What is Orthorexia?
Orthorexia is an eating disorder that was first recognized by the American physician Dr. Bratman in 1997. It is defined as an excessive obsession with healthy eating. Sufferers of orthorexia have a pathological fixation on eating pure food and feel preoccupied with making the “right” food choices at all times. They avoid eating at restaurants and parties if they are not familiar with the exact ingredients of their food.
Several of my clients who are contending with orthorexia have shared with me that their concerns with healthy eating often get in the way of their having a fulfilling social life. One of my clients, Mary, sought treatment because her orthorexia was hindering her job performance. Due to the nature of her job, she often had to take her clients out for lunch. She told me that her fear of eating out was so paralyzing to her that she had a hard time paying attention to her clients, which negatively influenced her job performance.
What differentiates orthorexia from anorexia and bulimia is that individuals with orthorexia are not necessarily concerned about the quantity of the food they eat. They fixate on the quality and purity of the food. They may not engage in binging and compensatory behaviors and body image disturbance is not an issue for many of them.
Personality Characteristics of Individuals with Orthorexia
The billion-dollar advertisement campaigns by the health food industry paired with anxiety and low self-esteem are in part at fault for encouraging an unhealthy obsession with eating pure food for many Americans across the United States. However, recent research highlights the personality characteristics common to many who struggle with this disorder.
One such characteristic is perfectionism. Orthorexic people often set high standards for themselves in various areas and see life through a black and white lens. They tend to be extremely critical of themselves and others. Many of them struggle with anxiety and share similar traits with individuals with obsessive–compulsive disorder. They often have rigid thinking patterns paired with strong willpower.
My first personal encounter with orthorexia was when my close friend from college, Sarah, was diagnosed with it. Sarah and I met during freshman orientation. I immediately gravitated toward her because of her vibrant, fun, and easygoing attitude. After college I moved away, and I didn’t see her for few years; however, I followed her life through social media.
I noticed a trend where her posts changed from inspirational quotes to various articles and video clips claiming that the food we all are eating is poisonous and explaining why we need to eliminate most food groups from our diet. And every time she posted a picture of herself she appeared more and more emaciated.
When I moved back to Los Angeles, a mutual friend threw a party and invited most of our college friends. I saw Sarah for the first time in several years and I didn’t recognize her. She appeared frail and the joy in her eyes was gone.
As I was talking to her, I fixed myself a salad from the large buffet that the host had set out, with all sorts of different foods. At the end, I added some mushrooms to my salad. Sarah looked at me with surprise and asked “Are you going to eat that?” She told me that mushrooms are the most sprayed item in grocery stores and should be avoided at all costs.
The rest of the night, she continued to tell us about various health concerns associated with eating almost anything, while she was eating the food she prepared at home out of her Tupperware. She told us she got interested in healthy eating after she had eliminated gluten from her food and her bloating disappeared. Then she transitioned to being vegan, and then she slowly eliminated any food that was genetically modified, food grown with pesticides, non-organic food, and food high in grain or fat.
A few months after I last saw her, she was hospitalized for severe malnutrition due to her very restrictive diet. She was diagnosed with orthorexia and has been receiving treatment for it since then.
Orthorexia came to the media spotlight after a well-known vegan, the writer of the blog The Blonde Vegan, Jordan Younger, announced her struggle with orthorexia. She began eliminating food groups at age 14 and by age 28 she was mostly drinking green juices.
In the video clip below, she talks about her struggles with this eating disorder and what triggered her orthorexia:
Dr. Nazanin Moali is a clinical psychologist and eating disorder specialist who treats bulimia, anorexia, binge eating, orthorexia, and other forms of disordered eating in her private practice in Torrance (the South Bay region of Los Angeles County). After completing her doctoral degree, Dr. Moali pursued a post-doctoral residency in an APA-accredited training facility where she received additional training and supervision in providing evidence-based treatment to this population. Dr. Moali lives in Rancho Palos Verdes with her family.