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The sad story of orthorexia

Orthorexia is an eating disorder that is slowly being recognised as a serious illness, despite the concept that it's a 'healthy' eating disorder. The behaviour surrounding food, as seen in orthorexia, indicates a similar feeling of control that anorexia exhibits, often hiding some underlying emotional issues.

The healthy eating disorder?

Anorexia, bulimia, and binge eating disorder (BED) are types of disorders that many are familiar with. In recent years, orthorexia, a new type of eating disorder has emerged. Until a few years ago, there were so few sufferers of orthorexia that doctors usually included them under the catch-all label of other specified feeding or eating disorders (OSFED). However, since then, orthorexia has taken up such a significant proportion of the OSFED group that experts suggest that it should be treated separately. The term 'orthorexia' was coined by Dr Stephen Bratman in 1997, to describe an eating disorder characterised by a fixation on what the sufferer considers to be healthy food. Where the meaning of the Greek work anorexia is 'without appetite', orthorexia means 'correct appetite'.

What is orthorexia?

A person suffering from orthorexia has developed an obsession with healthy food, frequently displaying symptoms that are consistent with obsessive compulsive disorder (OCD). Typically, eating disorders are accompanied by a ritualistic component. For someone with orthorexia, this might manifest in the meticulous planning of a meal, up to 24 hours in advance, despite rarely deriving any pleasure from the consumption of food. While the focus for most eating disorders is on the quantity of food consumed, the person suffering from orthorexia is obsessed with the quality of the food. The issues underlying orthorexia are often the same as anorexia and the two conditions can overlap. Both are characterised by a rigid 'black and white' thinking style as expressed by the need to distinguish between what they call ‘good’ and ‘bad’ foods. For people with anorexia, foods are frequently labelled ‘good’ or ‘bad’ based on their calorific content. However, someone with orthorexia may refuse to touch any foods that have come into contact with pesticides, sugar, salt, caffeine, alcohol, wheat, gluten, yeast, soya, corn and dairy foods. This can be just the start of their diet restrictions and what they label as ‘bad’. Whereas in anorexia, the driving force is to not eat, in orthorexia, the compulsion is to eat 'right’. Crucially, while extreme orthorexia may lead to symptoms resembling those of anorexia, what separates these two eating disorders is the underlying intention.

What are the causes?

According to Bratman, the problem starts with the deluded belief that every aspect of our health, from what diseases we get, to our emotions, can be controlled by the quality of the food we consume. Paradoxically, once the illness progresses, the sufferer's health becomes the thing that gets compromised.

Many clinicians describe eating disorders as an addiction to control, much the same way the alcoholic is addicted to alcohol. Similarly, orthorexia, although a disease disguised as a virtue, is offering the sufferer a sense of control and superiority as a means to cope with underlying emotional issues. On the surface, it may appear virtuous to be striving for optimum health, and while this alone will not cause orthorexia, it can easily become an illness. When the pursuit of healthy eating becomes an obsession, putting strain on other important areas of life, it becomes an illness. While orthorexia was first described in 1997, the behaviours accompanying the illness have been known long before. No figures of the exact number of sufferers in the UK are available, but anecdotal evidence suggests that orthorexia is becoming increasingly prevalent and that equal numbers of men and women are affected. With the frequent reporting of macrobiotic and raw food diets as promoted by a number of Hollywood celebrities, it sadly seems reasonable to fear that these numbers will continue to increase.

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