Is Orthorexia a Real Eating Disorder?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Orthorexia Nervosa is described as a “fixation on the virtue of food or unhealthy obsession with healthy eating. Orthorexia has been [styled] as a type of ‘self-righteous eating’ [or as] ‘clean eating'” by “sufferers” of the disorder. Wait, let’s take a step back here. First of all, though this “phenomenon…has been described in the scientific literature, it is not formally recognized as an official psychiatric diagnosis.” Furthermore, orthorexia doesn’t even have “an accepted definition,” nor “validated diagnostic criteria.” And, if you can’t validly diagnose it, or even define it, what good is it? Okay, well, first off: where did this concept even come from? Not from some scholarly source, but from a popular press article called “Confessions of a Health Food Junkie” in a magazine called Yoga Journal.

Let’s explore its “scientific legitimacy.” Evidently, it looks like “[o]rthorexics obsessively avoid [processed] foods, [unhealthy fats, and] foods containing too much salt or too much sugar.” But wait; by definition, we should avoid unhealthy fats—they’re unhealthy! And anything that has too much salt or sugar has too much salt and sugar. Is someone who’s a nonsmoker “obsessively” avoiding cigarettes orthospirexic? Obsessed with “right” breathing? “In many cases, parents try to “strictly limit their children’s sugar intake…” No! Off to the loony bin they go.

Orthorexics make the “nutritional value of a meal more important than the pleasure of eating it.” Uh, but if you didn’t just a little, wouldn’t you just eat doughnuts all day? If pleasure trumps health, maybe we should all just start shooting heroin.

One of the proposed criteria is “an unusual concern about one’s own health.” What does that mean? Do you have a mental illness if you decide to hold the bacon on your double cheeseburger? That could be seen as an unusual level of concern in a standard American diet.

“People with orthorexia pay excessive attention to the quality of consumed food,” so much so they’d rather not eat unhealthy food. I bet they put their seatbelts on too! We better reprogram their unhealthy healthy thoughts with “cognitive behavioral therapy combined [of course] with” drugs (SSRIs such as Zoloft, Prozac, and Paxil.) Hey, that’s what the “experts recommend.”

“With regard to psychotropic medication,” yeah SSRIs may help, but you may have to dip into the atypical “antipsychotics” as well. Now, often there will be a concession like: “Of course, from a clinical and public health perspective it would not be reasonable to suggest that individuals who follow a strict healthy diet are endangering their health.” It only reaches “clinical significance” when “health-directed eating” starts causing problems in relationships, or impairs an individual’s social life. But, like, if someone asks their spouse not to smoke around them and the kids, that “health-directed” behavior could cause “interpersonal distress” in the relationship. Should you just keep quiet? Or should you yourself keep smoking just to not cause waves with your smoking spouse? And social-life-wise, do you have mental illness if you tell your date you’d rather not go to the steak house or the smoking lounge?

“The problem…is when the behavior begins to hinder a person’s ability to take part in everyday society.” Like what if you start bringing food to dinner parties? Maybe I’ve just gone to too many potlucks, but bringing a healthy dish to share doesn’t sound like a druggable psychiatric offense to me.

And then, there’s Instagram. Think of “the implications social media can have on the psychological well-being” of hundreds of thousands of individuals. Did you know that “[h]ealthy food posts tend to receive more support from users than less healthy images, indicating a positive attitude towards healthy foods and healthy eating”?!? Soon, everyone might be taking pictures of broccoli. Quick, get out the straitjackets!

In his decades of medical practice, Dr. Dean Ornish says he’s “never seen” a case of orthorexia. “Most people,” he says, “have the opposite problem; they don’t care enough about what they eat.”

Please consider volunteering to help out on the site.

• Yoga Journal For Health and Conscious Living. 1997;136.
• Chaki B, Pal S, Bandyopadhyay A. Exploring scientific legitimacy of orthorexia nervosa: A newly emerging eating disorder. J Human Sport and Exercise. 2013;8(4):1045-1053.
• Costa CB, Hardan-Khalil K, Gibbs K. Orthorexia Nervosa: A Review of the Literature. Issues Ment Health Nurs. 2017;38(12):980-988.
• Turner PG, Lefevre CE. Instagram use is linked to increased symptoms of orthorexia nervosa. Eat Weight Disord. 2017;22(2):277-284.
• Varga M, Dukay-Szabó S, Túry F, Van Furth EF. Evidence and gaps in the literature on orthorexia nervosa. Eat Weight Disord. 2013;18(2):103-111.
• Olejniczak D, Bugajec D, Panczyk M, et al. Analysis concerning nutritional behaviors in the context of the risk of orthorexia. Neuropsychiatr Dis Treat. 2017;13:543-550.
• Davis JL. Orthorexia: Good Diets Gone Bad. 2000.
• Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatr Dis Treat. 2015;11:385-394.
• Missbach B, Dunn TM, König JS. We need new tools to assess Orthorexia Nervosa. A commentary on "Prevalence of Orthorexia Nervosa among College Students Based on Bratman's Test and Associated Tendencies". Appetite. 2017;108:521-524.
• Mathieu J. What is orthorexia?. J Am Diet Assoc. 2005;105(10):1510-1512.

Image credit: artistlike via pixabay. Image has been modified.

Motion graphics by Avocado Video

• animal products
• Dr. Dean Ornish
• junk food
• meat
• mental health
• processed foods
• Prozac
• salt
• smoking
• standard American diet
• sugar
• Zoloft