The Symptoms of Orthorexia Nervosa

Orthorexia nervosa is “an unrecognized psychological eating disorder in which the person becomes obsessed with eating pure, healthy and right kinds of foods to improve health.” Whereas individuals with recognized eating disorders like anorexia are concerned with the quantity of food, orthorexics care about the quality of their food. “Many researchers have raised questions about the validity” of orthorexia as an entity, but I always try to give the benefit of the doubt. A medical case report was published on orthorexia in a critical care journal about “eating disorder emergencies.” The article discussed cases of bona fide eating disorders, like a woman with anorexia collapsing from self-induced vomiting and laxative use after years of throat and rectal bleeding—indeed, a tragic eating disorder emergency. But what about  the orthorexic case? 

A 53-year-old man who had had a triple bypass two years prior went in for a check-up. His physician recommended he see a dietitian since his BMI was down to 18.5 or so, which is right on the cut-off for being underweight. Evidently, he had been eating so healthfully that he had lost a significant amount of weight. He stated that “since his diagnosis of coronary heart disease and high cholesterol, he only eats ‘natural and organic foods.’” Therefore, the author concluded, he “probably has orthorexia nervosa,” a psychiatric illness. “He clearly is preoccupied with food and judges others based on their food choices,” when, in fact, he very well may have been saving his own life. To me, the most outrageous thing this guy did was get a triple bypass. I mean imagine lying on a psychiatrist’s couch and saying: I know I could switch to bean burritos, but I’d rather pay someone to slice open my chest with a knife, maybe saw my breastbone in half, and put me at risk for stroking out instead of dealing with the underlying cause. What do you think, doc? 

Then, we learn that some orthorexics become evangelical as they share their feelings of disgust or disappointment towards their family, friends, and even children for their normal food choices.” I mean, it’s bad enough they care about their own health, but caring about their family and friends or even their children? Off to the institution you go! 

What we eat is the number one cause of death in the United States, killing hundreds of thousands more Americans every year than cigarettes, and it’s also the number one cause of disability. But, if you’re disappointed your kids are eating multi-colored marshmallows for breakfast, you may have a mental illness? Absurd.

If you recognize these so-called warning signs, what should you do? In my video Orthorexia Nervosa Symptoms, I talk about an article that suggests you should confront the person. I know it’s not easy, but if you see someone obsessively trying to avoid unhealthy foods—and, even worse, trying to get others to do the same—“the most important thing to do is to let them know you’ve noticed.” Confront them. The “possibility of helping them save their own life or get the help they may need far outweighs uncomfortable emotions.” The irony, of course, is that they are trying to save their own life and maybe yours. Imagine if you were able to talk Mr. Triple Bypass out of his healthy eating obsession. You’d probably kill him. 

To his credit, even Steven Bratman, the person who coined the term orthorexia has backed off, saying that he “did not intend to propose a new eating disorder.” As an alternative medicine practitioner, he just wanted his patients to “relax the dietary corset and live a little.” Where did people even get this idea that he was trying to “coin” the name for a novel eating disorder? If you go back to his original article, he just said he has “coined the name ‘orthorexia nervosa’” for a novel eating disorder—an eating disorder he saved himself from. “I was eventually saved from the doom of eternal health food addiction” with the help of “tacos, pizza, and a milkshake.” 

One of the directors of the Yale Center for Eating Disorders, Kelly Brownell, expressed his skepticism: “We’ve never had anybody come to our clinic with [orthorexia], and I’ve been working in this field for at least 20 years.” 

“Without research to back his theory, Bratman is simply another guy trying to make a buck off the health-conscious public, Brownell says. ‘They invent some new term, a new diet, a solution to a problem that doesn’t even exist. The burden should fall to the authors to prove that what they’re saying is correct, before they start unleashing advice on the public.’”