When Eating Healthy Becomes a Disorder


Orthorexia Nervosa is listed on the National Eating Disorders Association (NEDA) website as an “unhealthy obsession” with otherwise healthy eating.  When does healthy eating cross the line from a conscious effort to improve health, to a disorder? I believe the key word here is “obsession.” When your nutritional plan starts causing you anxiety and interfering with your relationships, then it would be considered a problem. A coworker once told me that he had a friend who was obsessed with healthy eating. It was to a point where their diet was causing them unhealthy amounts of stress and anxiety. However, some people choose to abstain from eating any animal products (vegan), eating meat (vegetarian), or eating grains, dairy, and legumes (Paleo) in the name of health, and I would not label it obsession. There are many more examples besides those three nutritional approaches that limit or omit specific foods. The question is, since they abstain from eating certain foods, should they be considered to have an eating disorder, and deemed unhealthy? Let’s look at the history, and the signs of this proposed eating disorder.

Steven Bratman, MD coined the term Orthorexia for obsessive healthy eating in 1997. Bratman suffered from this disorder himself. “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong.  The poetry of my life was disappearing.  My ability to carry on normal conversations was hindered by intrusive thoughts of food.  The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach.  I was lonely and obsessed. … I found it terribly difficult to free myself.  I had been seduced by righteous eating.  The problem of my life’s meaning had been transferred inexorably to food, and I could not reclaim it, ” said Bratman (from the National Eating Disorder Association (NEDA) website). Here are some signs to look for based off the NEDA Orthorexia webpage.

  • Worrying about food quality
  • Spending time focusing on food while neglecting relationships
  • Having difficulty eating a meal prepared by someone else, and not controlling what is served
  • Looking for reasons why a food is unhealthy
  • Other areas of life taking second place to following the perfect diet
  • Feeling guilt or self loathing when you stray from your diet
  • Feeling in control when you stick to your diet
  • Seeing yourself as better person because of your nutrition approach and looking down upon those who don’t eat the same

As with anything, healthy eating can be taken too far. I think there are three things to watch out for. One, thinking constantly about healthy eating and neglecting other parts of your life. Two, the creation of negative emotions such as stress, anxiety, guilt, and depression surrounding nutrition. Three, the idea that someone is superior to others in terms of nutrition, and that others are bad for making different food choices. I am not denying that this problem doesn’t exist, and it should be taken very seriously. However, I do have concerns that this idea can be twisted, and those that choose to follow a specific nutrition approach without obsession or feelings of superiority, can be labeled under this term.

I have read a few recent articles that I believe use the term Orthorexia inappropriately. Here comes a heavy dose of my opinion, and feel to disagree with me, or just skip it all together. One particular article looked upon eating dark chocolate, as a form of Orthorexia, because the author feels people are denying themselves an actual treat. I choose dark chocolate as a treat because it has less sugar than other ones, and I actually enjoy the taste. For me, I notice I can pick up on the subtle sweet taste of foods when I am eating less sugar in general. It doesn’t mean that I never indulge in any other kind of sweet treats, but I try to keep my intake of sugar to a minimum. Oops, those words right there may be considered the words of a person with an eating disorder according to the loose translation of Orthorexia by some people. For myself, I notice that I feel much better when I eat less sugar. I get sick less often and feel more energetic. It’s a pretty strong motivation to stay away from high sugar foods. My concern is that this message could be used to shun anyone attempting to eat healthier, and it could be used as an excuse to eat junk food.  I think it’s pretty clear that the Standard American Diet (SAD) provides poor outcomes in terms of health.  According to the CDC website, more than one-third of U.S. adults are obese. Obesity related conditions include heart disease, stroke, type 2 diabetes, and certain types of cancers, some of the leading causes of preventable death. A majority of people need to make some drastic changes to their nutrition, and they don’t need excuses to keep eating what they are eating. The message seems to be the same old tired message of the past, eat anything in moderation and make sure to exercise. Well, if everything you eat is junk food, exercise isn’t enough. I see it all the time. It reminds me of the recent articles that talk about the negative effects of too much exercise. A majority of people don’t exercise enough and don’t need an excuse to be sedentary. I equate making improvements in nutrition to making improvements in fitness, you have to be consistent to make progress. We have seen recent studies that show how being sedentary for long periods of time has negative health outcomes no matter how much we exercise. We need to make activity a part of our lifestyle, something we do each day, throughout the day. Nutrition works the same way. If we eat junk food consistently, there is a pretty good chance that we will have poor health and be overweight. With good nutrition, we can control our weight, reduce our body fat, and also improve our overall health. We can also get blood work to see how our body is reacting internally. HDL, LDL (including type of LDL particles), Triglycerides, Fasting Blood Sugar, and C-reactive protein levels are all things we can measure and use as a map to better health. Anyways, like i said, I’m chock full of my opinions. I think there are definitely things we may want to omit or reduce from our diet if we want to improve our health.

When Steven Bratman, MD came up with the concept of Orthorexia, I think he really just wanted to shed light on the fact that healthy eating, like anything else can be taken too far. “ I do not, and have never claimed that vegetarianism, veganism, or any other approach to eating healthy food is inherently an eating disorder! Furthermore, I entirely agree that the problem of addiction to junk food is immensely more serious than excessive obsession with healthy food,” notes Bratman on his website. As I mentioned earlier, it appears healthy eating becomes a problem when it turns into an obsession. Here are a some tips for finding your ideal approach to nutrition.

  • Keep a Food Journal (If you are not getting the fat loss results you want, identify your intake of macro-nutrients and adjust)
  • Track weight, body fat, and body measurements ( Check just one each week, remember not to obsess!)
  • Get regular blood work (HDL, LDL, Triglycerides, CRP, Fasting Blood Glucose)
  • Get tested for food allergies, or try an elimination diet to figure out what foods you are allergic/sensitive to

I hope that helps. I look at nutrition as an exciting experiment we get to perform on ourselves and I encourage you to do the same. I believe when we combine all the above tests and measurements along with identifying symptoms of food allergies, we can uncover the road map to optimal health for each and every one of us. Some people will confuse consistency with obsession, but as in all places in life, it takes consistent effort to make improvements. I don’t believe it’s a disorder to strive to eat healthy, as long as it doesn’t consume our every waking moment.

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