-800-931-2237.