The man who coined the term "orthorexia nervosa" says he has some misgivings about the way these words have been interpreted.

In a March 11 post on the blog jezebel.com, Dr. Steven Bratman spoke about topics including the relationship between highly regulated eating patterns and obsessive-compulsive disorder:

Now that his term has taken on a life of its own, he's a bit skeptical. He says that while many people are probably "overly-obsessed with diet" and "should lighten up a little," those who truly endanger their health in a quest for dietary purity are probably rare.

He speculates that orthorexia could be a variant of obsessive-compulsive disorder rather than anorexia, and adds that the disorder has "a religious quality to it." He points to extreme raw-foodism, some of whose adherents teach "that the great enemy of man is the cooking stove," as an example of such religiosity.

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To the uninformed, the terms "healthy eating" and "eating disorder" sound like opposites. But as those who are familiar with orthorexia nervosa are well aware, it is possible for a dedication to healthy eating to morph into an obsession -- and a form of disordered eating.

In a Feb. 12 article on the website of Time magazine, writer Bonnie Rochman explored the scourge of orthorexia, and the arguments in favor of its inclusion as a separate disorder in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders:

When [Kristie] Rutzel first sought help for anemia and osteopenia, a precursor of osteoporosis triggered by her avoidance of calcium, her doctor in upstate New York, where she attended college, had never heard of orthorexia.

"You should be trying to eat healthy," she remembers him telling her. He couldn't quite grasp that he was talking to a health nut who believed there were few truly healthy foods she felt were safe to eat.

Her condition was eventually identified as anorexia, a diagnosis that organizations like the Washington-based Eating Disorders Coalition think is a mistake.

The group, which represents more than 35 eating-disorder organizations in the U.S., wants orthorexia to have a separate entry in the bible of psychiatric illness, the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The American Psychiatric Association, which publishes the DSM, is currently accepting input on proposed changes to the manual. DSM-V is slated to be released in 2013.

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Some psychiatrists now recognize an eating disorder called "orthorexia nervosa."

Unlike bulimia and anorexia nervosa, people with orthorexia nervosa are worried about staying healthy rather than staying thin. They make up an elaborate set of rules around eating and often end up limiting themselves to a few food choices that they do not consider harmful to their bodies or to the environment.

"While orthorexia begins with a desire to achieve better health, it's very connected to an underlying fear of food," said Dr. Ellen Astrachan-Fletcher, director of the eating disorders clinic at the University of Illinois in Chicago. "If I believe the food will make me sick, I become afraid of it, and I avoid it and, bit by bit, continue to avoid more and more food types." Such behavior can lead to becoming underweight and malnourished.

Victims of orthorexia nervosa often have trouble eating in public. In extreme cases, their main interest in life becomes their obsession with following their various food rules.

Dr. Astrachan-Fletcher and others believe that orthorexia nervosa should be treated through psychotherapy in the same way psychiatrists treat other eating disorders.

An estimated 11 million Americans suffer from eating disorders.

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According to an Aug. 16 article in the British newspaper The Guardian, a little-known eating disorder called orthorexia seems to be on the rise.

First given its name in 1997 by Dr. Steven Bratman, orthorexia has been described as a "fixation on righteous eating." Guardian writer Amelia Hill provided the following details:

Until a few years ago, there were so few sufferers that doctors usually included them under the catch-all label of "EDNOS"  eating disorders not otherwise recognised. Now, experts say, orthorexics take up such a significant proportion of the EDNOS group that they should be treated separately. ...

Orthorexics commonly have rigid rules around eating. Refusing to touch sugar, salt, caffeine, alcohol, wheat, gluten, yeast, soya, corn and dairy foods is just the start of their diet restrictions. Any foods that have come into contact with pesticides, herbicides or contain artificial additives are also out. ...

If you or someone you love is showing symptoms of orthorexia, know that professional help is both available and essential.

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Though it's not officially recognized as an eating disorder, orthorexia involves the same obsession thinking and behavior patterns as other eating disorders. Orthorexia is an obsession with "healthy or righteous eating" and often involves highly restrictive eating habits in the name of "eating healthy".

"As with anorexia, many people with orthorexia can become pathologically fixated with food, although in this case, it is with eating 'proper food'. The insidious part is that it is all done in the guise of health&As it is with some of the officially recognized eating disorders, this type of approach to nutrition begins to take over, and you find yourself spending inordinate amounts of your mental energy, time and, in many cases, resources to meet the needs and expectations of the approach."

One of the dangers of orthorexia is that a person's diet can become so restricted that, in the name of "being healthy", the restricted diet becomes unhealthy and potentially dangerous. Read more at StateNews.com.

Labels: orthorexia, causes of eating disorders, mental_health

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Those who treat eating disorders are finding a new one called "orthorexia." Dr. Michael Bratman, who named the disorder, says it is a "fixation on righteous eating."

The typical anorexia nervosa patient starves herself to appear thin, but the orthorexic restricts her food for spiritual fulfillment. Orthorexics often develop such rigid rules about food choices that they end up starving themselves. Because they restrict themselves to only a few foods they believe are "pure" enough to eat, they usually cannot eat out or shop at ordinary grocery stores. Their quality of life decreases as their food obsessions increase.

Some studies have found a link between vegetarianism and eating disorders. In a 1997 Michigan study of 107 teenaged girls, vegetarians were found to vomit four times as often, use laxatives eight times more often, and diet twice as often as meat eaters. A July 2006 study in Israel found that 85% of anorexic patients were vegetarians.

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