Fatal Orthorexia

In December of 2003, I received the news that Kate Finn died of orthorexia.

Kate contacted me prior to the publication of Health Food Junkies and influenced my writing of it. Later, she gave media interviews about orthorexia, and posted an article discussing her recovery. Sadly, this recovery was not as complete as she hoped, and she later died of heart failure brought on by orthorexia-induced starvation.

In her article, Kate tells of the time when doctors diagnosed her with anorexia. She resisted the diagnosis and their recommended treatment because it just didn’t seem to fit. She wasn’t afraid of being fat. She didn’t want to be thin. She just wanted to eat healthy food. In her mind, she was sick, and therefore needed to cleanse. As a result, she brought her weight down so low it killed her.

Most often, orthorexia merely creates psychological distress and impairs various life dimensions, but does not present a physical danger. However, emaciation is common among followers of certain health food diets, such raw foodism, and this can at times reach the extremes seen in anorexia nervosa. Such “anorexic orthorexia” is just as dangerous as anorexia. However, the underlying motivation is different. While an anorexic primarily wants to lose weight, an orthorexic primarily wants to feel pure. Eating disorder specialists unfamiliar with orthorexia may fail to understand this distinction, leading to a disconnect between patient and provider.

Whatever the motivation, there’s nothing healthy and natural about starving yourself to death! If you’re obsessed with healthy diet, and yet people tell you that you are seriously underweight, please take Kate’s story to heart. You may not be anorexic in the ordinary sense, and yet what you have may kill you.

If you feel any of this applies to you, please seek help from an eating disorders specialist who is familiar with the concept of orthorexia.  Fortunately, since the time of Kate’s death, the concept of orthorexia has become much better known, and many providers and eating disorder treatment programs have learned to work with it.

Steven Bratman, MD, MPH

86 thoughts on “Fatal Orthorexia

  1. I kind of do this. Well, not exactly. I will scarf down whatever is the most convenient thing to eat at the time. This worries me, so I make sure to buy organic, nonGMO fruits, rice, and vegetables, and pasture-raised eggs, and other “superfoods” which are said to promote health and longevity. The idea is that if I make sure that the most convenient food to eat is also the most healthy food, then I won’t eat unhealthy foods much at all. On the other hand, when someone else gives me food for free, like if I’m at a family or friend’s house for dinner, then my concern over its nutritional value doesn’t matter much. I may opt not to apply their “buttery spread,” on their baked potatoes, but I’ll eat their GMO, pesticide-tainted corn on the cob, or their hormone-injected roast beef. I guess, if you were to ask me if I have orthorexia, I guess my answer would be, “depends on who’s buying.”

  2. While there can indeed be health effects to Orthorexia, the main impacts are to relationships and household finances. In my case me and my wife enjoy a combined gross income of over $100k per year in a low cost of living city, yet because of the money my wife spends on “pure food” from the most expensive stores, more than a hundred different vitamins and herbal pills, including self-injections of vitamin B, alternative practitioners” not covered by insurance – all accompanied by pseudo-medical talk of “adrenal fatigue” and “ferritin deficiency” (her RBC and HGB are fine) we are living paycheck to paycheck with no money for critical house improvements, vacations, possible new car, unemployment, etc. And the prospects for retirement (I’m 59) are not looking good.

    Not that would could take a real travel vacation because that would put my wife out of reach of the only food she will eat.

    And no, she won’t admit that there is anything wrong with her. I cannot bring the issue up all without her without a fight ensuing.

    Then there is the effect on me – I fear that my anger and rage at this situation is getting out of control.

  3. My 15 year old daughter, in her quest to become an elite athlete, started am obsessive exercise regime and progressively started black-listing more and more foods. She ate heaps – but it was mainly fruit, vegetables, meat and breakfast cereals. She was eventually professionally assessed and immediately admitted to hospital with a slow heart beat. It wasn’t until then, after she’d talked with the other girls in the ward that she told me she wasn’t like them. ‘They hate their bodies, hate eating. They obsess about calories and being thin. I love my body, enjoy eating and don’t know the first thing about calories’. It was only then that I researched the internet and discovered orthorexia.

    1. The trick is figuring out how to talk to someone who is obsessed with eating healthy food. It seems like pure virtue — and why would one need to lighten up on a virtue? It sounds like saying, “Go and steal a little. Drive drunk sometimes. Live it up!” But of course almost any virtue becomes a vice if taken too far, and that’s what happens in orthorexia.

  4. I spent lots of money on non-monsanto foods. My diet is 90% Raw. My intestinal tract broke down in my early thirtys. The only prescription medication I’ve ever taken was durning that time and burned my adrenals out. I suffered with chronic fatigue for 10 years. Then I cut out all wheat and things improved. Then i cut out all dairy that had sugar and only raw dairy when I did have it, and things improved more. Then I started to buy grass feed filet minon and eat it raw and my strength and health peaked like I was in my 20’s again. I stay away from most fish and most cooked food. I use the 2nd best suppliment on the planet which within 3 months of taking gave my body what it needed, and my adrenals healed. There maybe people who are not sufficently bright enough to understand that every gene code in our bodies requires a particular trace mineral or group of minerals for correct expression. The toxicins that are placed in our soil and on our growing food prevent to many Essential minerals from making it to the plants for the nutrition we need. There may absolutely be ocd people with this particular focus. But this is not where this will stop.This is to lable those of us who what to live health lives. My Congratulations to the Eugenisist of the U.N. on finding the perfect way to lable and discredit those of us who see what they are doing with Agenda 21 and are trying to stay health inspite of them poisening and destroying the nature of agriculture to control the poplus.

    1. Your remark IS a parody of a typical orthorectic with comorbid conspiracy theory disorder, right? Because you have practically all of the pseudo-medical quack-promoted boilerplate terminology plus a lot of the conspiracy terminology too.

      Hilarious!

  5. A lot of comments refer to veganism in some way, therefore I feel obligated to leave a few words regarding this matter. I’ve been vegan for 10 years (for ethical reasons, health benefits were a nice unexpected extra-feature :) ) and know dozens, maybe hundreds of other vegans. I think eating healthy should be the base of a consious life. But if it wasn’t for my boyfriend I would never have found this webside. Before I met him eating healthy and avoiding unnessecary toxins was normal and fine for me. I try not to use plastic bottles, but I won’t die and not even care much, if once in a while I need to use one. We buy only organic stuff, but I also enjoy eating in non organic vegan restaurants, though prefer organic if available. I would say I’m a good example for someone who lives healthy without any obsession. This I can also say for most vegans I know. Reading this comments I sadly realize, that for some people veganism is no longer an ethic choice but an excuse for obsessiv behavior. I understand now why lots of people think we just have some kind of eating disorder. Thanks (not). -.- Well, back to my boyfriend: Last month I had to see how prefering a healthy and sustainable life became an obsession to him: More and more foods went of the list, he didn’t want to fry or eat oil anymore, instead he eats… don’t ask me, he lost me on the way. This wouldn’t be a problem, you know, I also think healthy eating is essential. But it’s not everything! And that’s exactly the point! When he started to refuse my cooking, refused eating with other people, ordered only a smoothie in the restaurant while everyone else enjoys a more or less healthy vegan dish and complained afterwards how paying for a non organic dish seemed senseless to him (for the joy of eating with friends of course!?), I got scared. Not to mention the loss of weight and muscles, which he didn’t recognize as alarm sign, yet. I was scared he could become anorexic, but the symptoms wouldn’t fit. He doesn’t want to be skinny, he just wants to be healthy. Since his Asthma and his picks dissappeared in the process, he claims to feel absolutely wonderful etc., I have a hard time argueing. A lot of comments reflect the same problem with understanding this issue: Eating healthy is good, being obsessed about eating healthy is not. I don’t think it’s the right way to bring people to eat like normal people, because this is opposite from healthy behaviour. I think it could be helpfull to point out typicall symptoms, for example “if no “right” food is available, person eats nothing” etc. Anyway, thank you for this website Steven! I enjoyed reading and it helped me a lot. And thanks to all the people who shared their own stories! I hope you all will find your own way of a physically and psychologically well-balanced life-style. Lots of fun with beloved ones at dinner tables to all of you!

  6. One day I found a book that had advice on how to feel less depressed. I followed that book to the letter, lost loads of weight and felt great. I got loads of compliments. Since reading that book I’ve read other books telling me that cholesterol is bad for you, cholesterol is good for you, follow this diet, that diet, the other diet. I used to enjoy reading them, today they fill me with anxiety but still I read them, always hunting for the diet that will make me feel great. Diet can cure anything, you just got to get it right I told myself, going from one fad to another. Then it got harder and harder to eat, I had no energy, I had lost my job, possibly due to the effects one of my fads had on me, a juice diet that left me grumpy and unable to deal with stress. But its so good for you I thought, all this wonderful goodness will make my body strong and clean and stop me from being ill. It didn’t, I blamed the job and left to spend hours every day on the sofa wondering what I could eat. I was exhausted, I had brain fog, I couldn’t even look after myself. I wouldn’t eat ready meals, for some reason large packets of crisps were ok though I always felt guilty for eating them. Then I went vegan, by this time a bit paranoid that people would say it was just another diet fad, after all by this time I had already cut out quite a bit of food including gluten. I was sure that I was going vegan for the right reasons, that it was the right thing to do. Unfortunately the vegan world is full of the same messages, eat this, its good for you, don’t eat too much of that. There were people talking about all sorts of illnesses I’d never heard of before. Before I knew it I was cutting out things like spinach, soy was already evil and I was falling into the same trap again where I didn’t know what to eat and started skipping meals. Of course being a vegan gave me the best excuse to avoid eating out and when we did go out the restaurants had what I considered safe food anyway.

    So to jump forward a bit I understand now that something isn’t right though that doesn’t help, just adds to the anxiety at the moment. I have been physically ill for the past 4 years, luckily I do eat and don’t think that I’m at massive risk but I know I’m not doing my health much good with my eating patterns and it is quite distressing.

    For those who automatically think that this is a label to be applied to anyone who eats healthily please consider this scenario. Skipping meals because you are scared that the food will hurt you, cutting huge amounts of food from your diet so that there isn’t much left. When you are vegan, don’t eat meat, soy and even some of the vegetables and fruit, you will only eat fruit for breakfast, except for bananas which you will eat any time and you restrict pulses, do you think that this is a normal way to live? Is this the same as the person who goes to their local farm shop to buy good, organic produce?

    When that same person is suffering from ill health as a consequence I would say no, not at all.

  7. dear community, i’m working for a german tv station. We want to do a short report about orthorexia nervosa. Because of that reason i’m searching women who are concerned from orthorexia. We would like to get an interview and to accompany this person in normal situations of her life. If you are concerned, please send an e-mail to:
    b.weinel@picture-port.de
    thx,brenda

  8. I don’t think it’s ridiculous! It’s not about eating healthy food (which is ok), it’s about not being able eating anything apart from what you consider as healthy. My sister-in-law has never been really diagnosed with Gluten or Lactose intolerance or any other food intolerance, but meanwhile she has made up a list of ‘healthy food’ which is good for her and food that she isn’t ‘allowed’ to eat. This results in her thoughts revolving only about what she can eat and what not. Social gatherings are not possible without bringing her own food, going into a restaurant is impossible, buying in a supermarket is impossible, the food has to be organic and bio and only from farmer’s markets which is a serious money problem. Planning her meals takes up hours per day and every month she discovers new food that is unhealthy for her.
    People, this disease is not made up, it’s a serious mental problem. I try to eat healthy too, but my whole life isn’t about healthy eating, which hers is!
    And with her accepting less and less food to be ‘healthy and eatable’ pushes her into anorexia and mental problems, so this is really serious and not made uo at all!

  9. Why label people that only want to eat whole, unrefined foods? I have a too skinny friend who eats mostly junk food ,meat etc… and no fruit and vegetables.

  10. No, actually, this IS ridiculous! The examples they give are from anorexics, meaning they were NOT EATING ENOUGH! And they blame some of it on raw foodists?! Under carbed and under fed are not what raw foodism is about! Do your research before believing something an MD says… You eat MORE on a raw food diet, at least 3000 calories per day.. If these people were raw foodists then they didn’t do their homework! The reason people get obsessed is because the crap that is being passed off as ‘food’ is EVERYWHERE and companies go to great lengths and spend millions to HIDE it on the labels… it is nothing but a huge chemical mess in a convenient box, ready-to-eat to prepare your body for future expensive disease treatments. Ever wonder why so-called ‘doctors’ are never interested in finding a ’cause’? They just prescribe you DRUGS (chemicals) to cover your symptoms instead because most ‘MDs’ are in the pockets of Big Pharma… the more drugs they prescribe the more monetary kickbacks they get… ‘Orthorexia’ is a made up disease to fool ACTUAL healthy people into thinking they are sick. This guy is an MD, so he knows that the medical ‘industry’ is a BUSINESS, first and foremost, and healthy people are bad for business… If you think you are ‘Orthorexic’ and are under weight, then look up ‘Anorexia’… Don’t be stupid. This ‘disease’ is a hoax.

    1. I’m a licensed specialist in eating disorder treatment, telling you: this is a serious illness, and whether or not you want to deny it, it is real. There is scientific proof and tangible, measurable evidence. Just because you feel passionately against an idea does not make it false.

      1. While of course I concur that this can be a serious illness, I disagree that there is much in the way of scientific proof. Scientific investigation of orthorexia is limited at this time. It is certainly quite obvious that harm will be caused to people who, in the name of “eating healthy,” restrict their diet to the point of malnutrition. But harms caused by the more common forms of orthorexia are subtle and psychological, and evidence regarding this is thin on the ground. The analogy I like to use is workaholism: In extreme cases (and mostly famous in Japan), this can cause death. But run of the mill “workaholism” is simply a psychological limitation. Most orthorexia is like this. Workaholism is also a good analogy for how healthy eating can be a problem. It is normal and healthy to have a strong work ethic, but for some people this goes to far and other dimensions of life suffer. Similarly, it is normal to want to eat a healthy diet, but some people focus so much of themselves on this that they neglect other aspects of being alive.

  11. I think people are all too willing to confuse or lump together orthorexia and anorexia, despite its clearly defined differences. I started out over 10 years ago going vegetarian, my initial go was to lose weight; I lost 10lbs. Later I went vegan and lost another 10lbs. Then my focus shifted a bit to healthy eating for healthy eating’s sake. I went organic. Then I stopped eating anything out of a can or plastic due to BPA. Then I stopped eating hexane-processed soy. Then I wouldn’t eat fried foods. Then I wouldn’t eat processed, preserved, or food-dye containing foods. Then I refused to take medications or OTC products. Then I switched to only all-natural organic bath & body care products. Then I sold all of my clothes and bought only organic fair trade clothing. Then I became vitamin-obsessed. Then I tried juice fasts and cleanses. Then I went gluten-free. Then I went soy-free. Next I’ll probably try raw or sugar-free. I can’t stop, and I’ll always find another level that’s better than where I’m at. It’s not just about food for me, I’m not sure if this is the case with anyone else. I’m still overweight for my height, I don’t think weight is my primary motivation… after all, I only ever lost about 20lbs in all of this time with my healthy eating. Part of it might be that I feel so unhealthy being overweight and having the many ailments I suffer from right now (hypogonadism, hypothyroidism, fibromyalgia, plantar fasciitis, tennis elbow) and I desperately want control over some part of my life. I definitely feel this absolutely need to adhere to strict guidelines as to how I eat, what I buy, and what I’ll put on my body too. But would I change it, or opt for treatment if I fall under orthorexia? Probably not. I think my life choices though limiting are healthy ones that are better for me and the planet.

    1. Jenni, if you’re suffering from all those disorders, what makes you think that the way you’re eating is healthier for you, let alone the planet? At one time, I felt the way you did: I built a strong identity around the (false) idea that I was eating healthy, and engaged in every new vegetarian food fad that came along. When health problems came up, I couldn’t acknowledge that my restricted eating was part of the problem, or at least that finding some exotic new “miracle” vitamin wouldn’t cure my ills. I suffered from narcolepsy, my hair was falling out, my nails were brittle, and I lost all muscle mass, though I was not thin.

      After I went on a weight-loss diet that included going back to eating meat, I found out it was my restricted eating that had made me sick. I now have more energy than ever, since I’m getting enough complete protein to function again. Little by little, I’m adding back foods I haven’t eaten in years for one reason or another, and I’m enjoying life again. Even made a little money by selling off my juicer on craig’s list.

      Like I did, I bet every orthorexic believes they have “woken up to the truth” about healthy eating. (As we can see from other comments on this page.) I still have some eating-disordered vegan friends who tell me how they are now so aware and could never “go back,” as if these wacky diets make them enlightened. They don’t. They make people sick and crazy.

  12. I was diagnosed with type 2 diabetes 11 months ago so stuck to a non-fat, no-sugar, low-carb diet and lost over 45% of my body weight. I am 2 stone lighter than my GP’s target weight and still going. I have been diagnose with OCD so I acknowledge a connection there, merely to be in control of my eating habits and my diabetes. I rigidly stick to rules and advice and maybe, in this case, have taken it too far. I dropped from size 24 to size 10…and even 10 can be too big! But I get lots of complements from work and this spurs me on. My husband also likes the boney me. However, some colleagues have told me to stop losing weight and my GP and shrink have jokingly put the word ‘anorexia’ out there. I just fear having diabetic complications caused by obesity and high blood sugar levels and prefer to be in control. I do suffer with depression and so being in control is very important to me, especially if the reward is a better body, better health and positive reinforcement from friends and family.

    1. Julie, I’m not sure it’s emotionally healthy to base your own self worth on the compliments others give you. I very much understand how good the positive feedback others give feels because you’ve lost weight and your body is “a socially acceptable” size. Okay, that was a little sarcastic, I’m sure you are healthier being the weight you are, but please consider the idea of being a healthy weight; for you, not for anyone else or to improve anyone else’s opinion of you. Be healthy and live your life to the fullest.

  13. Of course people are going to criticize orthorexia. They don’t know what it’s like until you actually go through it. I have dealt with it for the past year and it’s not fun, at all. I’ve lost so many friends in the process but the eating has taken over my life. I can barely go out to a restaurant and if I do go, I have to make a ton of substitutions. I would love to one day be able to go to a restaurant with friends, and order whatever I want, no matter how healthy or unhealthy it is.

  14. Yes it is all too real. Orthorexia really describes a way of food restrictiing that can be disguised as just being healthy. This healthy eating obsession takes over the persons life and ends up controlling them. I too have personal experience with this. My 21 year old (now)daughter was able to come from the brink of death from anorexia almost 3 years ago and with much help to gain over 20 pounds….this may sound like recovery, but she is so obsessed with eating clean that her entire life revolves around meal prep (and working out). She has been unable to go to school or work, let alone eat out or go out with friends or go on a trip or have a normal life

  15. Hello

    This is very real and I have a 10-Year old daughter in the early stages of this and we are struggling to understand this obsession at such an early age.

    I am reading as much as I can without driving myself mad and ‘most’ of the comments made have been very helpful.

    Thanks.

  16. it is very real.

    i started eating healthily after having my son. i became obsessed with it, partly because as a single parent i wanted to guarantee my longevity so i would be there for him. as the obsession grew, i found i was isolating myself from my friends as any event or gathering that did/might involve food would induce panic, as if even being near unhealthy food would somehow negatively impact my health. i didn’t care about being thin. in fact, i didn’t even own a scale. but when i went into the doctor for a routine physical, i got grilled and sent to a psychiatrist. i was 5’8″ and had dropped down to 100 pounds.

    i was diagnose with ednos (eating disorder not otherwise specified) and then he mentioned a new term… orthorexia. my md had said i had all the earmarks of anorexia, except i wasn’t obsessed with being thin. i couldn’t relate to the wanting to be thin part. and many things anorexics do, i would shudder at (diet soda, artificial sweeteners, lots of coffee, laxatives, drugs to speed the metabolism, etc.). orthorexia on the other hand made sense.

    i consider myself very fortunate that i had worked with a psychiatrist who didn’t drug me up, but helped me understand the root of it and–more importantly–gave credence to “orthorexia” as something very real. it literally saved my life.

    obsession/addiction to anything, even something considered healthy, is never a good thing.

  17. I don’t understand why the candida issue was casually mentioned. That was likely the cause of Kate’s problems and death. I know, I had it and I know someone who died of it. At that time the medical establishment did not “believe in” internal candidiasis. (FYI- this was also before MOLD inspections became a requirement for houses—that’s how I got it). When you know something is wrong with you and no one can “find anything” you DO become obsessed with eating healthy because you know you have to cure yourself since no one will help you. I had 23 rotating symptoms- I made a list and my doctor didn’t even LOOK at it.He prescribed antibiotics for a “mixed sinus infection.” I am not an idiot, but he was. If I had taken those I could have died. That’s what happened to a man I knew– they can’t diagnose it because they refuse to acknowledge that a little fungus can wreak inner havoc on your intestines. And FYI, a person isn’t “obsessed with eating healthy” if they regularly eat ice cream, cake, etc. That was probably the “yeasties” in her gut giving her intense cravings for sugar to feed them vs. her mind telling her she should eat healthy. It is too sad. I luckily found a book in a library (it was the 90’s) that provided the word “candidiasis” and listed the symptoms. I then went to a naturopath who helped guide me through a regime of low carbs, no sugars, cleansing herbs and acidophilus. It took me about 8 months to get over the whole thing, and I have never been sick in my life before or since then. I found a giant patch of black mold on my bedroom wall behind a tapestry and I am 100% certain that is what caused my illness. I had blood tests done and went to 3 different doctors – nothing. I think one Diflucon pill (given for female yeast infections) would have knocked the fungus out of me – but I had no one to give this to me. I am lucky to have persisted in seeking health and self-healing and very thankful for the assistance of the naturopath who confirmed my suspicion of what was going on with me. I tell people this story because I learned/confirmed at that time to trust my instincts and my body and I lost ever more faith in the medical establishment, particularly after “Porky” died from the same damn thing about 2 years after I had it. It’s wrong and scary, and I shudder to think of how many people have died because of the denial of the medical world of such a very simple, very testable, easily fixable problem. I know they finally acknowledged that black mold is very bad for your health. I hope they have figured out some other things. Good luck, all.

      1. Yes, actually, it is… if you clicked on the link to Kate Finn’s article. In it she wrote about her history w/ food and it’s mentioned that she had overgrowth of bacteria and yeast (candida) in her intestines. Although she could be being dishonest about trying to gain weight and wasn’t actually eating enough calories, I’m wondering if she did have some issue with her intestines or her immune system such as a chronic infection.

        Although you have to keep track of how many calories you eat on a raw food diet (to make sure you get enough), from the way she writes it sounds like she was. It’s hard to tell though since it’s from her perspective.

        …And I’m about 2 years late with this post. Oh well, I just found it interesting.

  18. I’d just like to thank the author of this website for participating in continuing to destroy the human psyche through fear mongering bullshit like this and being in cohorts with big pharma to push the next therapy, vaccine, medicine, poison, etc and for also taking advantage of the “victim-minded” who just love to eat this shit up so they have yet another thing to identify with and be victimized by. One day mankind will wake up to this crap and when they do, I hope they hold scumbags like you accountable for the hundreds of thousands of lives that are lost each year due to iatrogenesis.

  19. What you all are speaking of isn’t someone obsessed with healthy foods…. there is nothing wrong with eating completely healthy… what you all are talking about is people that have phobias and are fanatics about an idea they have. This entire thing should be completely restructured and reworded!

  20. i’m really glad somebody addressed this issue, as here, in central europe, i feel like i am in an epicenter of a pandemic. “Bio” and “Organic” is experiencing a marketing boom and it kind of bothers me not to be able to invite many of my friends over anymore, because not only they will not touch the refreshments, they will provide a lengthy bitching. What really hurts though is to see pale and surpressed little children who will not be given normal food and parents who will not be reasoned with. I myself grew up a hostage to a mother who was, and still is paranoid about “unhealthy” food or even water. Needless to say health consequences are quite dramatic on both sides.

    Just like physicians (over here) are very often uneducated about your common eating disorders, orthodox picky eating can go undetected for decades in a patient, who only ends up seeing more doctors, as the body keeps deteriorating.

    Well done, Dr. Bratman!

  21. It’s really sad to see the comments that attack the idea of orthorexia as a legitimate problem. Especially when their main arguments are nothing more than made up theories about doctors, the govt, and corporations all working together to keep us from eating healthy. Please ease up on your paranoid accusations people, the author has a good heart and good intentions. Personally, hearing that this a common recognized condition has been very enlightening, and even comforting.

    I know and love an amazing young woman who has suffered from this condition for many years. She’s under 90 pounds and is constantly told by strangers that she needs to gain weight. She’s been plagued with a variety of mysterious health problems, sometimes going to the ER several times per month. All the while she sticks to a very regimented diet – almost entirely “raw” – and preaches about how healthy and pure it is. She looks and feels unhealthy but refuses to listen to the advice of everyone around and change her eating habits.

    It is absolutely a psychological issue. She admits to a life of ocd. But she also believes any and all of the seemingly infinite books and articles touting the ‘spiritual’ benefits of eating raw and vegan foods. Unfortunately those same (well intentioned) books also throw all of western medicine and psychology into one category, “unhealthy and unpure”. So it’s been an impossible struggle to get her help. She’s all too willing to go to ‘alternative’ doctors who claim they can heal her and she can keep her extreme diet. Years and thousands of dollars later and nothing’s better.

    It’s been hard on not only her, but her friends and family too. We have tried so many different ways to get through to her. It’s definitely a psychological issue. But it’s comforting to know that others have been through the same thing, some successfully. If nothing else, putting the label ‘orthorexia’ on this phenomena at least helps the victims and friends and families find others who can relate. Thank you for posting this site.

  22. I never heard this Orthorexia before but I am sure this post can educate people on how to prevent this thing. I’ve pitied the girl who died but of course that is life. Thank you anyway for posting.

  23. I don’t like labels, orthorexia is a label. What you have is a fear. Stop being afraid, eat healthy but do not be afraid, you don’t have control over your life! Don’t expect to have control, just live each day like your last day or two…… love yourself and love everybody else. Just love, be hopeful, and eat a pizza today, right now! You will feel better! If you are afraid that means you’ve lost trust in your destiny, your family and friends and your entire environment! Eat healthy but all you do do it in moderation not obsession! So what if you will get cancer and die who says that your life in your body is all you get! Do not identify with your body and your mind. Your body is a temple but your temple needs moderation, excess leads to less of something! That is the law of nature my friend! If you focus too much on something you decrease your access to something else!
    If you want to cure yourself let go, take all those books to the library and donate them, stop searching the net non-stop, eat well but be wise. If they put fear on you and you engaged in listening to them, let go of that for a while and see what happens! You have control over your life when you enjoy life not when you are fearful! If you are fearful something is wrong and you need to stop spending money! Stop spending money on others, just go home order a nasty pizza and give yourself a brake, watch a movie too, you’ll have less hell!

  24. I strongly believe Steven Bratman M.D. because:

    1. I live with someone who will starve himself if he doesn’t have pure foods available to temper his hunger.
    2. Does spend a lot of money only on super pure foods
    3. Does fasting way too much and also pumps water up his ass way too much
    4. Obsesses with going to Gabriel Cousens’s Tree of Live that costs thousands of dollars for vacation instead of spending time with loved ones somewhere else (ya suckers like this one make suckers like you raw food-ists and vegan purists rich
    5. I lived with healthy foods before coming to America, it is a right to eat healthy you are right but not with the price of fear induced bullshit that you all such money making fantasists do before you read your biochemistry books
    6. This country faces an epidemy of paranoia on many many levels, you people do not trust each other anymore and I don’t blame you, you all contributed to policy making that supported such monsters like Monsanto
    7. Fear is a challenge and people fear cancer and other forms of diseases, this disorder happens among those educated and privileged because you can afford it and because you people don’t know what it means to have less, should you worry less about yourself and focus on others your compulsive obsessions will decrease, lets put it this way , you could be hit by a car tomorrow and die before you realize that your pure foods will not purify your hearts and spirits!!!!
    8. You need to be in control of your life, be honest and try to connect to others in sincere meaningful ways and you won’t suffer of starvation in your soul.
    9. Stop buying and reading all those fancy books that will tell you the horrors of the food industry. Cardiologists, oncologists, pediatrists etc etc do save lives too! There is no perfect world and your ORGANIC food is not 100% organic, never in this country I tell ya for sure! Eat and have fun and you will live like all those other old people you see in assisting living home, the ones that you don’t have time to spend with!
    10. Be loving in your heart and don’t starve yourself because of paranoia, they make money off you! Eat and live, don’t eat to live!

  25. I am Wilhelmina, living in Sweden and suffering from orthorexia, my husband is battling against anorexia. It’s a nightmare. 2 months to go until Xmas and now we are afraid already for the family invites to have diner with them. What excuse we come up this year NOT to have diner with them? We simply can’t eat with others, we can’t eat at others, not knowing how the food is prepared, but most likely to our opinion too bad, too unhealthy. I am seeing doctors, therapists and a dietitian, at least 2 to 3 appointments a week. All the money we saved with not eating I have to spend for medical care. It looks like I got pre menopause, but no such thing. I messed up my total hormonal balance with a poor diet, living in the end only from oatmeal, chicken and apples. I am too tired to exercise at the moment, no energy left. But I am ready to fight the battle against this horrid eating disorder. It’s not worth it, the pains, illnesses etc day in day out all because I wanted to loose 2 stone. I wanted to be more healthy not dying a early death because my diet became too much of an obsession.

  26. The problem this woman had was with a phobia that expressed itself in her eating habits. These phobias can express themselves in many ways but are basically the same diagnosis. That’s what I hate about all these specialized little diseases that they have a name for to pigeon hole people with to create more phobias and send pharmaceutical companies more money. Because, as we all know, they’ll come up with a magical bullet to alleviate the symptom while the deep seeded problem still persists. No wonder I take responsibility for my own health and stay as far away from medical main stream as I can. The medical industry preys on the uninformed and set themselves up as the final authority. Sad state of afairs this country has come to.

  27. Having some OCD tendencies myself, I can well understand how this could be a disease and a very destructive one. Imagine someone who starts by cutting out red meat. Then they cut out dairy. Why stop there? Better avoid all canned foods since these often have added salts. Let’s eliminate soy too, since there are some indications it might be harmful. Enough of these restrictions and one is reduced to eating nothing but spinach leaves and apples, and even those must meet rigid standards of how they’re grown before they’re allowed to pass that person’s lips. Sure, spinach and apples are healthy foods, but they’re not enough for survival. One also needs proteins, fats (yes there are essential fats that we can’t live without), and even some amount of sodium for basic subsistence. It’s like the classic OCD person who washes his hands over and over and over, eventually withdrawing from life entirely as the fear of contamination becomes more and more overwhelming. There’s nothing wrong with washing hands or eating healthful foods, but anything can be pushed to such an extreme that it destroys one’s life.

    1. Thank you, Robin, I couldn’t agree more. I suffer from orthorexia on and off myself, if it wasn’t for my lack of willpower on sticking to this way of life, I most probably wouldn’t be here now. Kate’s story along with yours and some other intelligent comment have helped me realize that it’s rather healthy to concentrate on others around you (family, friends) more than yourself, “eating and living” rather than “eating to live” will keep the food related obsessions at bay until these become a thing of the past. Pure and raw food is great to a certain extent, cooking makes it easier to digest and process for the body. We just have to be sensible making sure we’re consuming enough calories and a balance of fats, proteins and carbs as well as vitamins and minerals. Purifying diets and fasting are an extreme shock to our system and if really insisted, should always be supervised. I believe that by focusing on making the most of every day, not being too hard on ourselves and by trying to recognize the reason of being obsessed, then analyzing it objectively, WE CAN COMBAT ANY OCD!

  28. Actually, no, not everyone does. Or, rather, for many people, that may not be the #1 priority. Artists may care more for their art, lovers for their beloved, leaders for their country, etc., etc. And people with anorexia very often want to feel thin far more than they want to feel pure — they may use diet drugs, for example.

    1. Doesn’t everyone want to lose weight, too? Push that to extremes and it’s anorexia. Doesn’t everyone want to be rich? Push that to extremes and one becomes a lonely miser, wasting away in the basement. It’s not that these basic desires are wrong. It’s that — in certain people — they can lead to obsessive behavior, robbing that person of the richness that life has to offer. If pushed far enough, any obsessive behavior can lead to death. Even obsessive hand washing could lead to death if one can’t stop for long enough to take care of one’s necessities.

  29. I think the important thing to focus on is the mention that it could be associated with OCD. When someone gets to the Orthorexia stage, the need to control the food that goes into their body is the compulsion that OCD causes. I have learned that OCD is manifested in many different ways for many different people. Since this compulsion involves food and can affect the amounts or proper foods someone consumes and it could potentially starve them to death it’s also categorized as an eating disorder. I can understand why some health professionals can and would mis-diagnose this so it’s important for those around the obsessor to step in and advocate for their well-bein. It’s sad to think that some people here are so insensitive and uneducated that they can’t see it.

  30. I have recently come out of a long and loving relationship with a wonderful young woman who I very firmly believe suffers from this exact condition combined with OCD and an exercise compulsion. The amount of unrelenting, crippling stress and anxiety it continues to place on her, and to a degree myself as I tried to support and understand her over the 4 1/2 years we were together, is impossible for me to encapsulate in a few sentences. It is distressing and frustrating to see someone go through this as they strive to do the best for themselves in such a self destructive way. Up until now I believe every health professional has misunderstood her.

    I’m not surprised, but I am disappointed that some people have dismissed the notion of Orthorexia, (very rudely in some cases here). I can assure them from my personal experience it is real and the cause of misery and physical debilitation. Dr Bratman should be supported in his endeavours to help sufferers and I applaud his efforts.

      1. GRP… I am so happy to have read the words of a supportive partener. Mine has been very supportive even though he had no idea what was going on.
        I have been dealing with this now for quite some time and have only discovered recently the term Orthorexia. Anorexia and exercise compulsion were the closest I had before but it just didn’t fit completely. I have done a number to my nervouse system and my adrenal system has now shut down. I am no longer able to move (run and train) because my system has completely shut down. My obsession with doing the “healthy thing” and the “right thing”. (eating right, exercising regularily, being a perfect mom, wife, teacher) has lead me to complete and utter exhaustion. Now I am searching for the why’s. Because I was doing everything right!!!! RIGHT!!!!
        NOPE….. I was not and now I will have to take many many many months to undo the years of what I thought was healthy. So to you all that think this is a money making scam or that this is part of the big pharm…I am so happy for you that you are not sick like me. For me… I am happy that there is a person or two out there that cares about people like me.

  31. Can’t help but wonder if the people promoting this idea are in the pocket of Monsanto & other producers of manifestly unhealthy food-like substances.

    1. I think I’m going to put together a page just for hatemail like this. Some of it is really quite funny!

      Just for the record, I don’t get funding from anywhere. My book stopped selling 10 years ago. I don’t go around getting paid for speeches on orthorexia. I don’t treat people with orthorexia. I just keep this website up in hopes that some few people find it helpful.

      1. I’m glad you’ve kept this page up. I work for food service in a women’s dorm at a major university. Part of my job includes providing nutrition info cards for the kitchen staff to put on the serving line, and putting up posters that are intended to inform students about “eating right”. I don’t believe for a moment, that very many of these young women actually understand anything about proper nutrition, they just have vague ideas from mixed sources. Listening to some of their comments on the serving line can be disturbing.

  32. It seemed like a crock at first, but that’s just how it’s been presented in a few places.

    It’s NOT an obsession with HEALTHY foods – it’s an obsession with what the sufferer considers the RIGHT foods.

    It’s a bit of perfectionism. I probably have a touch of it myself, but not a whole lot.

    Example: I avoid white bread and cut my portions of white pasta down when I remember. Why? I find that my belly gets a little squishy “bubble” a few hours after I eat that – and it stays. But when I eat 100% whole grain (not just “whole grains” – that can be a mere 51%) – the bubble goes away. The effect on my body is pretty instant. It’s probably the white flour soaking up fluids causing the bubble, whereas the whole grains don’t soak up as much – just as whole grains take a little longer to cook. Not really sure – that’s just my self-observations.

    If there are two choices, I TRY to choose the heathier option, and when I don’t, I actually feel yucky about 45 mins later. Not everything, mind you. I like hot dogs – I don’t eat them much but I enjoy them when I do. But if I have a regular McDonald’s burger, I feel empty, bitter and crabby about 45 mins later. Their 1/4 pounder DOESN’T make me feel bad though – but I suspect it’s more pure beef, or less fat, or something.

    Does this make me orthorexic? l dunno. I eat foods that make me feel good that have some justification of health benefits in my mind. I love extra sharp cheddar cheese. Justification? 1) Protein 2) Milk Fat (was it that?) can help curb hunger (a “Prevention” article a few years back) 3) I get phlemmy coughs from regular milk but not from lactose-free milk or cheese 4) I get a “charge” out of sharp cheeses like some people get with chocolate. (endorphins I guess).

    I try to get my facts right about food to make up for the bad stuff I eat/drink. I like sweet ‘n low in my coffee and love powdered non-dairy creamer. So to make up for the 100% transfat/candlewax substance that I like in my coffee, I try to eat monounsaturated fats and fish oil tabs at least a few times a week in hopes that they’ll clean the nasty creamer out of my bloodstream.

    Plus, I avoid sugar because when I cut the sugar out of my coffee about four years ago, I lost 30 lbs in six months. Stevia’s too expensive but my favorite. Sweet ‘n low is much maligned but works just fine (I don’t have picky taste-buds).

    So I’m a walking contridiction. I smoke cigarettes yet I do aerobic exercise. i feel guilt when I eat the “wrong foods” but then make up for it by having a salad or fiber or something.

    So do I have orthorexia or does my hypocrasy make me a normal human being?

    Ken, Naples, Florida

  33. No MelanieD, actually he has it right. However, what he forgets to mention is these people who are truly obsessed with “eating healthy” quite often forget or cannot see that they are not really eating a balanced diet or what they need to support all of their bodies and systems. This just addresses those who are manic obsessives about “healthy foods”. Like someone with OCD, being manically obsessive can kill you no matter what the obsession.

  34. It’s just a way for this “doctor” to make money from his book on this “disorder”. It’s sad that people will do anything now just to make them money. I’m hoping this “disorder” does NOT make it’s way into the already too expansive, DSM.

  35. MelanieD,
    You do realize he’s talking about someone potentially staving themselves to death due to an OCD like obsession with eating specific foods, not drowning themselves in too much broccoli, right?

    Please return to the bridge which you live under.

  36. It’s ok, MelanieD. I’m sure there is help for the disorder you have of making judgments without having any knowledge of the subject at hand. I don’t find a person’s mental anguish or death to be ridiculous in the least. Lack of empathy, however… completely ridiculous. And yes you can get sick from breathing too much air; are you the last person on this planet to hear the word “hyperventilation”? You can also get sick from breathing too high a concentration of oxygen. But I guess not understanding physiology makes you the smart one.

  37. I know someone who suffers from orthorexia, and he loses weight like crazy yet just wants to eat healthy. It’s not ridiculous, it’s real. And it’s scary to watch a friend go through it, not being able to eat with his friends when they go out because he is so afraid of eating unhealthy foods. He has been trying to kick this disorder, and he has even expressed extreme dissatisfaction with his low weight. People with orthorexia need support, not criticism.

    1. Our society has gotten so accustomed to our terrible diets that they want to label us that want something better. I have a friend that only drinks soda and he eats meat , dairy etc… He does not eat fruit and vegetables. he gets very little fiber. He is very skinny. I can’t help but question the motives for such a general label. I think that we have too many food choices( the majority of which are not real food). I believe that too much emphasis is placed on food. The main purpose of food is to nourish our bodies. There are too many restaurants and too many chefs.

  38. This is absurd. I bet the finding of this ‘disease’ was helped by gov’t funding. Why not just call it healthy eating disorder? Throw in some Latin and it sounds legit. America is waking up to this bullshit…not all of us are dumbed down.

    1. Absurb is right! Check this guy’s creditials…he’s probably on the board of directors of Monsanto or just another evil illuminati member that will stop at nothing to make the rest of us sick, dumb, and reliant on big pharm! Monsanto, the federal government, big pharm…one big happy family that wants to keep us down.

  39. I happened to come by your website, by reading an article in ‘the guardian’ UK newspaper titled ‘healthy food obsession sparks rise in new eating disorder’ http://www.guardian.co.uk/society/2009/aug/16/orthorexia-mental-health-eating-disorder where they state that ‘sufferers’ tend to be over 30, middle class and well educated.

    Could you confirm these findings? as I am in this bracket and avoid eating all the foods mentioned in their story such as diary, soy, caffeine, wheat, sugar and salt. According to the Wikipedia explanation I am a ‘sufferer’. But you know, I have never felt better :) since I moved to a healthier diet. So how can I be a ‘sufferer’?

    Judging by this article in the guardian, I should seek help for my ‘eating disorder’. You know Steven if you continue to invent diseases people will become more and more paranoid and that wont help anyone or maybe you don’t want to help people, maybe keeping people paranoid is good for business. You tell me.

    You might have intended that this ‘eating disorder’ be highlighted for the most extreme cases, but now its in main stream media and people such as myself are being labeled as having this illness. Let me say again, I have never felt better and its not right that people who choose a healthy diet be labeled ‘sufferers’. I hope to hear from you.

    1. You wrote, “You might have intended that this ‘eating disorder’ be highlighted for the most extreme cases, but now its in main stream media and people such as myself are being labeled as having this illness. Let me say again, I have never felt better and its not right that people who choose a healthy diet be labeled ‘sufferers’. I hope to hear from you.”

      This is a good point. I certainly wouldn’t label you anything! As you may know, it’s difficult to control what the media does. Pretty much everything anyone says gets tossed about and misused! I’m sorry if such misuse of the term has been a problem for you. I’ve been quite consistent myself in not supporting such things.

      Nonetheless, I do think some people get too obsessed with healthy diet. Since almost ALL media attention is in favor of healthy diet, a teensy bit of energy in the opposite direction is not really a terrible thing. Everyone gets labelled one thing or another. There are a lot worse things one can be called than, “orthorexic!”

    2. I’m pretty sure you have no idea what you’re talking about. You may eat healthfully but not have this disorder. If YOU are really not eating all of the things you listed for your health, you are not nessisarily orthorexic. If you obsessed and refuse to eat at all when presented with things containing unhealthy materials, you are becoming obsessive and that can lead to becomming orthorexic. I feel like you don’t get that orthorexic people are obsessed with healthy food, to a point when it leads to extreme weight loss, unability to consume “unhealthy” foods (or food they find unhealthy), and an obsession with feeling “light” and “pure.”

  40. Maybe so Melanie, but not in this case, I think. I am orthorexic. My orthorexia is not caused by a desire to feel pure. Mine is caused by the fear of pain that occurs when I don’t stick to my diet. And while I’m still a bit rounder than a fashion model, before pain eliminated potatoes and rice from my diet, I was easily 30 pounds (make that 25%) over the recommended weight for my bone structure and height.
    Even though periods of relative inactivity combined with high density foods might bring my weight up from time to time, it is gradually dropping, over all. It is scary to think that someone could willingly “purify” themselves to death.

    1. My concern lies here. How does one draw the lie between an unhealthy obsession with diet for unhealthy reasons, and a vigilant diet for health reasons? Celiac disease, diabetes, a variety of food allergies and certain diets for autoimmune disorders all could result in an appearance of Orthorexia.
      There have been people with Celiac disease who sought help dealing with the emotional impact of the diet sent into depression after retriggering symptoms when a well meaning therapist told them they were being too strict and it wasn’t healthy.
      I should think that the unhealthy avoiders would be the ones who make exceptions when they really want to, or who change their stance frequently and completely (milk is evil one week, the next raw milk is essential to good health and soy is the enemy)

  41. I don’t think this is ridiculous at all, and I don’t think he wrote this just to make “abuck.” I can competely see how this obsession with healthy eating could lead to malnutrition and death. I’ve had food addiction and obsession problems in the past, and I know it’s so easy to get pulled into that trap if you have low self-esteem or control issues.

  42. I am afraid, Melanie, it is not ridiculous and empty words. I have just learned today about the definition of a condition I have for 2 or more years. However, my case is a bit distinct. Although I lost weight in the first months when I adopted this lifestyle, now I brought back again some kilos. The thing is that my “diet” is based on my over-obsession with cancer diseases. In practice I avoid eating anything, which contains compounds with proven or suspected carcinogenic properties. The list of foods which I refuse to consume is long and includes some of my favorite foods in the past – total avoidance of fried and barbecued foods (they are taboo), most of the roasted foods (if I eat any of them – I remove the roasted surface and consume the rest), most of the cookies, candies, cakes, chocolate (well, I may eat 2-3 times per year, not a whole chocolate though), and… I think that’s most of it… Well, you may ask what I eat at all. I will tell you – any boiled food is more than welcomed, as I said I may eat roasted stuffs (after removal of the baked surface), I love cheese and other milk products, boiled eggs, ice cream, all stews… Frankly, I have stopped eating red meat because of my carcinophobia (so now I eat only chicken and rarely fish), and now it tastes bad when I try… Of course, all fruits and vegetables, mushrooms, are my friends :)

    The thing is, I realize my behavior is a non-standard (I deliberately do not use “abnormal” because I do not think it is), but I will not change it at all – I am not thin, I have adapted to this lifestyle (well, it was very difficult in the beginning – people’s reactions, your desire to eat but you can’t, relatives, etc) and it does not bother me now.

    Best

  43. Unfortunately it isn’t ridiculous, i have a very good friend who suffers from this condition and to see the distress it causes her and her family is heartbreaking, not knowing what to do to be able to help is so frustrating and upsetting, i just wish someone would offer her some help before it is too late.

  44. This is totally ridiculous! Next thing you know we’ll hear about people who get sick from breatheing too much air. People will write anything to make abuck

    1. @MelanieD:when you see your child’s pelvic bones sticking out of their back because they are “eating healthy” let me know how ridiculous this disease is!
      Ignorance!

      1. Sadly, the image of my skeletal 5’3″ body will haunt my mother for the rest of her life. To all the other Moms, I am sorry that you have had to endure these same images.

        To Melanie, I’m sorry, but this is not ridiculous. I can attest to the fact that this is a real disorder and because of it, at 28 years of age, I weighed 75lbs. and nearly died. I hope it never affects you directly or indirectly…because you would be too ignorant to know what was going on to help yourself or others.

      2. Thank you ‘Mom’. MelanieD is the ignorant one. My brother has been diagnosed with this illness. First it was about ‘eating healthy’ but his obsession has become worse and worse over time. Its difficult to understand when you haven’t been faced with it personally. He was a muscly teenager, and due to the diagnosis of a chronic illness his ‘healthy eating’ became more and more strict. He doesn’t get that it is destroying his body, and i pray that he will stop before it is too late. It is just horrible that someone can comment on something they haven’t witnessed. It is destroying my brother and our family.

    2. Sadly, the image of my skeletal 5’3″ body will haunt my mother for the rest of her life. To all the other Moms, I am sorry that you have had to endure these same images.

      To Melanie, I’m sorry, but this is not ridiculous. I can attest to the fact that this is a real disorder and because of it, at 28 years of age, I weighed 75lbs. and nearly died. I hope it never affects you directly or indirectly…because you would be too ignorant to know what was going on to help yourself or others.

    3. I think it’s important to understand what is happening here. There is nothing unnatural about being healthy and wanting to be healthy. This disease however is VERY real and should not be underestimated or judged by someone who has not either experienced it themselves or been close to someone who has. Our food in general is not in the best shape nutritionally speaking. This is a no brainer. The price of organics and cleaner foods are considerably more. Many people who end up in the orthrexia bunch have been faced with some pretty horrendous health challenges to start. I am speaking of things like cancer, heart disease etc. Many people are aware of how harmful chemicals and additives are and that it cuts immunity levels in half. The happy medium that we want to see happen here is that those that eat healthy, eat enough to properly feed their bodies. And, to work on related fears associated with the occasional junk food which won’t hurt in moderation. What we need is support, not ridicule people. Just because it isn’t happening to you, doesn’t make it any less important.

    4. Actually, breathing too much air WILL make you sick. Just try it. Try breathing a lot of air in a short time. It will make you feel terrible. If you have a disposition for a heart attack / asthma attack / epilepsy, it could trigger such an event and even kill you. Look up Dr. Buteyko, you will find many studies that show how sick people breathe more than healthy ones.

    5. It’s not about healthy eating alone, eating healthy is great and obviously not unhealthy. It’s the obsession that makes you starve yourself because you thinkk you overate. The obsession that makes you get away from all your friends because they sometimes eat unhealthy.

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