What is Orthorexia?

Orthorexia nervosa, as I defined it in 1996, indicates an unhealthy obsession with eating healthy food. The term is derived utilizing the Greek “orthos,” which means “right,” or “correct,” and is intended as a parallel with anorexia nervosa. I originally invented the word as a kind of “tease therapy” for my overly diet-obsessed patients. Over time, however, I came to understand that the term identifies a genuine eating disorder.

Please note that I do not, and have never claimed that vegetarianism, veganism, or any other nutritionally sound approach to eating healthy food is in itself a disorder. That would be absurd! Nor do I think that people who pay close attention to labels on the foods they mean to purchase are demonstrating a psychological problem (as some web articles on orthorexia would appear to imply.) Finally, I entirely agree that the problem of addiction to junk food is immensely more prevalent than obsession with healthy food.

Nonetheless, it is possible to have an unhealthy obsession with healthy food.

Anorexia is the parallel. Obesity is by far the biggest lifestyle-related health issue today, and every reasonably health-conscious person does what is necessary to achieve and maintain a normal BMI. Still, for various psychological reasons some people go overboard and become anorexic. Similarly, any reasonably health conscious person would wish to minimize intake of preservatives, pesticides, antibiotics and all the other garbage that pollutes our food supply. However, some people who are devoted to healthy eating go overboard and develop an eating disorder in relation to that focus, just as some people in their quest to avoid obesity become anorexic.

For people with orthorexia, eating healthily has become an extreme, obsessive, psychologically limiting and sometimes physically dangerous disorder, related to but quite distinct from anorexia. Often, orthorexia seems to have elements of OCD, as does anorexia. Some people with orthorexia may in fact additionally have anorexia, either overtly or covertly (using pure food as a socially acceptable way of reducing weight.) But orthorexia is usually not very much like typical OCD or typical anorexia. It has an aspirational, idealistic, spiritual component which allows it to become deeply rooted in a person’s identity. It is most often only a psychological problem in which food concerns become so dominant that other dimensions of life suffer neglect. In rare cases, however, it can be much more severe, even resulting in death via malnutrition.

The primary feature distinguishing orthorexia from anorexia is that while a person with anorexia focuses on weight, a person with orthorexia obsesses about purity. People with anorexia possess a distorted body image in which they see themselves as fat regardless of how thin they really are, whereas those with orthorexia constantly struggle against feelings of being unclean or polluted by what they have eaten, no matter how carefully they monitor their diet. Both conditions involve control, but whereas an anorexic seeks continually to reduce weight, an orthorexic feels compelled to achieve ever great heights of dietary perfection; to feel entirely clean, pure and transparent. Sometimes people recovering from anorexia “graduate” to orthorexia, keeping their disordered eating habits and moving the focus from weight to purity.

Although widely discussed by eating disorder experts, orthorexia is not yet a DSM diagnosis, and I am not sure that it should be. There is a tendency in the modern world to pathologize an increasing number of human behaviors and I have no desire to contribute to this trend. On the other hand, naming has power. I have heard people say, “I want to eat healthfully, but I don’t want to be orthorexic.” Perhaps this is the best possible use of the word.

Do you have orthorexia? Ask yourselves these questions: Do you turn to healthy food as a primary source of happiness and meaning, even spirituality? Does your diet make you feel better than other people? Does it interfere with relationships or work, friends or family? Do you use pure foods as a sword and shield to ward off anxiety, not just about health problems but about everything that makes you insecure? Do foods help you feel in control more than really makes sense? Do you have to carry your diet to further and further extremes to provide the same kick? If you stray even minimally from your chosen diet, do you feel a compulsive need to cleanse? Has your interest in healthy food expanded past reasonable boundaries to become a kind of brain parasite, controlling your life rather than furthering your goals?

Food, no matter how pure, cannot fill the space in your soul that longs for love and spiritual experience. If you are trying to use it for this purpose, you may have gone astray on your journey.

Perhaps the resources on this site may be helpful, including my occasional blog posts. You might consider reading my book, Health Food Junkies. But most of all, if you feel your condition has become too much for you to manage on your own, visit an eating disorder specialist who understands orthorexia.

Sincerely,

Steven Bratman, MD

To contact me, leave a comment, or find me on Twitter @StevenBratman

 

141 thoughts on “What is Orthorexia?

  1. Dear Mr. Bratman

    We are four girls from Denmark, who are doing a project on Orthorexia Nervosa. In Denmark Orthorexia isn’t a commonly known syndrom, and therefore it isn’t possible to find statistics, surveys etc. about the syndrom.

    We have already seached for american surveys and statistics, and have found a couple of useful websites such as:
    http://www.ncbi.nlm.nih.gov/pubmed/21989097
    https://www.nationaleatingdisorders.org/orthorexia-nervosa

    But it’s a struggle to find valid statistics and useful quantitative data. If you know any useful websites, surveys, statistics etc., it would be very helpful!

    Sincerely,

    Elvira Jansaa

    1. Elvira,

      There really isn’t any good data. The problem is that the research “test” used to identify orthorexia, the ORTO-15, seems to identify “high interest in proper diet” rather than “obsession with proper diet.” Because of this, a majority of dieticians (for example) score as “orthorexic,” which is not right. Various academics are working on a new test, but it has not been created yet.

  2. Hello Dr. Bratman,

    Just went through all your comments here, after finding your work on “Natural News,” what ever that means:P

    Just wanted to say you really opened up a can of worms! No pun intended. Haha! (well, maybe alittle.)

  3. I think the author should reregister this website as orthrexia.BS, because this is what it is. A big pile of BS and medical ineptness.

    1. As someone who came out of Orthorexia before I even knew the word for what I was experiencing, I can say 100% for sure this isn’t BS.
      The disease is already isolating and not having a term for it was more isolating. His work is invaluable and will save many from a horribly isolating, unhealthy place in life.

  4. To have a separate diagnosis of ‘orthorexia’ is as absurd as having seperate diagnosis for the various manifestations of OCD such as washing hands repeatedly or checking if the door is locked repeatedly. In those cases the focus is on the OC aspect of the behaviours not on the behaviours themselves. Just as washing hands is essential for preventing infectious diseases and locking the door is essential for security in many situations, so is eating healthy essential for avoiding the diet related diseases which most Americans suffer from and die of today and most health care dollars are spent on today. If we don’t need seperate diagnoses for excessive hand-washing or door-locking we surely don’t need one for excessive focus on healthy eating. In fact if our society was not flooded with unhealthy food it would not require as much focus or effort to eat healthy. The time required to prepare meals will vary depending on what’s available locally – with greater food prep time likely reflecting a lack of local healthy food availability rather than a mental disorder. We need to fix the non availability of healthy food choices rather than create labels for those who refuse to poison themselves with unhealthy food even if prepared “with love” by their local restaurants or friends/families. Let’s not pathologize something our society desperately needs- a shift to eating healthier. Its like pathologizing hand washing during a cholera outbreak!

    1. I agree that the last thing the world needs is yet another diagnosis. I also agree that junk food is a vastly more prevalent problem than orthorexia. But obesity is also much more common than anorexia, yet anorexia can kill.

      Orthorexia is not simply OCD because of the power of food to tap into dark, powerful places in the psyche. The term “orthorexia” can serve as a signifier, a kind of mental signpost to indicate a limit, a boundary not to go beyond even in search of healthy diet. There are people (especially young women) who can say to themselves, “I want to eat healthy food but not be orthorexic.” This, I think, is the best use of the term.

  5. Hello. Good to see you have updated the site, I used to visit a few years ago. – I remember a hate mail section ? lol

    Also good to see your ideas are getting more mainstream online. Yes I think this is a real problem now in society.

  6. Dr. Bratman,

    The hatemail you get is as predictable as it is annoying.

    You’ve described a condition that my wife shows and it’s been a help to me that I’m not alone in observing someone I love act so very differently.

    Thank God she’s not a coke head or alcoholic or other truly harmful behavior. It’s just a little inconvenient and strange that her eating habits are so different than others.

    1. Dr Bratman,

      I can’t tell you how grateful we were to finally identify our 16yr old daughter’s problems. The ‘healthy’ eating began in Jan 2014, also an increased level of exercise (gymnastics & running). She was always slim so it took a while to see that she was loosing weight/fat and gaining muscle. Our GP said I was worrying for nothing and that it was better than being in front of a computer all day … agreed but my instinct told me something was ‘off’. She didn’t feel she was overweight and wished she had more curves so that ruled out classical Anorexia but yet I felt something was wrong – for those who ridicule the concept, it happens very gradually and it is as simple as stopping butter and replacing veg with salad … when I saw that she had lost 3kgs I started to panic – I felt no healthy ado should be losing weight!! It took 3 doctors and finally a Nutritionnist to finally get a diagnosis of an ‘Eating Disorder’ but all this time we were sure it was not full anorexia – by now she had gone from 46kg to 40kg (sorry we are metric in France!) … to make a long story short (over a year!) and lots of tears later (all of us!) she ended up finally accepting the problem (she was now down to 36kg) as the body had gone into famine mode and even though her diet had improved the weight loss continued – little by little things improved and she began to accept a little bread and we changed our family diet to accommodate her illness – Anyhow now she is back to her original weight and has her monthly cycle again which is very significant in knowing if your teenage daughter is healthy. Anyhow, I just wanted to say thank you for the term – I do feel it described the problem our daughter had and she also accepts it as she could see herself in the description! She still avoids sauces and chips but at least she now has a healthy BMI and seems happy in herself – I guess that’s all we can hope for as parents! To other sufferers, it is a struggle but if you are prepared to invest the time and effort, things will get better ….Best regards, O (France)

  7. you understand this is giving the rise to more and more dangerous mindsets about food? When the deduction that if you stay away from GMO and processed foods you could become sick? This comment has been linked to this information of yours. For thousands of years food has been nourishing the human body just fine and now science can screw with the genetics and add chemicals without knowledge of what any of it will lead to and people with enough sense to do research are the ones with a problem? You need to shut this thinking down quick. I will post this and call attention to it until there is a scream against the entire medical community – people have had enough.

  8. Thank you for your observations. I am looking for help for my very healthy? wife. She exercises four hours a day. Daily, for years, she eats bananas, romaine lettuce and pita bread (and a half glass of white wine after work). Granted, similar to another poster, it may be 15 bananas per day and three heads of lettuce. Her OB reports, “Wow, you are beyond Olympic health…” Perhaps. I am scared to death.

  9. LIsten you retards… how do you think doctors will continue in a way they have become thoroughly accustomed to if the dumb-fuck public start eating well (albeit a little less)… BINGO a lot of illness di$apear$ or diminishe$ $$$ignificantly. A healthy diet might lead to a healthier lifestyle & Gawwwwd-struth where will the good doctor$ be – indeed where would the illth/health insurance system be. I’ll tell you epidemic$ & induced di$ea$e$ will be tinkered around with, over-servicing will be rife & the good doctor$ will protect them$selve$… by sabotage. The banks do it, industry & markets do it, even the scientists do it & of course the politicians have been doing it since forever.

  10. This doc is a quack,.. I have a mental illness because I eat all organic and I think about what I’ll be eating tomorrow. Geeeez get the fuck out. What do you think Humans ate hundreds of years ago????

  11. Please please eat all the fast food you can so we can rid the world of morons like you, does the MD stand for mentalty down? You are a horrible person that let greed and money dictate his joke of a life. I hope you get struck with the worst case of depression possible and that you know your life, your one now worthless life amounted to nothing and if anything could start a fire for horrible health of individuals to come. God save us, besides you, no place for you anywhere but a McDonald’s booth. God you are an awful terrible worthless person.

  12. I really loved reading your webpage! Cant wait to read your book! I am interested in this topic a lot and currently writing a medical article on it. Wanted to ask if it is possible to purchase an electronic version of your book? As I found it difficult to get the book shipped to Lithuania :(

  13. Hi Dr.Bratman,

    My husband has this condition. His BMI is 13.5,(weighs 95 lb) he really cannot help himself, he realizes he does not want to be this thin, but he cannot bring himself to eat any grains. He eats mostly powders-chia seeds, spirulena,chlorophils,maca– mixed with a teaspoon of yogurt which he swishes around in his mouth for a half hour and calls it a milkshake. He has also started drinking lots of coffee and raw chocolate–superfood metabolism boosters. He might eat some sardines too,(he thinks it great if he eats a half can(35 calories). He has a wound on his leg that won’t heal. His belly is distended from what I believe is malnutrition.
    The only thing strange is he has very Large green bowel movements. Why would he have these large BMs? I think perhaps his muscle is breaking down. He looks like he came straight from a concentration camp. He thinks to solve his health problems he needs to exercise more… Do you have any explanation for the large BMs? Thanks,

    He does go the doctor, they prescribed IV nutrients but he won’t go.

  14. I was shocked to see that this condition existed and that someone had put a name to it. For years my mother has been sick with something similar to this. She was in her late 50’s- early 60’s. She had been to a plethora of doctors because of various complaints. She had a skin condition on her face that looked like red boils and was itching and burning. She started to cut things out of her diet, one by one. No sugar, no fruit, nothing prepackaged. Then it was no vegetables. She began having sugar issues, hypoglycemia attacks, heart palpitations. We told her this was because she was not eating properly. She refused to believe us. She never listened to anything the doctors said. Finally she was down to eating nothing but little bits of boiled chicken and 1 green been every few hours. It went on for months until finally she was rushed to the hospital when her organs started to shut down. She was probably 65lbs at the time. The ER dr told her if she didnt take the glucose/ saline drip, that she would die that night. She hesitated. Can you believe? SHe finally consented to the drip. they gave her an antipsychotic med and eventually sent her to the psych unit. But still, to this day, she was never diagnosed properly. SHe has gone back and forth with the eating disorder over the last few years and then 2 years ago she was DX with lewy body dementia which presents itself like Alzheimer’s with Parkisons. She is in a nursing home at 67. I feel that the medical community failed her. No one researched anything in order to come up with a proper DX for her. SHe was the round peg that did not fit into their square hole and she got pushed aside for easier, more predictable patients. If research money is spent on anything, I feel that it should be spent on eating disorders that have become so insidious and prevalent in our changing society. Food is not what it used to be. The FDA can not be trusted as it once could be. Times are changing and people are afraid. Fear breeds everything negative.
    Now I see my son, who has chosen to become Vegan, heading down the same path. He would rather starve at work, than cheat on his “diet” and eat something that could contain animal products. His weight is very low. He weighs about 100lbs and it 5’6. I worry constantly for him. Thank you for your website which brings awareness and alternate thinking to this realm of eating disorders. As antibiotics need to become stronger for the evolution of the bacteria, so does the mental health community need to become stronger for the insidiousness and ever evolving disorders of the human psyche.

  15. Dr. Bratman, I read your 2000 book “Health Food Junkies” and found it convincing. Can you direct me to any books or articles about orthorexia published since then? How can I reach you?

    1. Hugh: I’m glad you found the book useful. The best way to find more recent information is to google it :-) Seriously, there has been some recent research, and you will soon find it online. My own relationship to orthorexia is mostly parental (in that I gave birth to the idea, but it has grown up and moved out, and I am not too closely involved anymore!)

  16. Dr. Bratman,

    My 12 year old son needs help for this problem. I desperately want to get the right treatment for him before it gets completely out of hand. Can you please contact me? I hope to hear from you soon.

    1. Jill: I recommend you find a local eating disorders specialist who works with orthorexia. There are many (but I am not one of them, sorry!)

  17. As a psychiatric nurse practitioner who occasionally sees anorexics in practice, I understanding just how dangerous and resistant to treatment eating disorders can be. I also suffered from an eating disorder myself when I was younger.

    My 28 year old son lived overseas the year after he graduated from college. He came back trim and muscular; he had never been overweight but had been very resiistent to eating healthfully in HS and college and never formally exercised. The new person worked out and was fascinated with eating whole, fresh foods. Over the past five years he has redefined and searched for the “best” diet; one that will prevent constipation and bloating and meet his standards of what is best. He now eats eggs, very small amounts of fish, nuts, lots of raw vegetables, and I’m not sure what else. He is about 70.5 ” tall and extremely thin at 125 lbs. He is a professional in a very high power job working long hours. I have tried during multiple conversations to convince him to at least gain enough weight to be at a BMI that is not considered underweight. I am terrified that his eating disorder will continue to progress. He is also a philosophy major and a has a strong thirst for being a righteous Christian man.

    No, the DSM 5 does not have a specific Orthorexia nervosa diagnosis but this is a very real condition.

  18. Dr. Bratman,

    I’m a reporter working on a story about orthorexia for The Fix. I would love to talk with you, but my deadline is pretty tight. Do you have some time to chat by Aug. 1, 2014? Please email me at ericapsweeney@hotmail.com and we can set up a time. I couldn’t find another way to contact you.

    And, if anyone else has personal experiences with orthorexia that they would like to share, please email me.

    Erica

  19. My 30 y.o. son was muscular, trim and fit being 6 feet tall and 200 lbs. He always ate a healthy, balanced diet until about a year ago when he gradually became obsessed with food purity. His diet became more and more restrictive. He couldn’t eat at restaurants or at other people’s houses. If invited somewhere, he brought his own food. Only organic foods, specific combination regimens, not this, not that, etc… He spent hours everyday shopping, chopping, preparing, making mega messes in the kitchen and thinking about food. That’s all he talked about. He lost most of his friends over this compulsive, purist behavior and he gradually became more and more isolated.

    He didn’t feel depressed and thought he was doing very well. He was proud of his will-power to maintain this extremely stringent regimen. He made remonstrances to us. Even when we were health conscious, it was never enough. If, for some reason, he felt like he had strayed from his diet, he compensated the next day by not eating, to detox. At times, he was very hungry and succombed to binge eating (all organic and healthy). He felt he was loosing control and became terrified of eating too much. He lost the sense of eating when hungry. He couldn’t keep up with all the time spent in the kitchen making his own sauerkraut, fermented veggies, spouted grains and beans, kefir, etc… It became easier to not eat and he started skipping more and more meals, especially at work. He got to the point where he wasn’t hungry anymore.

    He rapidly lost weight. He lost all his muscles and became severely emaciated. Literally just skin and bones, he looked like a Holocaust survivor, all the while believing he was doing great and was healthy. He didn’t see himself as too thin. He had trouble moving, walking, lifting his arms. He fell asleep at the wheel several times. He went down to 109 lbs. His speech slowed as well as his mental functioning. His hands turned blue. His nails got deformed. His legs swelled. He was dying.

    A few weeks ago, we finally found an eating disorder specialist who mentioned the name orthorexia. We read an article about it on-line and found this web-site. It fit to a T. It was very hopeful to finally see that he is not the only one experiencing this disorder. There is even a name for it (now) which is somehow reassuring because it means that someone recognizes that this conditions exists and there might be a way out of it.

    My son is now working at recovering from it. He’s too weak to work. It is very difficult to break his obsessions and convince him to eat a wider variety of food. I hope he has not suffered permanent damage to his organs, particularly his heart. He so wanted to be healthy. This disease kills.

    In our family, we believe in eating healthy and we do well with it. For him, it got out of hands. He got trapped in an obsession with food purity and almost died. Yes, it is ironic and weird. But it’s real.

    I thank Dr. Steven B. for writing about this condition and giving us hope. I can’t understand all the flack he is getting for it. By telling his story, he’s just trying to help others and he gets smashed by the very people who should have the most compassion for those who suffer. 8 Now, that’s ironic and weird! Poor humanity…

  20. Dr. Bratman,

    I’ve been following the conversation for years now beginning with beyond vegetarianism website. I stumbled (thankfully) on your article and the stories of others trying to understand what was happening to my family member. I knew that my loved one would likely progress as her mind was rigidly set in compulsive dogma of the raw, detox, cleansing lifestyle. She has been on the path in some form for over 20 years. What I didn’t realize until this weekend that this monster can truly destroys the body, the mind, and the spirit. I am horrified and helpless at the same time. I’m afraid that I have witnessed the end stages. So is there a way to reach sufferers? How can you reach someone encaged behind steel walls of dogma? What I’m not seeing today are clear treatment center options- specific to orthorexia.

    I would be grateful that you will contact me Dr. Bratman. As a colleague in the medical field, I will respect your time and effort.
    Signed,
    Desperate Doc.

  21. Dear Dr. Bratman,
    Thank you for sharing your experience. I think that I perfectly fit the definition of someone suffering from Orthorexia Nervosa, except that my obsession is not only about the foods I eat but also about the foods my kids, husband and parents eat. I have a 3 year old girl who was born with a heart defect and needed surgery when she was 5 days old. Both of my parents have chronic heart disease, my mother has had two open heart surgeries in the last two months (bypass and valve replacement). I had convinced my parents to follow a no oil vegan diet (after reading the books “The China Study” & “Prevent and Reverse Heart Disease”) but now they have been told by their mainstream dietitian that they need animal protein. I cant enjoy a meal when I see them eating chicken, cheese, eggs. I am just terrified of being again inside a Cardiac Intensive Care Unit visiting a loved one. I had hoped that I could at least change the people around me to make healthy eating something normal but that I am starting to realize that is just impossible. I am taking care of my parents this summer but once I return to the U.S. I will buy your book hoping it gives me tips to cope with this problem that is now distracting me from my work and making me feel sad, angry, powerless..

    1. This is a pretty common feature of orthorexia. Usually it’s parents controlling children, but sometimes it’s adults trying to control their aging parents.

  22. I understand your definition of orthorexia, nervosa or not, having see it here in Miami where certain people spend inordinate amounts of time talking about the healthy [sic] qualities of the foods they eat. While there’s nothing wrong with proper nutrition, there’s a lot I feel is unhealthy in talking about it all the time; even nutritionists take a break, after all.

    However, I believe there is a related disorder that you have not discussed, and that is what I call “orthorexia obnoxiosa,” an unhealthy obsession with what *other people* are eating. And telling them so. I can’t even enjoy a Diet Coke without some jerk lecturing me on the dangers of aspartame, never mind having an occasional hot dog at the ball park. (Hey, it’s the communion wafer of the Church of Baseball….) There are undesirable side effects to this condition, ranging from angry stares to suggestions to “buzz off” (and worse) all the way to black eyes and missing teeth. Can anything be done about this compulsion?

  23. @StevenB I imow this may seem strange but I am a minor and an orthorexia sufferer stuck in the hospital system, and it’s NOT the right way to handle my problem. I’m desperately seeking your help! I wouldn’t seek your direct help if it wasn’t urgent, please if you could get in touch, or if another reader knows a way I can reach Steven, I literally would owe you my life. All replies helpful, J-Anon (age 17)

  24. My daughter died June 23, 2014 at age 25, as a result of extreme weight loss due to anorexia. She was first diagnosed at age 11, hospitalized and was critical for at least 6 months. She remained in recovery for over 10 years, then ED came back with a vengeance turning a once vibrant, positive young woman with a very successful career into a very secretive, isolated person who was obsessed with food, nutrician, vitamins, quantity to a point it took over her life. As I read about orthorexia, I am convinced this was the dominant disorder because the restriction and compulsions were all focused on the details. Vitamins, calories, nutritial value and whether or not it was organic, it began with a obsession with potential familial health concerns she had no symptoms of. Salt, sugar and all fats were the enemy.

    1. Ellen, I am so sorry for your loss. It is so hard to fight this because what they say and believe seems local, but infact they are starving themselves. My husband has this disease. It is so hard to get help for him. If he goes to a doctor that figures it out he quits that doctor and finds someone else. Again I am so sorry for the loss of your daughter.

  25. Are there any suggestions for helping a friend who seems to be orthorexic? I know someone who not only keeps herself on an extremely limited diet (and seems to be suffering health problems because of it) but also has her children on this diet. She controls everything they eat, and they just don’t seem to be growing normally.

  26. i ll pick up your book health food junkies,
    and im not sure how one can die from it if your whole healthy diet
    is balanced, but i can see how if one refuse to eat anywhere/anything
    thats not “up to their standard” while around friends, family and the spouse it must be
    really limiting, as with any fear, phobia and obsession often is.

    will def look up your book.

  27. I’ve read your book in the spring. Loved it. It helped my sister stop being a raw foodist 10 years ago (and she has recovered and doing beautifully). Now, I’m running into a problem because I’m vegetarian and breastfeeding my child who has a skin rash (going on 1 year). The usual routine is the elimination diet. We stopped dairy and wheat and I was going crazy without dairy protein. My homeopath suggested I start eating meat again. That really threw me. Everywhere in the blogosphere/mom chat groups it seems that people are turning to the Nourishing Traditions/Weston A. Price dietary principles. I would just love your advice and maybe I need to read the book again. If one starts following NT/WAP is that just orthorexia in the other direction? Those types of diets are not the norm and can be restrictive too (in terms of being able to socialize and hang out with friends). Do you do phone sessions?

    1. It’s just another diet book. There’s no obstacle, no bar, no criteria of accuracy or even relationship to reality in between the invention of such a book and its publication. People seem to have an endless desire to be told what exactly they should eat, and why. The answers given in such books are almost entirely just made up. I’ve watched authors (famous authors) cynically design the elements of a diet and then publish it, and sell a bazillion copies. Other authors are true believers. But it’s still just diet obsessions presented as if they were dietary facts. Diet is not really that interesting. Find some way to get enough protein, and then stop thinking about it!

  28. I just read the first 4 chapters of your book and have been in tears. Finally, there was something to help me identify the anxiety and high stress I have put on myself regarding food. So far, your book has been life changing. And in honor of my new found freedom, I went and had a greasy hamburger and fries today:)

  29. I just had a really good friend of mine pass away. He killed himself….. He has an extreme case of orthorexia it was so bad that he ate absolutely nothing that was cooked and pony ate vegetables and fruit and supplements…this disorder got so bad for him that three days before his death he came to work and told us he went on a strict liquid diet because it was more healthy then what he was already doing!! I wanna know if orthorexia can cause any mental abnormalities or chemical imbalances in the brain?? If anyone has any info please email me….. Thank you

  30. What about how orthorexia affects families? I am a mother of 2 young children, ages 6 and 8. I often am afraid to say yes to their requests for certain types of food. I think this disease can lead us to cause our children to be malnourished. I working through this and trying to get better. I am opening myself up to foods that are easy to grab, such as fruit cups by Dole, trying not to be such a purist and allow the kids to have a few things with “questionable” ingredients, etc. I am so thankful for your website that has opened my eyes to these things and is helping me stop going hungry all the time and stop depriving my kids.

    On one of your pages you say that the article about you states some things that are not true, and you also say you do not believe exactly as you used to. I was wondering, is there any way you could write a follow-up article about yourself, correcting the things that the previous article had that were untrue and giving us a true picture of what you believe? Because that would be very helpful to me. I want to learn everything I can about this disease, and I think having your thoughts and experiences to refer to on my journey would be very helpful.

  31. I have a friend that is approximately 5’4 and weighs approximately 85 lbs. She eats tiny amounts of food and cannot sit still for a minute. It is very sad and she will not do anything to get help. I wish this disorder was publicized more. Perhaps then her family would be able to get her the help she needs. She’s been this way for years and now believes she is borderline diabetic so she won’t eat any carbs. It’s very sad.

  32. HI Dr Bratman,
    I would really love to speak with you. I have had anorexia and orthorexia. I see orthorexia in many of my patients. I am currently struggling with some physical issues that many doctors are suggesting I restrict my diet more than I already do. The current alternative strategies for dealing with many medical issues is food restriction. NO Gluten, No Dairy, no grains, minimal carbohydrates. I question this. I think we have become, as a culture, extremists in diet. Or many orthorexics are leading the way in alternative health. Please contact me.
    Thank you
    Deanna

  33. Dear sir,
    I absolutely disagree with the “invention” of this new concept, this new word to mean a new invented mental disorder, as it will be used to treat everyone who try to get out of the mass by eating less and healthier as a insane… actually I see the happiness in Monsanto, MacDonalds and company’s faces: public opinion is being manipulated… again.
    Sorry for my English.

  34. I have sold my car and I use my bike for everything. Am I a Bikorexic?
    I have thrown the TV away, cause I think it’s bad for my brain. Am I a Beirdorexic?
    I read books without stopping. Am I a culturexic?

    Money, money, money…everything for the money.

  35. Los psicólogos y los psiquiatras ya no saben qué hacer para seguir catalogando a la gente, para someterla a unas pautas elienantes en las que todos estemos controlados y seamos iguales.
    ¡Cuánto daño hace esta gente a las mentes menos fuertes!
    Resulta que el libre albedrío, en estos tiempos y según estos individuos, degenera en todo tipo de enfermedades y trastornos.
    Ahora también comer sano es una enfermedad psicológica.
    Es mejor no seleccionar el alimento y comer toda la mierda que nos ofrecen, cargada de pesticidas, conservantes y porquerías por el estilo.
    Pues no, señor psiquiatra. Yo no voy a dejar que usted y otros como usted me cataloguen con supuestas enfermedades.

    Gran trabajo realizan ustedes en pro del control humano y el sometimiento a los dictámenes del poder.

  36. For about a year now, I have developed are really unhealthy obsession with what I eat. Some things described in this article I can see in me. I will go for weeks not allowing myself any unhealthy food then i will feel depressed and binge, This makes me feel terribly guilty and disgusted with myself that I will go back to the extreme of eating hardly anything and only foods I consider to be ‘good’. Its a vicious circle and once you get caught up in it, it is very hard to stop. I don’t think I would class myself as orthorexic or to have an ED because I am aware of what I am doing to my body. I just cant stand the guilt.

  37. This website has been extremely beneficial for me personally, especially many of the supportive comments. I know someone who has the exact same characteristics frequently described here, and it’s been very destructive to her and everyone in her life. It’s very comforting to know we aren’t alone and that others can relate.

    Regardless of whether Orthorexia is an official diagnosis, it’s nice to have an umbrella term for this general personality/condition/obsession/whatever-you-want-to-call-it.

  38. As an educator I’m just saddened by what I’m seeing in most of the negative comments on here. They show a terrible ability to read.

    It’s as if they don’t get past the first sentence before typing out their rants and attacks. Such sad misdirected anger.

  39. Please someone do some research into this. I know several people who are so severly into this lifestyle I believe they are abusing their children. I think in some cases this is the new legalized munchousersyndrome byproxy. In one case in particular the woman makes her children take several vitamins and other suppliments each day. Including 5 fiber pills at a time 6 times “doses” a day. They are not allowed to eat ANY fruits or vegtables. Their diet consists mostly of beans. The slime in the bean can is what they call juice in their home. The children are always sick and have rashes. But it is never just a childhood illness. Every rash and fever gets blamed on something they must have ate or a chemical they must have been exposed to. I think the mother enjoys the attention she gets when she explains how restricted her family has to be with food.

  40. This blog post is ironic. There is actually a medical sickness for the unhealthy obsession with healthy food. Too much of something is bad enough. Moderation is key. I like healthy food and my craving is just right. Thank God.

  41. Your proposed new, independent “diagnosis” cannot be logically differentiated from Obsessive Compulsive Disorder (OCD; if obsessive thoughts are present in addition to the compulsive healthy food choices/ fear of unhealthy food choices) or Obsessive Compulsive Personality Disorder (OCPD; if the patient’s pathologic need to control eating habits has caused significant social impairment, without obsessive thoughts). Furthermore, the addition of “ortho-” as a prefix to an existing diagnosis, anorexia nervosa, is laughable. Anorexia Nervosa is a disorder of self image that literally means “loss of appetite due to nervous reasons”. A person with “Ortho-rexia Nervosa” would not have self image issues and “correct eating due to nervous reasons” is not a disorder. That is something that would be welcomed by most proponents of healthy living and most antagonist to cardiovascular disease. A similar case to the one you have described is Mysophobia, or the idea of being a “germaphobe”, which is a presentation of OCD. As Mysophobia is characterized by preoccupation with cleanliness due to fear of germs and infection, so is pathologically healthy eating characterized by preoccupation with healthy food choices due to fear of being unhealthy.

  42. Brainwave Entrainment has worked wonders for me throughout the couple of years that I\\\’ve been listening to it.
    I had wonderful outcomes in a brief time period and I still continue to listen to the entrainment sessions each and every day.

  43. Eating meat/dairy does not do anything for the environment, it destroys it, no matter if factory farm or so called humanely raised. It also does not promote peace and a healthy mind because participating in violence by consumption of such can never create true inenr peace. There is no such thing as humane slaughter (its an oxymoron).
    Vegans actually expand their food choices, we gain by choosing to live a compassionate and cruelty free life style.

  44. I have been vegan for 4 1/2 years – being vegan would in your eyes be a mental disorder? i would say meat eating and dairy consumption should fall under such category. Only because the majority of the US eats meat/dairy does not mean there is not something wrong with a meat/dairy consuming society. If compassion is a mental disorder wow then my question is what has this socity come to?

      1. Nicholas,

        When she posted on the page a few years ago, the content was different. Also, let’s be kind!

  45. I think it’s about time that this behavior is recogonized and understood as something that can lead to unhealthy consequences, mentally, socially and physically. As a person who feels very strongly about the importance of choosing healthy foods, organics,sustanibly and humanely raised, and or homegrown. These are the foods I choose for myself and my family and the planet. Having this focus in my life has offered me the opportunity to interact with other “whole foodies” as well as with many individuals who I have seen as masking an eating disorder by adopting highly regimented, highly restrictive manners of using healthy foods in a very unhealthy manner, all the while claiming that this deprivation is for their own good,even that its healing some kind of disorder, either real or imagined. The bottom line is that any obsession can be crippling and dangerous, listen to your heart, your body and exercise common sense. Everything in moderation, everything natural and nutritous, eating to satisfy body, soul and mind. If your food choices cause constant anxiety,if your obsessed with what you can and can’t eat, if maintaining your diet consumes much of your time and energy, then that’s. Unbalanced, and can lead to serious problems.

  46. Dr. Bratman,
    A client who has been involved with another Client for over a year asked if I knew this term orthorexia. I did not. But I have certainly seen this situation before and cannot understand WHY ii will not be in the next DSM. THANK YOU for naming it and bringing to our attention. **
    **An enlightened TX Licensed Professional Counselor who’s been in practice 20 years.

  47. I understand the point that Dr. Steven is trying to get across, especially when it comes to people following dangerous diet fads. A few years ago when I was diagnosed with learning disabilities in community college. I decided to go on a strict diet that a neurologist claimed to cure any kind of brain disorder as he claimed that his diet could heal any brain disorder. Well, to make a long story short the diet required one to heavily restrict fluids to 16 ounces a day, and wheat, salt and all sugars were to be cut too. I went on this diet thinking it would “cure” my brain of the dyscalculia and hearing impairment I had, but I started feeling worse after a week and couldn’t concentrate on my studies. I went to the academic counselor after two weeks as I noticed I couldn’t keep up in class due to being tired and headaches. I thought my headaches and constipation was due to my body detoxing. She noticed that I had the symptoms of dehydration, and urged me to go off of the diet as my brain was getting enough hydration from the amount of water I was drinking. This academic counselor and heard of the strict diet of this neurologist as the counselor was a brain injury specialist, and she told me not to follow diets by anyone but trained dieticians.

  48. I am absolutely convinced my “food nazi” brother has Orthorexia. He has suffered from eating disorders his entire life – he was extremely overweight and addicted to food until he hit age 40. At that point, he made a change to his diet and began exercising and lost 150lbs. That part is wonderful. The bad part is now he has a different, opposite kind of eating disorder. He is literally obsessed with eating a healthy diet and is as just as addiced to food and eating as he was when he was heavy….it’s just a different type of addiction/obsession now. Thank you Dr. Steven for putting a name on this, and the rest of you who disagree with Dr. Steven are IDIOTS! He is not saying that healthy diet is bad. He is saying that a person can take that too far and become completely obsessed with it to the point of endangering themselves. As someone who has an immediately family member with these issues, I can assure you it’s very real. My brother has become IMPOSSIBLE and it’s to the point where we refuse to invite or involve him in family meals. He is intolerable with his healthy eating obsessions.

  49. Dr. Bratman, I believe that usually people at any extreme may have a problem: If one obsess over what to eat, they really fear getting sick. Let me know if you want me to talk about my book more. I have science degrees and am a trainer. http://www.louizafitness.blogspot.com
    Book Pocket Guide to Fitness http://www.amazon.com/Pocket-Guide-Fitness-Louiza-Patsis/dp/1452072604/ref=sr_1_1?ie=UTF8&s=books&qid=1298396726&sr=8-1 or

    http://www.authorhouse.com/Bookstore/BookDetail.aspx?BookId=SKU-000379166

  50. Hello Dr. I would have to say that after reading all of this I 100% have this. Comments left by others explained EXACTLY what I do. I have lost 100 lbs about thwo years ago…in a 9 month span and have kept it off. I am 164 lbs now…and I am a 6 ft 3 guy. I read all the labels, obess over carbs ect… At some points, I will only eat vegetables and salad, especially if I am going on a trip. I don’t stave myself though. So anx. is not it. I wonder does the exercise and food obessession go together. i lov ethe earlier persons statement that balance is everything. I have been working towards that, but if I go to a fats food place I obsess over calories. in Vegas I make the pizza places make my pizza without cheese- I will wait the extr ahour. I have so much more to say but want to hear your thoughts.

  51. Hey Doc!!! your a quack!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! This is the most rediculious thing I have ever heard in my life. America is full of unhealthy, over weight people. And now you are saying that people that eat healthy have an eating disorder!!! I think you are the one with a a disorder!!!

    1. American isn’t the only country in the world filled with overweight people. Several other countries are just as bad, if not worse. The doctor never said eating healthy was a disorder. He said it can be taken to the extreme. You need to read the article, of which it is obvious you didn’t even bother to read.

    2. @ Zhanna I don’t think you get the doctor’s point of view. He is referring to ‘dangerous health fads’ such as the ‘after 6pm diet’ etc

      If you have an obsession with dangerous health fads and it’s affecting your life, then that is what you call disorder.

  52. Mr. Bratman,
    I don’t know your true motivation and interest in adding another classification label to further stratify humanity. Maybe that is something you need to revisit.
    In the U.S., our government has no motivation to promote good health for its citizens. There is no monetary benefit of the U.S. government corporatocracy to support a healthy food supply, non-toxic tap water, organic farming, raw foods, etc, etc…
    The pharmaceutical companies, the manufacturer’s of our food supplies, the deceptive goals of disease-focused societies/institutes (American Cancer Society), the health care system, chemical manufacturers, they would all lose a great deal of money and be far less powerful if our society was eating the foods that nurture our immune system and rid us of a major portion of our societies sickness and disease.
    The leaders of our government systems such as the FDA, who are largely drawn from the corrupt financially hungry corporations, are in control legislatively. Laws that focus on the public good are few and far between, replaced with legislative actions that build the corporate coffers, no matter the cost to the citizens, and our health.
    Americans are waking up, no longer drinking the Kool-Aid of blind trust in our government and there will be repercussions to those who have abdicated their responsibilities to the people they serve.
    Your somewhat careless and thoughtless attempt to add another label, and in effect, another tool for the corporatocracy to use in continuing the degradation of their citizens health and well being, was likely not motivated with the intent to serve the good of humanity, but what really appears to be a self-serving means of your own.
    I ask you to search yourself and your motivation for your own sake and to be clear of your premise and intent.
    Peace!

  53. The term “orthorexia” is absurd. Not paying attention to eating healthy foods leads to obesity and actual eating disorders. Contamination of our foods in the US with GMO ingredients whose safety on the human population remains untested should gain your focus. Instead, you focus negative energy and call names and label those that try to eat healthy. Further, the use of your M.D. title to give you some artificial authoritative stance is equally absurd. I hope those that put any weight into your label also read your disclaimer. I appreciate that you state you are NOT an expert on eating disorders. Sticks and stones…

    1. The doctor wasn’t trying to label those who are trying to eat healthy as having a disorder. He said it can taken to extremes. I dare you to try to eat a completely sugar-free diet. You’ll find it’s impossible because most foods contain a tiny bit of sugar, including fruit and vegetables, of which get theirs from photosynthesis. You cut out these foods because of a fear of having even a little sugar in your diet, and you could jeopardize your health because they contain vital nutrients. You need to read the article. It’s obvious you didn’t even bother. One more thing, the US isn’t the only country in the world with overweight people. Other countries have just as many, if not more.

  54. THX TO YOU DR.BRATMAN I FINALLY CAN HELP MY PYSCHIATRIC DR. HELP ME. BUT IN MY REALITY… THERE IS NOT SOO MUCH GREENER GRASS OVER THERE…I CALL MYSELF A DOUBLED EDGE SWORD. DAMNED IF I DO & DAMNED IF I DONT. JUST SO THE POOR MEDICAL FIELD I AM LIVING IN I HAVE TO MAINTAIN MY WEIGHT OR THEY ARE JUMPY WITH ME. TRYING TO PUSH MEDICATION MY WAY..ETC.. I TOLD THEM NO MORE PILLS 3 1/2 YEARS AGO OTHER THAN MY ANTI-ANXIETY PILLS-SO TO MY DISSATISFACTION I AM MY OWN SLAVE AND ABUSER TO MYSELF-BASICALLY A LIAR TO MYSELF-THAT GOES EVEN FURTHER THAN THE BRAIN CAN LIVE OR FUNCTION PROPERLY==OUT OF SIGHT OUT OF MIND!! I AM REALLY GLAD THERE IS A NAME FOR WHAT ILL’S ME THX DR.B–WISH I COULD HAVE SEEN U IN COLORADO WHEN I LIVED THERE YEARS AGO..THX I HOPE TO HELP MY COMMUNITY AND MY SERVICE PROVIDERS

  55. It’s obvious to me those who made ugly comments didn’t even bother to read this article. It never said eating healthy was a disease. It merely said that it can be taken to extremes. Eating healthier is wonderful, but when you let it get to the point where you are cutting out important foods in order to be that way, it can become very dangerous.

    I knew someone who became obsessed with eliminating all sugar from her diet. It started off with just cutting back, but it got to the point where she became obsessed with having a sugar-free diet and cut out fruits and vegetables, which have traces of it. Her weight got down to a dangerous level, and she nearly died. She was diagnosed with orthorexia, an unhealthy obsession with eating healthy. It’s characterized by trying to maintain a ‘healthy’ lifestyle by being fearful of consuming foods that patients see as ‘bad.’ Some of these foods are actually important for maintaining a healthy lifestyle, and cutting them out can be dangerous to your health. My friend got help and has recovered completely. Now, she eats a balanced diet consisting of fruits, vegetables, nuts, wheat, and some meat.

    Before you even think of going off on her and accusing her of being spoiled, why don’t you take a look at yourselves in the mirror? You’ll find you’re not exactly perfect yourselves. You want to eat healthy? Good for you. However, you can’t let it become the focal point in your life, or your health can suffer badly. Eating junk food once in a while won’t hurt you. Until you know someone with orthorexia or experience it yourself, you have no right to pass judgment.

  56. Orthorexia is such an important sickness to bring to light. We are so focused on things that are healthy for us it is easy to forget that even things that are good for us can go to far.
    Especially those of us with addictive personalities. It can be so easy to take a healthful addiction to a point where it becomes unhealthy or even dangerous.
    Thanks for sharing!

  57. I had this and was misdiagnosed with anorexia! It took so long to convince my gp that I didnt care what I weighed, and it wasn’t about control, I just wanted to be healthy because I have quite a weak immune system and thought eating healthier would help!

    The stupid thing was, I wasn’t fat, never have been, didnt have a troubled home life, and am popular at school; i.e, not bullied etc. Yet, he was convinced for 6 months that I was anorexic, and made me go to all these anorexia based therapy sessions that I most certainly didn’t need.

    Example: Therapist- So can you tell where these feelings of being fat stemmed from?
    Me- I dont think Im fat?
    Therapist- So was your anorexia about control?
    Me- No, control of what?
    Therapist- Well, have you ever been bullied?
    Me- No
    Therapist- Ever felt not good enough?
    Me- Umm, no? Look, are you trying to depress me!?
    Therapist- Oh, so you felt depressed!? (Obviously now clutching at straws! XD)
    Me- Not until I started talking to you -.-‘
    Therapist- Sooo?
    Me- Oh look, times up! Byyeee!!

    And so on twice a week for 6 months -.-
    Is actually quite funny looking back at it! Was damn irritating at the time though!!!

  58. Dr. Bratman, I remember when your article came out in Yoga Journal. You were on one of the raw food, I think it was, email lists I was on back then.

    I feel I got my own ‘health food junkie’ issues straightened. Your article was my first step. Thanks for writing it.

    I find myself right now at Children’s Hospital in Denver, where my 12 year old son is admitted. He developed some severe constipation after some surgery last November, and consequently stopped eating many kinds of food because of the pain he was feeling. He lost so much weight, and I finally brought him in to see a pediatric gastroenterologist. Along the way, I noticed him developing very obsessive thoughts and behaviors around the foods he was willing to it. I no doubt fed into it, as I was trying to find the reasons for his pain as well, and my tendency is to look at the food, of course.

    I understand that you aren’t an eating disorder expert. I am wondering what your feedback would be about how a 12 year old kid that stopped eating any food with fat because it caused him pain. I mean, that’s pretty logical. But it spiraled out of control. Right now they are feeding him through a NG tube, and in a few weeks they will want him to go to the Eating Disorder Unit. Is an eating disorder an eating disorder, whatever way you get there? Whether through concerns about heatlh, pain, fat …… seems like it is all about “fear of food”.

    I hate seeing him go through this. I feel like, in my own case, I more or less chose my obsession. He didn’t. All he agreed to do was get his tonsils out to avoid chronic strep.

    thanks for your work.
    Trish Pottersmith
    Lafayette, CO

  59. Thanks good doc for this very revealing article. I used to eat foods laced with neurotoxins such as MSG and carcinogenics like Aspartame, and high-fructose corn syrup, milk with rBGH, GMOs, tuna laden with mercury, I even used to advocate vaccines containing thymerasol, water containing hexaflurocilicic acid, and I would frequently eat food from containers which leeched bi-phenol-acetone into the food, I would also eat caged hens eggs, meat containing carbon monoxide, etc, until one day I learned that all of these caused adverse health effects and stopped them from my diet, started foraging for wild food, eating organic and free range food, and I thought that I was getting better, and yet when I looked around I saw people did not know or care about any of this, and I thought they were mad! Now I know it was just me all along. :)

    E.U.Genecist

  60. This is my daughter…this has a name. She has been anorexic for 12 years and has tried everything from the raw food, veganism, being a vegetarian, you name it, she’s tried it in her quest to find the perfect meal plan for herself. In the meantime, her digestive system is so messed up now that she can only eat a narrow range of foods because her system is intolerant to so many foods. Supplements…yes, many, many supplements. My daughther is a nurse and a personal trainer who can tell other people how to maintain a healthy lifestyle, yet she is consumed with finding the perfect meal plan for herself. She is severely malnourished currently and is seeing a team of people to help her overcome this disease, but the process is slow I worry about her emotional and physical health. Those people who think that going to McDonald’s will fix the problem are unbelieveably apathetic to the pain and worry this illness has caused my daughter and those who love her. As a mother, it is a horrible feeling to watch your child slowly die while feeling so helpless at the same time. Thank you for your work. I am so glad to have found this website.

  61. I have a friend who has this problem. She recently went through chemo and a double mastectomy. They may not be able to do chemo because of how thin she is! This is a devastating illness and it is horrible to watch your friend go through it. The terrible thing is that she refuses to recognize she has a problem. And it came on so gradually that it got out of hand before we knew it. It started with eliminating sugar. Then she would decide she had certain illnesses such as celiac disease and eliminate more foods. Now she claims to get the shingles due to eating sugar. I’m so scared for her and I wonder if we should try an intervention…but then I do not know of a treatment provider in my area (Memphis) who recognizes this illness and knows how to do anything about it. Just very concerned about my dear friend!

  62. Pingback: Steven Bratman
  63. Actually, I developed a lot of these symptoms as healthist eating as I’m wont to call it was supposed to make me slim. This behaviour also ramped up compulsive eating disoder, where your appetite will not close up and switch off, to counteract it.

    I didn’t make the connection until I stopped trying trying to live by calorie manipulation.

    Truth is, unless you have an actual health issue-such as celiac’s disease or gluten intolerance/allergy or say diabetes-which is mainly genetic, most stringent eating regimes are either (early stage) anorexia or orthorexia etc., in the form of a lifestyle. People have to understand they can both trigger overconsumption of the very foods you are trying to avoid.

  64. Dear Dr. Bratman – I appreciate your definition. My daughter has an obsession about not eating anything with saturated fat, no matter how small the amount (even .5 grams). Unfortunately, many things you buy in the grocery store have at least a negligable amount of sat fat, and if they have no sat fat, they are usually fat-free. Therefore, this greatly reduces the amount of food available to her that would be otherwise healthy and well balanced, and limits her to mostly fat-free items when she could use some fat in her diet. Further complicating this is that she weighs 106 lbs and has gastroparesis, so her choices are even more limited. Even Ensure has a small amount of sat fat, so I have to order fat free nutritional drinks. If you would kindly e-mail me and let me know if her condition fits within your definition, I would appreciate it. Thanks!

  65. Orthorexia sounds like it means healthy appetite. Of course people are going to become obnoxious at the idea a healthy appetite should be labeled a disorder and corrected with prescription drugs. Since you wanted the emphasis to be on “unhealthy obsession”, why didn’t you label it that instead? Why not call it “obsessive compulsive eating”? As currently labeled, it can be used by vested interests for their gain and maybe even used to determine what food choices we will be allowed – for our own protection. For example, if we want to choose organic, someone out there can now “diagnose” us. The word is even in my spellcheck program! Scary. It sounds like you would call this a misinterpretation of your term. If true, I hope you’ll try and rectify it.

  66. Dr. Steven Bratman, most professional athletes are obsessed with eating healthy. They carefully calculate their Carb/Protei/Fat intake every single day of their life. Do they have Orthorexia nervosa too, or due to the nature of what they do, it makes it okay for them to have such obsession?

    According to http://www.diabetes.org : 23.6 million children and adults in the United States—7.8% of the population—have diabetes. The numbers are growing every year. The cause of this is mainly poor diet.

    Lets assume that a person has Orthorexia nervosa and is obsessed with eating only healthy food and has easy access to it. On average, he or she will eat 3-4 meals a day. This persons refrigerator is filled with organic products so he/she never has a problem with eating healthy. Whenever this person runs out of organic food, they just go to the local store and get some more. How can this person be considered ill? They just chose to be as healthy as they can be, because they have the opportunity to do so.

    Some people are obsessive by nature. Obsessive behavior in general could , and in most cases is considered a disorder. But it has a name already ‘OCD’ and has treatments for it. All Orthorexia nervosa is, is a form of OCD that you have isolated and labeled as a separate thing.

    If a person has an unhealthy obsession of closing the door 12 times before they exit the room you do not label his syndrome as ’emmoní̱ me to kleísimo to̱n thyró̱n’, which in Greek means ‘obsession with closing doors’ and invent a cure for it. You just label him as having OCD.

    I can’t really understand how an individual who is intelligent enough to become a doctor could come up with something so ridiculous.

    I have to compliment you though. The level of creativity that is required to come up with something like that is truly impressive. You must have waisted a great amount of time coming up with it.

    And here we are, stupid every day people, thinking that our doctors are spending their precious time searching for cures to cancer and other real medical conditions that threaten our existents, when in fact some of them are just inventing new ones.

  67. Ha ha, oh yea – – I would still rather eat cardboard than eat at Micky D’s! And I still won’t own or use a microwave.

  68. This is just my experience, it doesn’t mean I think everyone who eats healthy has the same experience or motivation. It’s just what happened to me:

    I went on a decade-long search for what was ‘wrong with me’; I had debilitating migraines and extreme lethargy, fits of rage and TMJ. I started with SugarBusters and then removed Red Dye 40 and both made a dramatic difference in my health (I also added chiropractic care and other natural approaches to health). At first I made gradual changes and it felt good so I went deeper in to health and wellness, nothing wrong with that, right? And at 5’7, 130 pounds it was never about the weight. I wanted to feel better. After I had a child diagnosed on the autistic spectrum we added gluten-free, casein free and more natural health measures (energy work, detoxing, getting rid of all toxic products in the house) – – who can argue with that? I learned so many things and I was thrilled to make these life changes. It was better for my family, for the environment – – I shopped local and paid attention to the source of our meat/fish/grains/etc. My grocery bill went sky high and it was worth it! We were ready to grow our own food, considered buying into a whole cow, bought our whole raw milk ‘under the table’ at the farmer’s market, picked up our goats milk direct from the farmer down the street and bought a diesel old school mercedes to get ready to drive a grease car – – I don’t know where I turned the corner.

    Eventually, slowly, unbeknownst to me I wasn’t able to eat anything. Sounds extreme but say it was, a salad: are all of the greens and carrots/etc organic, locally grown, fresh? Do the dried fruits contain sulphur? Are the nut seasonings msg free? Does the dressing have msg, hydrogenated soybean oil, or high fructose corn syrup? I would add beets and chickpeas for nutrition – – I hate beets and whole chickpeas. Is there aspertame, artificial dyes or any other GMO’s in any of the ingredients? I still think all of that stuff is unhealthy and in many cases, unethically produced and sold to the masses, however…When the salad was served at my mother-in-laws house or in a restaurant while I was eating with friends then one of two things happened: I didn’t eat it or I ate it and immediately found a way to ‘detox’ it, I never made myself throw up, I used enemas (coffee or lemon or whatever my health books recommended) and detox diets. I felt toxic until I had done my routine. As I chose not to eat more and more things there was, eventually, nothing left for me to eat. If one MUST have organic, locally produced, steel cut oats and the health store is out of them, then no oats for today! I did have less headaches. I educated everyone I know about the dangers of food, additives, organic and became a go-to source. I started a blog called ‘Radical Natural’. It was all very noble and spiritual and common in my community.

    All meats were polluted so I ate none (today clean meats are easier to find in my town but at the time it was very difficult to find – forget eating out!). I didn’t swim in pools because of the chlorine or use any products with sodium laurel sulphates, etc. Whole house filter, natural toothpaste, natural make-up or none, cotton only clothes organic cotton when possible. Homeopathics, herbs, vitamins, supplements, filtered air, watch out for outgassing!, NO MICROWAVES EVER, nothing charred and the list goes on.

    Healthy living! And then I weighed 105 pounds, my ribs and hips were jutting out; I’d had two children and was now a size 0 – – I had never, even in high school, been a size 0. My friends were so proud – they took me shopping to celebrate my new emaciated frame. My skin was grey and my hair was greasy and dull and my eyes were sunken in and I thought it was great! I was so CLEAN. And my family was so healthy. And it was all about the food, soaking grains, making yogurt or cheese or bread…I had total control over our diet and the kitchen and the groceries. I would’ve kept going except that my husband and I separated and when I moved in with a friend she flung open the cabinets and said, “there’s no hay and sticks in there, but you can eat whatever you want.” The first time I ate an apple from her fridge I felt like gagging.

    But I ate it… and that was the beginning of a road back to balance, FOR ME. My husband and I reunited and started to try and pick apart the food web we had created. I did eventually get treatment for the mental obsession element of my version of ‘healthy living’.

    I’d never heard of orthorexia. I saw a TV program about it and my jaw dropped open. I cried because I felt like I had been spared the fate of the man on the screen who weighed 90 pounds and spent his days obsessing about healthy food and food preparation.

    I still don’t touch Red Dye 40 or MSG and we do the best we can with the rest. (My friend that I lived with eventually saw the value in organic foods and has since started to eat healthier.) We hardly get sick (I have three kids) and I almost never have headaches. I should exercise more but I don’t and while I would rather swim in a salt water pool I refuse to let chlorine keep me from something I love to do. (It’s still toxic and itchy, but so is everything!) I’m about 10 pounds overweight and everyone I see tells me how great I look (hair, skin) and then express their concern about how I used to look and act and be about food.

    I have a friend with celiac disease and I am proud that we have the knowledge to have her over and feed her safe foods. She has a disease. Certain foods save her life. If she could eat more freely she would.

    While orthorexia has not been made into an official diagnosis, it describes my experience. It is a form of OCD. When I start thinking about feeling impure or like all food is poison or I need to detox I tell someone and talk it through.

    We are a happy, healthy family doing the best we can in the world we live in (and yes, it is toxic! I wish it weren’t but, it is.) I don’t reject healthy living. We just enjoy life.

    If this diagnosis helps someone restore balance and be able to live in the world we live in, enjoy food, feel healthy and HAVE TIME TO ENJOY GOOD HEALTH then what’s the harm of this website?

  69. You so-called doctors need to find something else to do other than coming
    up with “illnesses” to treat so you can line your pockets.
    The only reason doctors are creating in their minds and “Illness” of eating
    right is because they are angry that people are finally taking their health
    into their own hands instead of relying on $500 medications in to keep them healthy.

  70. Dear Steven,

    My name is Sophia Jansson and I am a Swedish student who is currently working with a project about orthorexia with my friend Helena Hallin. We have several questions and would love for you to answer them since you’re the one who came up with the term Orthorexia. If you have time and wan’t to help us, please contact us my mail (sophiajansson@hotmail.com).

    Thank you for your time
    Best wishes, Sophia and Helena

  71. Dear Steve,
    First of all, I can not believe some of these rude and negative comments on here. These people don’t understand this problem, and should keep there comments to themselves. Last week was the first time I had ever heard of the word orthorexia… now it’s a major part of my everyday life. My best friend’s 16 yr old daugher , we believe, has orthorexia. In the past 6 months we have watched her (in this order) start a diet, exercise, loose weight, become heath concious, loose more weight, obsess with the backs of boxes in grocery store, stopped eating processed foods, etc. Last week she spent 3 hrs in one isle just reading the labels on foods. She has lost so much weight….. she looks ill, pale, tired. She needs help. All the while thinking she is doing her body good, and proud of herself. It is a scary disorder. She looks anarexic now, and still is completely consumed with the food she puts in her mouth.
    Thank you for your studies. Dawnya Goodridge

  72. i know what helped mt orthorexia, is having health goals, and when i reached them, my orthorexia went away a lot, and i felt les guilty about eating bad food because my goals were accomplished anyway

    like clearer skin
    more energy
    a stable weight

    etc

    1. If a person is overweight, has a goal of weight loss, and achieves it, they’re not anorexic. Similarly, healthy eating with achievable goals is probably not exactly orthorexia. It’s just healthy eating.

  73. Keep in mind that Holistic Harry is fiction! Also, you haven’t read the end yet … but, yes, it is more or less autobiographical. I’m not so much cynical about alternative medicine as deeply disappointed.

    For those interested, it’s available here: http://www.mendosa.com/Confessions.pdf

    This is really going to get me a lot of hatemail … however, keep in mind that I nail the quackbuster in the story too!

  74. Hi Stephen,
    I am curious about this ‘Orthorexia’ term you have come up with. I am not clear what you mean by it.
    I can imagine a couple of different ways it can apply to people:
    -If you invite someone to dinner, and tell them you used Organic product, and then after the meal you told them you had lied, that these people would either become violent, or would throw up the food.
    Or
    -Do you mean it to describe people who will only eat Organic food, non-GMO, non-treated foods (Milk without BVGH and pesticide free), and foods that don’t contain high-fructose corn syrup?
    Or
    -Do you mean it to describe people who, if they do not have the option of the previously described group of food will choose not to eat at all?
    I also noticed that the woman, Katie who starved to death was included as an ‘Orthorexic’. I am confused as to why you included her in this group since starving yourself is termed as ‘Anorexia’, which is thought to be caused by more than just a desire to lose weight; genetic inheritance, environmental factors, mineral and chemical imbalances are just a few examples of an excessive list compiled by physicians to be causes.
    I guess I’m confused because of her desire to eat healthy and instead of eating so called healthy foods as Organic foods, non treated or natural foods (which are widely available), she chose not to eat at all. Did she simply have an aversion to all foods because her standards of healthy meant that nothing was healthy? As far as I can tell she had an aversion to food full stop.
    I’m also confused about you talking about Raw Foodists and vegetarians as ‘Orthorexic’ (I enjoy my veggies the most when they are raw, but also eat cooked food and meat), I know a good number of raw foodists and vegetarians, none of whom are either emaciated, unhealthy or display a reluctance to eat food, if any thing these people really like food and eat with the same gusto as carnivores do. I understand that you do not consider these people to be unhealthy as a whole, yet you lump them into the Orhtorexic category. So again I’m confused by what you mean.
    After reading about ‘Orthorexia’ I am curious as to whether there is a term describing people who refuse to eat anything healthy. One of my college roommates was one such examples, he ate nothing but microwavable and processed food, for breakfast, lunch and dinner; the idea of eating a ‘home-cooked meal’ , fresh vegetables or fruit simply repulsed him, we all just figured ”his loss, more for us”.
    It would only seem logical, given that there are people who won’t eat (Anorexics) and people who will not stop eating (Bigorexia or muscle Dysmorphia), that there is also a group of people who are the opposite of Orthorexic, yet you do not mention this group. I have not read your book and cannot say for sure that you have not also coined a term for them.

    In essence, I’m confused.

    I am very interested in hearing your thoughts on the matter, unlike others who apparently are not, and only want to vehemently criticize you, as can be seen on your ‘Reader Hatemail’ page.
    I hope you respond,
    Thank you for you time.
    Max from sunny Colorado.

  75. Dear Steven/Dr B,…Thanks for the validation. i observed this phenomenon in a small group of friends who became interested in yoga and eastern spirituality. What began as simple vegetarian choices, which seemed moderate and balanced, eventually morphed into what felt to me like “food fundamentalism”. As long as ten years ago I began to question whether they were displaying “an eating disorder veiled behind white gossamer cotten.” which I wrote in an article at the time. I suspected people were not choosing as much as reacting. In a culture where over consumption of food in general is the norm and excessive meat eating is common, are many people merely reacting to that extreme by going to the other extreme?
    While I sensed what you have confirmed, it was challenging at times to trust myself since so many close friends were espousing this dogma, which they saw as an essentail part of their spiritual identity. While I was comfortable with my middle path, I questioned whether or not I was just not spiritual enough, disciplined enough.,Peer pressure is tough. And tricky because what they were doing looked so noble…both from a physical health and spiritual angle. Just goes to show anything taken to extreme can be potentially harmful, hence the wisdom in “everything in moderation.”
    Best Wishes, Dianne

  76. Hi Steven, I hope you don’t mind me popping a message on here. I am trying to get hold of you for a feature I am writing about Orthorexia for a leading young womens magazine in the UK. I have tried your publisher but no joy! It would be absolutely fantastic to speak to you/or communicate by email. I have a bit of a tight deadline (tomorrow) so if you get this I hope to hear from you, Kind regards, Amanda Kelly (amandae.kelly@ntlworld.com)

    1. Amanda: Hi. The book has been out of print for almost ten years, so I’m not surprised the publisher can’t find me. (It’s technically available at Amazon, but it’s printed on demand, about 10 copies a year.)

      But, sorry, I’ve stopped giving journalist interviews. I really don’t have anything new to say!

      1. Hi Steven
        Thanks for getting back to me! Well, it may interest you to know that I have spoken to several experts over here who all acknowledge Orthorexia and have come across it in their practice. I am surprised at the nasty comments on here! Anyway, thanks again, Amanda

  77. Good food prepared with love and eaten in good company is always good medicine.

    Julia Child managed to make it to 92 as a joyful omnivore. Here’s to butter, wine and love – in whatever order you like most.

    Thank you, Dr. Bratman for your insight. Not only is there health and wisdom to be found on the Middle Path, but love and joy. It saddens me deeply that so much good food is eaten (or piously not eaten) in the pursuit of unattainable perfection. If the perfect diet has neither love nor joy in it, I want no part of it. I think I have caught a glimpse of this Orthorexia creature, in my own mirror. I have just abandoned a “detox regimen” because I noticed one morning that all the fun had gone out of preparing and eating food, and I am now determined to cultivate a healthy, happy and yes, even flawed relationship with food. I am happily married to a wonderful and imperfect man, my little house is never spotless, my dogs bark when they should be quiet and my beautiful daughter talks back to me and doesn’t floss her teeth or practice her violin or clean her room every single day. My grandmother used to have a little sign in her kitchen that read, “My house is clean enough to be healthy and dirty enough to be happy.” I am working to live – and eat – by this very guideline. If anyone else would like to join me, then maybe we could get together for dinner.

  78. I fully agree with you Dr. Bratman. As you say it is only in total extreme cases, so you’re not atall encouraging people to eat unhealthy, just to be aware of extremeness good or bad, right?
    Could I be wrong when I suggest that stress is the most harmfull fact in Orthorexia?

    1. It’s only _dangerous_ in utterly extreme (and very rare) cases. But it can be a psychological problem in less severe cases. Workaholism is a good analogy. Few people die of workoholism, though, of course, it _can_ happen. But there are many people who so overfocus on work that they neglect their children, their spouses, their souls, etc.. Similarly, there are people who so overfocus on healthy diet that they neglect everyone and everything in their lives other than food. This isn’t dangerous, but it’s certainly out of balance. There’s no point in living so healthy a life one hasn’t time to live!

  79. ohhh and also….when did this disorder took place? or it has been all along since bullimia and anorexia? this is very interesting not just for personal info but because it´s important for me as a psychology student.

  80. Dr. Bratman… i recently learn abour orthorexia, also about vigorexia and tanorexia (those written in spanish) but my question is…are these disorders included on the latest edition of the DSM? i mean….these are disorders with a cientific support rigt??

    1. It’s crazy how people can’t even read. Look at the page your posting on, Abby, he says it’s not a DSM diagnosis!!!!!

  81. I have recently come out of a long and loving relationship with a wonderful young woman who suffers from this exact condition combined with OCD and an exercise compulsion. The amount of unrelenting, crippling stress and anxiety it placed 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 incredibly distressing to see someone go through this as they strive to do the best for themselves in such a self destructive way. Up until now 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 it is real and the cause of misery. Dr Bratman should be supported in his endeavours to help sufferers and I applaud his efforts.

    1. I’m glad you found it helpful!

      To the others who get so angry at me: It’s this kind of situation that I’m writing for. I’m not trying to talk the world into eating junk food!

    2. Its apparent that you and this Bratman are both jackasses in the extreme. It is beyond comprehension how any sane individual can come to such a mentally crippling conclusion , that eating whole clean food is now considered a “sickness” when in fact, it the support of GMO foods and pesticide laden foods as espoused by the eugenisists that is the real sickness and destructive to humanity.

      Every five years, the fake profession of psychiatry comes up with their new mumbo jumbo list of diseases. These people are pathetic charlatans who definitely need mental help.

      I eat , as best as I can, Organic foods. I am neither obsessed with it, nor am I malnourished by it. To state that eating healthy food is a sickness, is indeed a sickness. GET A LIFE JACKASSES!

  82. what a crock…so what is it called when you eat processed foods with chemicals not meant for the human body—and eating foods with pesticides on it–give me a break

  83. Wow, its ashame no one actually seemed to read what Dr. Bratman had to say. I think it is an extremely far cry to conclude that he is in any way recommending people go out and abandon healthy eating. Healthy eating is definitely something that is crucial to ones overall health, but what the doctor is trying to say is that when it is taken to an EXTREME it can cripple people to the point of starvation. Rather than coming in here with a terrible attitude and attacking him with outlandish claims, lets just take a minute and examine the possibility that an obsession of anything, even good, can become harmful when it begins to interfere negatively in people lives.

      1. Then call it an obsession. Don’t make up disorders out of the blue, that’s absolutely… hmm, let’s say… UNORTHODOX!!

    1. OK, first off how can eating healthy have a negative affect on anyone’s life??? second, explain to me how eating healthy can be taken to an extreame. clearly, if you starve yourself you have a problem and need help. but anyone who watches what they eat and makes the concious choice to eat healthy foods isnt going to starve themself. and if im correct starving yourself thats called anorexia – NOT HEALTHY EATING!! i can only imagine what your diet consists of and how much you weight.. oh and also what kind of life style you life… UGH!

  84. I can understand where you’re coming from, Dr. B, but the problem is, how do you quantify when someone has reached an OCD-level in their food choices? I have chosen to eliminate grains and refined sugars from my diet, because I understand the damage they do on the human body. Does this make me obsessive? I don’t have nightmares about it, it’s not all I think about all day long, but it IS a conscious choice.

    I think this silly term you’ve coined is irresponsible.

    1. How would one quantify when someone is a workaholic? Do you think the term “workaholic” is irresponsible?

      1. You can not equate “workaholic” to healthy eating. Workaholic is a term meant to bring focus on a healthy life-work balance. The negative label you place on those choosing to eat healthy is destructive and irresponsible.

  85. dr. bratman,
    You are a moron. please go to mickey dee’s and chow down on a few big mac’s and don’t call me in the morning.
    I guess Monsanto’s GMO products, high fructose corn syrup, aspertame, processed sugar and flour are great for us.
    Amazing that they give a PhD in medicine to a fucking imbecile.
    Have a great day and don’t forget to supersize you idiot.

  86. you sir, are an idiot!
    So now avoiding unhealthy food is a mental disorder!
    ok, so to prove my mental well being I think I’ll go fill up on some greasy McDonalds.

  87. What an idiotic statement. This is as moronic as psychiatrists trying to tell people they have math disorders because they have trouble with algebra or that kids are mentally ill because they have trouble speaking in front of the class.

    All these mental “diseases” that the psychs are inventing (not real diseases that come from biopsies, bloodwork, etc.) are for profit only. They make things up so that they can sell bogus treatments and drugs and the gullible fall for it.

    But this one is about as stupid as they come. You’re an idiot and an opportunist for even suggesting such a thing. I hope somebody turns you in for fraud and incompetence.

    1. It’s all over the Internet that he’s a a shill for the AMA and big Pharma. They’re afraid that if we don’t eat their crap we won’t get sick and then the won’t make any $$$.

      If he publishes this comment it’s because he wants you all to think that he’s not those things, other wise why would he? And it’s true, you eat right, you won’t get sick. Why do you think people used to live to thousands of years old? Because they ate nothing but raw.

    2. John Galt, you said it! But why wait for “someone” to turn this a*hole in for fraud and incompetence…. Let’s do it together now!

  88. So good to hear a Doctor is taking the problem of people eating healthy seriously. Its just sad to see people go buy organic food, with no pesticides or herbicides, or GM food, when McDonalds across the street are serving wonderful non-ecologically farmed, meat-tenderized hamburgers and pesticide lazed salads served with a fresh cup of aspartame based soft drink. Yum!

    Go Dr Steven!

    1. LOL!!! this is great!! yes lets go eat mcdonalds and drink pepsi and eat fries. I wonder what this doc eats and what health hes in. He should be serioulsy evaluated for his outrages statements!

  89. Hello Steve,
    What a pleasure it is to come across your work on orthorexia as I am preparing to lead a workshop entitled, “The are of baking bread and an evolving picture of human consciousness”. It has been some time since we had our dish washing conversations back in Olympia. I hope that your journey is proving as interesting as mine.
    Best wishes,
    Warren

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