ORTHOREXIA
by Dr. Lawrence Wilson
© August 2020, LD Wilson Consultants, Inc.
All information in this article is solely the opinion of the author and is for educational purposes only. It is not intended as diagnosis, prescription, treatment or cure for any health conditions.
DEFINITION
This is a new (1997) eating disorder characterized by an exaggerated or obsessive focus on healthy eating.
DIAGNOSIS
In 2016, formal criteria for orthorexia were proposed in the peer-reviewed journal Eating Behaviors by Thom Dunn and Steven Bratman. These criteria are as follows:
Criterion A. Obsessive focus on "healthy" eating, as defined by a dietary theory or set of beliefs whose specific details may vary; marked by exaggerated emotional distress in relationship to food choices perceived as unhealthy; weight loss may ensue, but this is conceptualized as an aspect of ideal health rather than as the primary goal. As evidenced by the following:
Compulsive behavior and/or mental preoccupation regarding affirmative and restrictive dietary practices believed by the individual to promote optimum health. (Footnotes to this criteria add: Dietary practices may include use of concentrated "food supplements." Exercise performance and/or fit body image may be regarded as an aspect or indicator of health.)
Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
Dietary restrictions escalate over time, and may come to include elimination of entire food groups and involve progressively more frequent and/or severe "cleanses" (partial fasts) regarded as purifying or detoxifying. This escalation commonly leads to weight loss, but the desire to lose weight is absent, hidden or subordinated to ideation about healthy food.
Criterion B. The compulsive behavior and mental preoccupation becomes clinically impairing by any of the following:
Malnutrition, severe weight loss or other medical complications from restricted diet
Intrapersonal distress or impairment of social, academic or vocational functioning secondary to beliefs or behaviors about healthy diet
Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined "healthy" eating behavior.
REASONS FOR OUR INTEREST IN THIS DISORDER
One reason is that some of our clients may suffer from it. However, we are not aware of any at this time.
A second reason is that we may disagree that it is a disorder. Instead, we may view it as a necessary or helpful way to navigate through the junk food universe that we live in.
For example, it does cause some social isolation if a group of people whom you know all want to go out drinking beer or eating a McDonald’s restaurant and you don’t want to go along. Your anxiety, however, we would not view as an illness. We would view it as wisdom and common sense.
The question arises, Who has the real eating disorder? We would say it is those who have little knowledge of nutrition and health and therefore are swayed by advertising, convenience, taste, appearance, or some other superficial criteria that has little or nothing to do with the quality of the food they put into their bodies.
Reference:
Wikipedia has a good article on orthorexia, from which we took the diagnostic criteria above.
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