A blog by Araminta Jonsson.

In recent years, concerns over individuals who pathologically eat healthily has risen. Clinicians and researchers, mainly within Europe, have shown more interest in what has been termed the eating disorder: Orthorexia. However, this is a fairly new phenomenon and it wasn’t until 2014 that the condition really became known in the public domain. It was in 2014 that a woman named Jordan Younger, author of the blog “The Blonde Vegan”, shocked her thousands of Instagram followers by admitting that behind her happy clean eating public persona, she was actually suffering from an eating disorder. Not one that was based on the quantity of food she consumed, rather the quality of it.[1] Once Jordan went public with her condition, the media leapt on it. They reported her story across various media outlets and interviewed her on a multitude of news programmes and chat shows - thus ensuring that the previously little known about condition, orthorexia, was now public knowledge.

It was the physician, Steven Bratman who, in 1997, first described Orthorexia Nervosa in an article written for Yoga Journal. He created the word orthorexia from the Greek words “ortho”, which means “straight or correct” and “orexi” which means “appetite.[2] However, it wasn’t until 2004 when five Italian food scientists; Lorenzo M Donini and colleagues, conducted a preliminary study[3] of Orthorexia Nervosa in which they proposed a diagnosis and attempted to measure the dimension of the phenomenon, that the term and the condition became noteworthy enough for other scientists to begin exploring it.

As outlined in Donini et al’s study, those who suffer with Orthorexia Nervosa value the type of food they consume above all else, regardless whether the eating of it causes them negative health consequences: ‘In extreme cases, orthorexic subjects prefer to starve themselves rather than to eat food they consider “impure” and harmful to their health[4]’.

The current problem for those suffering with Orthorexia is that, despite there being ‘convincing case studies and broad anecdotal evidence to conclude that sufficient evidence [for Orthorexia Nervosa] exists[5]’, it is currently not recognised as a condition in its own right in the DSM-5. This is an issue with regards to treating individuals suffering from ON because, unlike Anorexia Nervosa, (which is what many people with ON will be classified as having), ON sufferers are not restricting food in order to loose weight. They ‘tend not to have issues with how their perceive their weight or body shape, nor is their self evaluation unduly influenced by weight or shape.[6]’

The National Eating Disorders Association does recognise Orthorexia as a condition and on their website they categorise it as ‘an unhealthy obsession with otherwise healthy eating[7]’. However they also suggest that it is closed linked to OCD and that studies have shown a link between the two conditions[8]. Because it doesn’t have a formal diagnostic criteria, it is difficult to get a hard estimate as to how prevalent the illness is. However, we are seeing a trend these days for healthy eating. Awareness around foods we consume and what we should and shouldn’t be eating is growing. However as more and more people go vegan, gluten and diary free, more and more people are presenting with symptoms of Orthorexia.

According to Dr Angela Guarda, director of the Johns Hopkins Eating Disorders Program, ‘eating disorders reflect the culture… “Twenty years ago, many of the patients I saw with anorexia were vegetarians. Now, they also talk about eating exclusively organic food or say that they are lactose intolerant and allergic to gluten, when their blood tests show that they are not. These explanations are convenient ways to hide their fear of eating high calorie foods or foods prepared by others which provokes anxiety.”[9]’

It is rare today that there isn’t someone within your friendship group, or out of your acquaintances that hasn’t been on a fad diet in a quest to become more healthy, or loose weight. We live in a food obsessed culture where entire sections of supermarkets are taken over by gluten free/diary free/vegan produce, despite the fact that only around 1% of the population actually suffer from a serious allergy to these ingredients.[10]

Sondra Kronberg, a nutritional therapist and spokeswoman for the National Eating Disorders Association, says that ‘healthy eating can take on a quality similar to religious fervor, in which certain foods are sinful and eating in a certain rigid way is godly and rewarded[11]’. However, people need to be aware that it isn’t too big a jump from attempting to eat healthily with the best of intentions, to starting to restrict more and more food groups until you are no longer able to partake in social activities for fear of having to eat something “forbidden”. In our society today where the wellness industry is thriving, we need to make sure that our “healthy” habits are not turning into something more sinister.