Are you always driven by the urge to eat a perfect diet? You could be having orthorexia, a disorder that makes you obsess over the quality of what you consume

We all know that eating healthy and minimising the intake of calorie-rich items guarantees a longer and better life. But when people become total health freaks, it can lead to an eating disorder called Orthorexia — an unhealthy preoccupation with following diets perceived to be healthy. The term Orthorexia comes from the Greek word ‘orthos’ meaning ‘proper’, and ‘orexia’ meaning ‘appetite’, coined by Steven Bratman, MD, who described it as a ‘fixation for righteous eating’. This subclinical eating disorder is characterised by an excessive attention to the quality of what one eats, to the extent of it almost becoming a cult. Orthorexics allow their life to be consumed by what they eat. Unlike anorexia, for othorexics, the quality, rather than the quantity of what one eats is severely restricted. Orthorexics are driven by the urge to have the perfect diet, while anorexics and bulimics are consumed by weight loss.

Orthorexics believe that certain edible items are impure and avoid preparations containing artificial colours, flavours, preservatives, pesticide residues, genetically-modified ingredients and unhealthy fats. They relinquish the desire to eat items with sugar, artificial sweeteners and alcohol, and distance themselves from restaurant and processed items. Any item is unacceptable unless it has been certified ‘organic’ or ‘wholesome’.

The restrictions vary in degrees, with the extreme step being people completely removing a group of items, (either salty or sugary) from their diet. They also insist on using ‘pure’ items, and by reinforcing their self-control, somehow feel better than the people who indulge. They browse healthy recipes, find healthy replacements for practically everything and micromanage preparations. Some are such fanatics that they even painstakingly make nutrient charts.

Causes

“All eating disorders stem from underlying insecurities. Being healthy, when taken to an extreme, is generally more than just being healthy. Orthorexia is initially motivated by health concerns, but there are underlying motivations, which can include maintaining a safe distance from poor health, having a compulsion for complete control, an escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through eating, and using diet to create an identity,” says Marjorie Nolan, National Spokesperson, Academy of Nutrition and Dietetics.

Misinformation

“Individuals struggling with significant life stressors and a poor body image are easily influenced by misinformation regarding nutrition in the media and are hence, susceptible to orthorexia. Misinformation leads them to the mistaken notion that they have mastered the art of nutrition with their self-inflicted dietary restrictions. The Internet fuels orthorexia because orthorexics can find websites to help support their pure approach to eating, in order to help justify themselves. Unfortunately, most of their information sources aren’t supported by evidence-based research,” says Julie Upton, dietician and author, writer and co-founder of ‘Appetite for Health’.

Impact

Clinical nutritionist and founder of Whole Foods India, Ishi Khosla explains: “If orthorexics consume preparations that conflict with their belief, they get depressed. Gradually, their preoccupation eats into healthy social relationships. Usually, they move away from friends and relatives who don’t approve of their dietary habits and gravitate towards people who have similar philosophies on eating — laced with a sense of superiority or morality.” Ms. Khosla goes on to add that an orthorexic type of personality is usually a perfectionist, a very careful, and tidy person, with an exaggerated need for self-care and protection. They are control freaks and only their diet may have a calming effect. Sportsmen, athletes and body builders are at a greater risk and both genders are equally affected.

With the surfeit in the availability of edible items and society approving of health-conscious behaviour, it’s hard to comprehend that eating way too healthily can be damaging. “Orthorexia is serious, chronic, and can extend beyond a lifestyle choice. Preoccupation with healthy eating can progress to a point where it occupies pride of place, affecting activities and interests, impairing relationships, and even becoming physically dangerous. When this happens, orthorexia takes on the dimensions of similar eating disorders such as anorexia or bulimia. It can put a strain on relationships with family and friends, as relationships become less important than holding on to dietary patterns,” adds Ms. Nolan. Treatment of orthorexia, like the rest of the disorders, requires a multidisciplinary team involving physicians, psychotherapists and nutritionists to get to the root of the problem.

Symptoms

Feelings of guilt when deviating from strict diet guidelines.

Increase in the amount of time spent thinking of edible items.

Regular advance planning of meals for the next day.

Feelings of satisfaction, esteem, or spiritual fulfillment due to eating “healthy”.

Condescending attitude towards people’s eating habits.

Apprehension that eating away from home will make it impossible to comply with one’s diet.

Distancing self from friends or family members who don’t have similar views on eating.

Avoiding preparations by people at social events, even if they are starving.

Worsening depression and mood swings.

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