{"id":3433,"date":"2015-03-29T21:36:18","date_gmt":"2015-03-29T21:36:18","guid":{"rendered":"http:\/\/www.lifeandnews.com\/articles\/?p=3433"},"modified":"2016-09-03T02:54:17","modified_gmt":"2016-09-03T02:54:17","slug":"orthorexia-nervosa-when-righteous-eating-becomes-an-obsession","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/orthorexia-nervosa-when-righteous-eating-becomes-an-obsession\/","title":{"rendered":"Orthorexia nervosa: when righteous eating becomes an obsession"},"content":{"rendered":"

Rebecca Charlotte Reynolds<\/a><\/p>\n

Orthorexia nervosa, the \u201chealth food eating disorder\u201d, gets its name from the Greek word ortho<\/em>, meaning straight, proper or correct. This exaggerated focus on food can be seen today in some people who follow lifestyle movements such as \u201craw\u201d, \u201cclean\u201d and \u201cpaleo\u201d.<\/p>\n

American doctor Steven Bratman coined the term<\/a> \u201corthorexia nervosa\u201d in 1997 some time after his experience in a commune in upstate New York. It was there he developed an unhealthy obsession with eating \u201cproper\u201d food:<\/p>\n

All I could think about was food. But even when I became aware that my scrabbling in the dirt after raw vegetables and wild plants had become an obsession, I found it terribly difficult to free myself. I had been seduced by righteous eating.<\/p><\/blockquote>\n

Bratman\u2019s description draws parallels with many modern dietary fads that promise superior health by restricting whole food groups without a medical reason or even a valid scientific explanation.<\/p>\n

Raw food followers might meet regularly to \u201calign their bodies, minds and souls\u201d by feasting on \u201ccleansing and immune-boosting\u201d raw foods. Such foods are never heated<\/a> above 44\u02daC, so \u201call the living enzymes in the food remain intact\u201d. No gluten, dairy or \u201csugar\u201d is allowed.<\/p>\n

Clean eaters may follow similar regimes, removing gluten, dairy and even meat from their diets. You might overhear a discussion about \u201csuperfood green smoothie\u201d recipes after a yoga class that also happened to \u201ccleanse your gall bladder\u201d.<\/p>\n

And finally, around the corner, paleo pushers may \u201cbeef up\u201d together with a Crossfit class, followed by a few steaks. Again, with paleo, there is no gluten \u2013 or any grains for that matter \u2013 and no dairy or other such \u201ctoxins\u201d are allowed.<\/p>\n

How common is orthorexia?<\/h2>\n

There is a blurry line<\/a> separating \u201cnormal\u201d healthy eating and orthorexia nervosa, but one way to define the condition is when eating \u201chealthily\u201d causes significant distress<\/a> or negative consequences in a person\u2019s life.<\/p>\n

They may be<\/a> \u201cplunged into gloom\u201d by eating a piece of bread, become anxious about when their next kale, chia or quinoa hit is coming, or eat only at home where \u201csuperfood\u201d intake can be tightly controlled.<\/p>\n

Such behaviours can have a significant impact on relationships with family members and friends, let alone on their mental health.<\/p>\n

\"\"
Under the paleo regime, steak is in but dairy is out.<\/span>
\nTaryn\/Flickr<\/a>, CC BY-SA<\/a><\/span><\/figcaption><\/figure>\n

Orthorexia nervosa is not a clinically recognised eating disorder but researchers have developed and tested questionnaires in various populations to get an idea of its prevalence.<\/p>\n

Italian researchers developed the ORTO-15<\/a> questionnaire in 2005, with a cut-off score below 40 to signify orthorexia nervosa. Scores above 40 can still signify a tendency to pathological eating behaviours and\/or obsessive-phobic personality traits.<\/p>\n

Questions include: \u201cDoes the thought about food worry you for more than three hours a day?\u201d and \u201cDo you feel guilty when transgressing your healthy eating rules?\u201d<\/p>\n

Using this questionnaire and cut-off value of 40, another Italian research group<\/a> reported a prevalence of orthorexia nervosa of 57.6%, with a female-male ratio of two-to-one. However, using a cut-off value of 35, the prevalence reduced to 21%.<\/p>\n

Most studies have been conducted in population sub-groups that may be at increased risk for orthorexia nervosa, such as health professionals<\/a>. Again using the ORTO-15 and a cut-off value of 40, the prevalence of orthorexia nervosa in Turkish medical doctors<\/a> was 45.5%, in Turkish performance artists<\/a> it was 56.4% (81.8% in opera singers to 32.1% in ballet dancers) and in ashtanga yoga teachers in Spain<\/a>, 86.0%.<\/p>\n

Using another questionnaire, the Bratman Test<\/a>, 12.8% of Austrian dietitians<\/a> were classified as having orthorexia.<\/p>\n

You can test your own tendencies towards orthorexia nervosa using this Bratman test here<\/a> and access support services via the National Eating Disorder Collaboration page<\/a> and Body Matters Australasia<\/a>.<\/p>\n

Is it a mental disorder?<\/h2>\n

Orthorexia nervosa is not listed in the American Psychiatric Association\u2019s Diagnostic and Statistical Manual<\/a> (DSM-5), which psychologists and psychiatrists use to diagnose mental disorders. The DSM-5 currently lists<\/a> anorexia nervosa, bulimia nervosa, binge-eating disorder, \u201cother specified feeding or eating disorder\u201d and \u201cunspecified feeding or eating disorder\u201d.<\/p>\n

Some clinicians<\/a> argue orthorexia nervosa should be recognised as a separate eating disorder and have proposed clinical DSM diagnostic criteria<\/a>. They note distinct pathological behaviours<\/a> with orthorexia nervosa, including a motivation for feelings of perfection or purity<\/a> rather than weight loss, as they see with anorexia and bulimia.<\/p>\n

\"\"
Under a strict raw food diet, no gluten, dairy or \u2018sugar\u2019 is allowed.<\/span>
\nMarta Gal\/Flickr<\/a>, CC BY-NC-SA<\/a><\/span><\/figcaption><\/figure>\n

Others disagree and argue that it falls in current<\/a> eating disorder or other mental disorder categories. As Bratman explained<\/a> in 2010:<\/p>\n

At times (but not at all times) orthorexia seems to have elements of OCD (obsessive compulsive disorder). It may also have elements of standard anorexia. But it is often not very much like typical OCD or typical anorexia.<\/p><\/blockquote>\n

It\u2019s clear that more research<\/a> is needed on orthorexia nervosa, including its diagnosis and potential DSM listing<\/a> as an independent eating disorder.<\/p>\n

It\u2019s also important to consider that people can move between mental disorder classifications. Sometimes labels may not be as important as providing solutions<\/a> to patients with disordered eating, such as cognitive-behavioural therapy<\/a>.<\/p>\n

Striking a balance<\/h2>\n

As a nutritionist and a recovered sufferer of bulimia, I leave you with some advice:<\/p>\n

Don\u2019t trust all-devoted kale consumers, including health professionals and celebrities, if their advice isn\u2019t based on scientific evidence.<\/p>\n

Don\u2019t make food the most important focus of your life. As Bratman says<\/a>:<\/p>\n

Rather than eat my sprouts (or kale) alone, it would be better for me to share a pizza with some friends.<\/p><\/blockquote>\n

Try to be a balanced food consumer with a \u201cmostly and sometimes\u201d mantra.<\/p>\n

\n

Rebecca will be on hand for an Author Q&A session between 2 and 3pm AEDT on Friday March 27. Post your questions about the article in the comments section below.<\/em><\/p>\n

\"The<\/p>\n

This article was originally published on The Conversation<\/a>.
\nRead the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Rebecca Charlotte Reynolds Orthorexia nervosa, the \u201chealth food eating disorder\u201d, gets its name from the Greek word ortho, meaning straight, proper or correct. This exaggerated focus on food can be seen today in some people who follow lifestyle movements such as \u201craw\u201d, \u201cclean\u201d and \u201cpaleo\u201d. American doctor Steven Bratman coined the term \u201corthorexia nervosa\u201d in […]<\/p>\n","protected":false},"author":40,"featured_media":7764,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[42,10],"tags":[],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3433"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/40"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=3433"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3433\/revisions"}],"predecessor-version":[{"id":7765,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3433\/revisions\/7765"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/7764"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=3433"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=3433"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=3433"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}