Orthorexia nervosa, also known as orthorexia, is not mentioned in the Diagnositic and Statistical Manual of Mental Disorders, but was first used by Dr. Steven Bratman to characterize people who develop an obsession with avoiding foods perceived to be unhealthy.
Are those who seek the highest quality food orthorexic?
Here is the explanation of each tier above, as is published on the Pasture Prime Family Farm’s website:
- American Grass-Fed-Association [AGA] – Certified Grass-Fed. Taking the USDA standards to a higher level. Grown and produced in the U.S.A. Grass fed from wean to harvest and never given antibiotics or hormones, certified by a third party audit and farm visit every year.
- Grass-Fed – nothing but grass from weaning to harvest. Could be imported and no guarantee it wasn’t given antibiotics or hormones, not certified or verified.
- Organic – Raised without antibiotics or synthetic hormones, pesticide and herbicide free, however the feed can be grain based, and contains no GMOs.
- Grain-Fed – Fed grain at some point and comes from a large or a small farm. Animals can be confined and given hormones or antibiotics.
- Naturally Raised – Never been fed animal by-products, growth hormones, or antibiotics. Could be fed grain or grass and confined. Not certified or verified, meaninless terminology. Self-made claim.
- Natural – No artificial ingredients or added color and minimal processing. Nothing to do with how the animal was raised or fed. Even E. Coli is “natural.”
I don’t like to think that the work of our educational initiative is encouraging orthorexia. Dr. Weston A. Price observed people who only ate nutrient dense foods. That was all that was available to them. There simply weren’t any processed or “unhealthy” food for them to avoid. So why may those of us who seek out nutrient dense food rather than lower quality, industrially produced foods considered orthorexic?
Perhaps the “diagnosis” is found in the word obsession. How do you define obsession?
From the article, Orthorexia: An Obsession with Eating Pure:
“Orthorexia starts out with a true intention of wanting to be healthier, but it’s taken to an extreme,” says Academy of Nutrition and Dietetics Spokesperson Marjorie Nolan, MS, RD, CDN, ACSM-HFS, who specializes in working with eating disorder clients. “If someone is orthorexic, they typically avoid anything processed, like white flour or sugar. A food is virtually untouchable unless it’s certified organic or a whole food. Even something like whole-grain bread – which is a very healthy, high-fiber food – is off limits because it’s been processed in some way.”
“Orthorexics typically don’t fear being fat in the way that an anorexic would, but the obsessive and progressive nature of the disorder is similar. Orthorexics may eliminate entire groups of food – such as dairy or grains – from their diets, later eliminating another group of food, and another, all in the quest for a “perfect” clean, healthy diet. In severe cases, orthorexia eventually leads to malnourishment when critical nutrients are eliminated from the diet.”
Well, I completely avoid white flour and sugar. Virtually all of the food I eat is organic and whole. I don’t consider whole-grain, high-fiber food to be healthy. Read Wheat Belly and The Fiber Menace. Yet, I don’t want those of us who are deeply committed to consuming only high quality, nutrient dense food to be pathologized. Are those who keep kosher or halal dietary laws orthorexic? Are those who follow a paleo diet orthorexic because they’ve eliminated wheat and dairy?
Here is a quick self test for orthorexia. I took the test and was diagnosed with a modest case of orthorexia. “You may have a modest case of orthorexia. You may need to relax your diet standards.” I likely wasn’t diagnosed with a more extreme case because I am not socially isolated. I encourage you to take the test.
26 Responses to Are we orthorexic?
mildly orthorexia also. I think it is BS. :)
The whole thing is based on the fallacy that processed and adulterated foods are harmless or even good for you; therefore if you conscientiously avoid them, there must be something wrong with you. It is as if the test is asking you if you go out of your way to avoid eating rat poison, drinking bleach, or giving chalk dust and motor oil to your children. And yet, that is exactly what we “orthorexics” are doing!
Even with our Weston A. Price Foundation community, I have heard the term used a fair amount. When one is closer to 100% rather than closer to 80%, like myself, I’ve heard the diagnosis used. I don’t want to “treat” myself to certain foods in order to arrive at 80%. I really don’t experience it as a treat!
You ask an interesting question when you talk about people eating Kosher. I guess in some ways it is orthorexic, but then again, is it? Orthodox Jews have a community. They aren’t isolated. When my orthodox cousins visit us; they bring their own food because they know that even when we try, we don’t have kosher kitchens.
I saw a news show about this a while ago, and the people they depicted were really sick. They got more and more restrictive with their diets. I don’t think that’s always WAPers. And, I think there’s something wrong with putting a label on people who are concerned about what they eat, who want the highest quality food. Yes, if you won’t eat any meat that’s not grass fed, then there could be problems if you are going to a dinner party. For myself, I try and just not think about it when I’m out, but when I’m home, we only buy grass fed.
That said, I don’t always enjoy going out because I know the meat is going to be crap and usually the food is too, but that’s just personal preference. does that make me have a condition? Maybe we are thinking too much about this?
One other thought; I DO think that some fads are causing issues. For instance, I’m working with someone who thinks everyone should go gluten free. I think it’s problematic when you say “everyone” should do something. That also puts a lot of pressure on people. After a few years of thinking everyone should eat a certain way, I have come to realize that we really are all different and need different things.
You might think, for instance, that wheat is bad, but is it always when it’s traditionally prepared? I did read “wheat Belly,” but I wonder if a little is really going to hurt me.
Anyway, I’m not sure I’ve really answered your question, but this is an interesting topic to discuss. I’m curious to see what others have to say.
One last comment…maybe worrying about it is part of the problem! :)
Lori, I posted this “card” today that I created and some responded in the comments that they thought it reflected orthorexia and reminiscent of an eating disorder: https://www.facebook.com/photo.php?fbid=10151321321210172&set=a.165692065171.119870.165679030171.
That was the impetus for exploring the topic further here.
That’s hysterical. i’ll have to read the comments there later!
I think there comment about the questions answered “correctly” is silly. I eat healthy but I am not making myself crazy. I am making myself healthy. But according to them I may have a modest case of orthorexia. It is silly because I do eat what I enjoy which is key. I get enjoyment from my food because it tastes good.
I think part of the definition of a mental pathology is that it decreases the quality of your life. This could be someone who is avoiding dinner parties because they don’t want to eat the food, someone who stays on a diet because they believe it is the “right” diet, even when they are becoming sicker, someone who is going over budget buying “the best”, someone who would rather starve than eat an unapproved food, or anyone who is simply stressed out by trying to eat well.
I’ve gotten “stricter” on my diet, but I don’t think in a pathological way. As I’ve been able to find better foods, I really try to buy only the better foods, within my budget. I’ve also found that certain foods make me feel unwell, so I am stricter about not eating those. It’s been more or less an organic progression for me. I do think at times I have felt a little bit orthorexic, if I were to be totally honest with myself, but I’m pretty good about reminding myself to relax. Health is important, but diet isn’t the only thing that contributes to good health–finding balance in life does, too!
I think people could get a little stuck on trying to eat perfectly in a traditional foods diet, though the diet itself isn’t really strict in regards to the types of foods eaten–if fact, one of the things I love about WAPF is that pretty much all types of real food are included. I feel like I see more of this “orthorexia” among stricter diets such as paleo or vegan. In fact, when I see paleos and vegans going at each others’ throats because they each think they are eating better than the other, the term orthorexia does come to mind.
This is an unfortunate side effect of trying to be healthy in our modern culture. The most natural and healthy attitude toward eating is to just eat the way everyone around us does. Our ancestors ate the food that was available but there was some mindfulness there. However, they didn’t have to think about whether or not it was organic, or whether it was local or sustainably grown, whether the ruminants were grassfed, whether it was GMO, etc. Food was just food. But we can’t just assume that food is food today and we can’t just eat the way everyone around us does. I think the way to overcome this is through education and a gentle progression toward eliminating non-nourishing foods from our plates, in such a way that we are incorporating more nourishing foods in a way that feels natural and comfortable to us and not worrying about anything that we can’t or aren’t willing to change at the moment. I think also it helps to be involved in a community (online or in person) of people who share similar food values with a healthy mindset.
I agree that a disorder has to decrease quality of life! That’s where the obsession comes in- not just being purposeful about what you put in your body. I also agree with the previous poster who said that the view assumes that processed foods are not detrimental! Thanks for the post! I enjoyed the little self-assessment and consideration of why I try to eat better each day!
For me, there are several reasons why I eat the way I do. First of all, I feel better. I eliminated nearly all wheat for a couple years, every once in a while trying something to see if I would still feel the same strong reaction to it (joint/muscle pain and weakness, fatigue and brain fog) Usually I did. So I’d go a little longer before I tried again. Meanwhile I added kombucha to my life. My first love in the world of fermented and cultured. I also gave up caffeine entirely, other than what may remain in kombucha and decaf coffee. Then I added sauerkraut and coconut oil and grass fed butter. I’d been drinking raw milk and making bone broth for years, keeping our own chickens for eggs and subsistence fishing for salmon every year. It has been a slow and steady progression of about 20 years. Now, there is one sourdough bread I can eat periodically and still feel good. Yeah!
I love to cook and feed people and I love to eat really good food. I may be a little obsessive about sourcing but not about eating! I will eat nearly anything… as long as it is actually food that doesn’t make me feel bad and, if it is an animal food, has been raised well according to the nature of the animal, or is wild.
What I won’t eat is food-like substances, things that make me feel shitty (most wheat, pasteurized milk, most legumes) and food from abused animals. Pretty straightforward.
The test said I might have a milk case of orthorexia. I say BS, MS and PHD.
Because of the number of “correct” answers I chose, I am determined to be mild. My quality of life is vastly improved with this “mild” condition. Sally frequently mentions not to be “obsessed” with the WAPF info. That to me is the bottom line.
Yes, but how does one define obsessed? I am sure that many of us would be considered obsessed by others who can’t related to the amount of time, money and effort we extend to procure nutrient dense foods.
Honestly I’d rather have my kids want to eat good food than have the kids that I often see around me with all the behaviour issues and health issues. I don’t care about orthorexia much, the test gave me a moderate case of it. And I am only striving for 80%/20%. Some stuff I simply cannot obtain in proper quality.
For me it really is a practical thing, why should my family and I be less healthy than we could be. I’ll let them tell me I am an orthorexic, but I am simply not willing to pay the price of not being one :-)
I suffered from anorexia and bulimia for 12 years when I was younger and seeking and only eating nourishing foods is NOTHING like an eating disorder…good grief!! Avoiding and choosing appropriate, nourishing food as opposed to toxic food that wrecks your health, causes disease and sucks all nourishment from your body due to an allergy or something else is not obsessive, but smart and a good steward of your body and your families.
Wow, those questions are crazy. Modest case here.
Did you notice the comparative results at the bottom though? They didn’t show any “you’re fine” results. It was either mild, moderate, or severe. So apparently everybody has it a little. Phft, what a crock.
“You answered 3 out of 11 questions correctly.” Correctly?!? According to whom? There is so much debate over what constitutes “healthy” and these people deem themselves the “correct” ones? Ridiculous. The questions are phrased so as to make you feel like a psycho if you don’t respond in a certain way. A true test would phrase it situationally, to ascertain your natural response without a knee-jerk reaction. “Do you isolate yourself?” Who would answer that affirmatively? And the question about limiting what you eat, then qualifying it by saying, “of course, if you’re 20 lb overweight, you have to limit what you eat.” As if, anyone else should use no caution at all.
this “quiz” is a crock… i answered everyone of the questions NO which resulted in “0% of 11 questions correctly” and “a mild case of orthorexia” WTH??
I recently realized that I was, actually, heading down the path to orthorexia. The day I realized I’d been trying to eat gluten-free even though I and my family have zero problems with it. We are constantly assailed with this dietary protocol and that protocol, and nightshades are bad and grains are bad and this is bad and that is bad.
I don’t think that eating a traditional diet is orthorexic but it can certainly lead there… because I saw it happening in myself. I think a lot of the problem is many bloggers see what works for them and assume that means _______ is unhealthy, period, so then it is represented as unhealthy. So if you are an avid researcher like I am, it’s easy to just be over-informed which then causes a sort of food paralysis.
When I realized that I was going down the wrong path, it was one day when I realized I was making huge, 75% changes to our diet without even knowing if it was what we needed. I also realized I was making, for instance, gluten-free baked goods made with pre-ground, who-knows-how-processed flours and gums when I *could* just be grinding up some wheat berries in the bag that STILL is sitting in my pantry, and making some of my awesome tasty pizza crusts and breads. And let’s face the facts – no grain-free or gluten-free bread or cookie or whatever is really going to give the same satisfaction as one made with wheat flour.
I thought about how I’m so constantly paranoid about what I should be eating (this also is my internal battle regarding carbohydrates as well, since I’m overweight and in the process of losing a lot of weight) that I don’t think I’d been eating enough to fuel my body.
I thought about what I’m trying to avoid – modern diseases like diabetes, heart disease, cancers, etc – and realized that if I went back in dietary traditions even a few hundred years, I could still eat the way I actually *want to* (which DOES involve wheat) but eliminate the processed food.
I also thought about people I’ve observed who have continually declining health, and they continue to eliminate more and more foods and find themselves becoming sensitive to those foods they didn’t used to have a problem with. Obviously this is a real chicken/egg situation, but I have to question if eliminating those food groups is always a good decision.
So my decision was pretty much made, and I can’t even express how FREE I feel now that I saw with a clear mind the path I was taking and have now chosen a different path. But all this to say – I don’t think someone who avoids processed foods is necessarily orthorexic, but it definitely can lead there. I also feel we need to be very careful about how we present things to our children, because I think we can easily become orthorexic in terms of THEM.
I know a lot of people who eat a traditional diet are very scrupulous in avoiding white flour/sugar/etc and then when their kids are invited to a birthday party or something, they either cannot attend, are forbidden to eat the birthday cake/ice cream, or even worse – have to bring their own “special” food. Obviously allergies/food sensitivities need to be accommodated, but what are we really doing when we do that? Physical health is important, but the mental and emotional ramifications of setting up our children to be excluded in that sense is even worse than eating birthday cake at a party, in my opinion.
It reminds me of how, in the United States, it’s a huge ritual for young adults to get completely drunk on their 21st birthday. Why? Because finally alcohol is no longer “forbidden” and they are legally able to drink. Compare this to other countries, such as France, where it’s pretty standard for teenagers to have wine or other alcoholic drinks at home and in an everyday setting – they grow up having it occasionally and there’s no legal drinking age, so it just is no big deal.
So – I ind myself getting a bit off topic, and this is probably a blog post in itself (lol) but I guess my main point is no – eating a traditional diet is NOT orthorexic but I think it can be a “gateway” to orthorexia, which I think also applies to our children.
Bethany – what a beautifully honest comment. Thank you for your insight and candor. You have made some really great points!
Wow, I am so surprised and, well frankly, hurt by so many of the comments on here. Eating disorders are very real and very serious – not at all “hooey” or “b.s”. As a teenager I suffered from anorexia and as an adult orthorexia. Let me clarify that in no way do I think eating healthy or consuming a traditional diet means you have an eating disorder. However, in my case, I started off wanting to do right for my body and it spiraled out of control. I cannot even describe to you the overwhelming feelings of guilt that I would have if I strayed from my traditional diet plan. I began to avoid restaurants, dinner parties – basically socializing. I would scrutinize and obsess over every meal plan I made and make sure every ingredient was aligned with the traditional foods guidelines. Because this took an enormous amount of time, it consumed the majority of my thoughts. If I strayed from the natural food principles at all, I was so overcome with guilt and sadness that I was a failure and damaging my body. I felt like it was my responsibility to push the natural food agenda and if I didn’t adhere perfectly I was a hypocrite. It was absolutely horrible each and every day. I did seek out help from an eating disorder specialist and have now made it my life’s work to work with women on finding balance and happiness in their lives. My one major rule – there is no guilt about your food decisions! But let me tell you, this is very real and very serious. No, not all people who choose “healthy” eating are labeled as orthorexic. But for those of us who struggle, a helping hand, a caring thought, and an acknowledgement of our struggles mean so much.
Christine, I really appreciate your sharing and perspective. When I made my simple “hooey” comment I should have specified what I was referring to – particularly to the comment in the original post by the AND spokesperson:
“If someone is orthorexic, they typically avoid anything processed, like white flour or sugar. A food is virtually untouchable unless it’s certified organic or a whole food. Even something like whole-grain bread – which is a very healthy, high-fiber food – is off limits because it’s been processed in some way.”
I would not put my personal health in the hands of this woman – her idea of what is healthy is likely pretty different from mine. I probably reacted bluntly because I have been accused of such orthorexia, and I sincerely do not believe this is so for me. Just like because I have a profound respect for homeopathy does not make me some ungrounded woo-woo quack-believer. And I certainly have questioned these things about myself and these modalities and ideas. Which is a good thing. But what is not good is the self-doubt and the dismissal by those who don’t share my non-mainstream point of view.
Yes, I do believe that orthorexia is a valid concern and reality for some people. I recognize the potential and tendency in all of us. And I would want support and understanding for anyone suffering from this affliction. But I certainly take issue with what sounds like to me an overly broad definition of what orthorexia is, likely coming from a quite biased perspective. In their attempt to be helpful they may actually cause more harm.
I do think that people can go overboard with eating a “clean” diet. I see it quite a bit in the vegetarian/ vegan community. I experienced it myself back when I thought that I would rather die than eat any animal products. The more time I spent in nature, however, the more my black and white thinking dissolved. Over time, my diet came to reflect a sense of inclusion in the processes of nature as well as the social occasions that I value.
I still make the best choices that I can in any given situation. For example, I may eat that slice of Grandma’s apple pie, but I will choose to omit the Cool Whip on top. I use my hard-earned money to purchase foods that are high quality from companies and farms of my own choosing. My standards for restaurant or social eating are slightly lower – sort of like a don’t ask don’t tell policy most of the time – except for obvious offenders like fried food.
I think there is a balance to be had with healthy food choices. I also think that balance is very different than just throwing our hands in the air and saying it doesn’t matter. I believe that if most of the food we eat is nourishing and we have ample amounts of fermented foods and beneficial bacteria, we can let go of perfection.
That said, people all around me are achieving extraordinary health benefits from gluten free, paleo or specific carbohydrate diets. In their cases, mental health actually improves with good nutrition and even very strict attention to an extreme diet. I support them in their personal food journeys and hope that the social and psychological stresses that can come with strict eating habits don’t overwhelm their efforts to heal. I believe we should eat socially and share food. I also believe we should surround ourselves as much as possible with people who understand and respect our choices.
I don’t know if “Orthorexia” should ever be a genuine diagnosis or if it is just backlash against a growing real food movement that threatens the all-powerful food industry. I do think that we can all feel good about every positive choice we make and hopefully forgive ourselves whether we tend to be too strict or too permissive with our diets and what we feed our children. I’m thankful to Nourishing Our Children for creating a supportive community where we are free to discuss our own personal food journeys and help each other along the way.
I think the root diagnosis of “disorder” should only be used if a habit is negatively affecting your physical and your emotional health. There is an ABC documentary on orthorexia that you can watch on YouTube that shows two legit cases of orthorexia, a mom with kids and a hipster guy. The guy is terrifying to look at, he’s frighteningly thin and spends the majority of his waking hours looking for and preparing food.
Part I is here: http://www.youtube.com/watch?v=D-RinnfW52c
Some people are genuinely sensitive to “entire food groups” such as dairy, grains, and nightshades — INCLUDING them in their diets will negatively affect their health.
However, ANY “diet” can induce that negative emotional state that many people here are identifying as “orthorexia lite.” When you turn it into a war of You Vs. Food or You Vs. Your Body, and start making some foods “good” and others “bad” and giving yourself guilt trips about what you’re eating or craving or doing … that’s not orthorexia, but it certainly isn’t healthy. One reason I really love a primal way of eating is that it’s reversed many of those emotional diet tendencies for me.
[…] Of related interest, if we eliminate certain “foods” from our diet, are we orthorexic? […]