Orthorexia: Is This Eating Disorder Trend or Foe?

Leslie P. Schilling, MA, RD, CSSD owns Schilling Nutrition Therapy, LLC in Memphis, TN where she specializes in disordered eating and sports nutrition. She provides nutrition programs and presentations to teams and professionals across the nation.

In a nation full of people stricken with chronic diseases, many linked to lifestyle choices, why would we worry about those engrossed with healthy eating?  You may have heard the term “orthorexia” in the media and even in conversation. Orthorexia nervosa was first termed by Steven Bratman, MD in 1996 and published in Yoga Journal in 1997. A dissection of the phrase translates to straight or correct (Ortho), desire or appetite (-orexia) and obsession (Nervosa). Bratman suggests that the term wasn’t one so much of clinical meaning as it was a way of teasing his patients with an unhealthy fixation on their way of “healthy eating.” But, has it become our newest eating disorder?

As a nutritionist/dietitian working primarily with persons with eating disorders, I’d have to say there are two sides to this coin. Orthorexia nervosa is not a clinical diagnosis and is not in the current Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-IV. Yet this unhealthy obsession of superior or righteous consumption can lead to clinical diagnosis of an eating disorder. Time and time again, clients tell me “I just wanted to be healthier… how did I end up here?” “Here” often being severely malnourished, fearful of what we consider normal foods, and paralyzed by the thought of something as simple as eating at a restaurant with friends. When someone can no longer function in a social setting because of these issues, we may be dealing with an eating disorder. Questioning the motivation of the diet regimen may help one determine an eating disorder or orthorexia. Generally, orthorexia isn’t driven by a weight loss goal like the eating disorders, anorexia nervosa and bulimia nervosa. Nutritional purity and health is generally the driving force behind orthorexia.

According to research noted by the National Eating Disorders Association, more than ten million women and one million men suffer from eating disorders in the U.S. It is suspected that the actual number of those suffering is much higher. In a diet-minded society, it’s easy to see how this could happen. When I speak on the topic of eating disorders, I like to say “if you don’t think you’re encountering eating disorders, your eyes are not open.” It is all around us. Orthorexia nervosa may be the newest gateway to a potentially life-threatening eating disorder.

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