When the Pursuit of Health Descends into an Obsessive Nightmare—Orthorexia

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We can see our cultural obsession with the body and the way we moralize how we treat our bodies everywhere in our language. We now have something called cheat days. We also use terms like good carbs and bad carbs and clean eating. The term clean eating is particularly revealing as it implies that other eating forms are somehow unclean. The term is fascinating because the terminology of clean and unclean are common religious terms that are related to one’s moral state and their relationship with God.

The term orthorexia was coined by Dr. Steve Bratman in 1997. Orthos is Greek for straight, right, or correct. In his practice, he was increasingly seeing patients whose quest for health had become a dangerous obsession that was not only ruining their life socially and psychologically but was also harming their bodies. Today, doctors and eating disorder clinics are seeing an alarming rise in patients presenting symptoms attributed to orthorexia. Orthorexia does differ from other, more well-known eating disorders like anorexia and bulimia. “Unlike other eating disorders, orthorexia mostly revolves around food quality, not quantity. Unlike with anorexia or bulimia, people with orthorexia are rarely focused on losing weight. Instead, they have an extreme fixation with the ‘purity’ of their foods, as well as an obsession with the benefits of healthy eating.” (Orthorexia: When Healthy Eating Becomes a Disorder by Alina Petre, MS, RD (NL), April 2, 2010, healthline.com)

In a YouTube video (Orthorexia—When Clean Eating Becomes a Problem, ABC Science, November 2019), a young woman named Megan talked about her Orthorexia. Her journey began as an overweight teenager striving to lose weight, get in shape, and get healthy. As she lost weight and got more fit, she noticed that her life and mind were increasingly being taken over by her quest for health. When she realized it was causing an enormous amount of anxiety, she talked to her doctor about it, and her doctor simply congratulated her on her weight loss and told her to keep up the good work. Many of her friends and family members were also commenting on how good she was looking and how healthy she was living. “In our current culture, cutting out entire food groups like sugar, fats, carbohydrates and dairy are commended. Foods have been given ambiguous labels that have unhelpful and even harmful labels like ‘good’ and ‘bad’ attached to them. For this reason, many of those living with orthorexia can easily be identified as ‘health-conscious’ or ‘healthy’ to the untrained eye, making many who may be suffering from malnutrition and debilitating rigidity think that their lifestyle is ‘normal.’” (8 Warning Signs of Orthorexia, waldeneatingdisorders.com) Besides orthorexia being reinforced and even commended by friends and even physicians, what also makes getting help more difficult is that although psychologists, medical doctors, dieticians, and eating disorder clinics see and treat countless orthorexia patients, the condition is still not included in the DSM-5—the diagnostic manual that doctors and insurers use to classify mental disorders.

How disruptive is orthorexia to a person’s life and health? In a Google Talk by registered dietician Renee McGregor, she listed the impacts of orthorexia: it creates anxiety, leads to vitamin and mineral deficiency, leads to poor performance in school and work, causes hormone imbalances, affects bone health, causes digestive issues, and leads to social isolation. (Renee Mc Gregor: Orthorexia—When Healthy Eating Goes Bad, Talks at Google, 2018, YouTube) Orthorexia can be just as severe as other eating disorders and can result in permanent damage to a person’s health. The toll on one’s psyche can also be intense. “If someone strays from their rigid eating patterns, or from their strict self-prescribed exercise regimen, severe anxiety, distress, shame, guilt and/or depression typically follow.” (8 Warning Signs of Orthorexia, waldeneatingdisorders.com)

Orthorexia affects both males and females. People who are high achievers, determined, self-critical, obsessive, and sensitive are the most prone to developing orthorexia. (Renee Mc Gregor: Orthorexia—When Healthy Eating Goes Bad, Talks at Google, 2018, YouTube) Orthorexia can be challenging to catch and treat early by both the sufferer and medical professionals because pursuing health is so celebrated and deemed so good by our culture. Friends, family, and even physicians will often admire and congratulate the orthorexic who might already be suffering but who might not know they have an eating disorder. The National Eating Disorders Organization lists on their website a few warning signs of orthorexia: “cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products), spending hours per day thinking about what food might be served at upcoming events, showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available.” (nationaleatingdisorders.org) If you suspect you or a loved one might be suffering, know there are help and treatments for sufferers of orthorexia.

The rise of orthorexia and our cultural obsession with equating eating healthy, fitness, and the physical shape and state of our bodies with goodness suggests that we have shifted our moral focus from inner qualities like honesty and modesty to outer physical qualities like eating healthy and exercising daily. However, it is important to note that striving for inner moral perfection can also wreak havoc on people. I am very fond of studying the lives of the saints, and it is evident that many of them were struggling with a destructive obsession with moral perfection, leading to brutal self-punishments. St. Catherine of Sienna was one of the rock stars of self-inflicted harm. She wore a tight belt of barbed wire under her dress and if she felt she was not as perfect as she should be, she would tighten the belt or add another ring of barbed wire. Many other saints from every world religion have also committed remarkable acts of self-mortification in their pursuit of moral perfection. A great Zen mortification story is that of a rejected follower who wanted to be taught by a famous Zen master. The rejected follower froze and starved for years outside the monastery gate. One day the master checked on the rejected follower. As a sign of sincerity, the rejected follower cut off his own arm. The master, impressed by the follower’s zeal, finally accepted the student.

I believe what is revealed both through religious self-mortification and orthorexia is something incredibly human. As we strive for either moral or bodily perfection, some of us have minds that can run away from us, and we can become consumed and harmed by what was originally a very wholesome impulse. As I researched orthorexia, I found myself moved by the survivors’ accounts and saw just how hard people strive to be good. Also, it was clear how shockingly dangerous orthorexia can become, as was the case of one teenager who no longer could eat. It was horrifying to see the video of her parents struggling to get her to eat a bite of food. (Obsession with Instagram ‘Clean Eating’ Trend Turns Eating Disorder, 60 Minutes Australia, 2019, YouTube)

Eating clean shows the world that you care about your body, which signals that you care about doing what is right. However, eating clean can also take over your life.

Jennifer Barnick is a painter and writer. She studied painting at the San Francisco Art Institute. She founded Twenty-two Twenty-eight. “One of the most exciting aspects of Twenty-two Twenty-eight is building a channel for artists and writers to share their work with the world.”

Check out Jennifer’s book. You can read the first short story for free on Amazon here.