CLARIFYING ORTHOREXIA:

Obsession with Dietary Purity
as an Eating Disorder

NEWS (19 MAR 2008): TV news program seeking orthorexics
A national (U.S.) TV network news program is conducting background research for a possible story on "orthorexia." Orthorexia is the colloquial term for an obsession with eating only healthy foods. It is motivated by a desire to feel healthy, natural, and "pure" -- as opposed to anorexia, which is motivated by a desire to lose weight. They are looking for individuals who who think their health-conscious behavior has taken over their lives (for better or for worse) and who would be willing to talk a little about their experiences All conversations are not for attribution. If you are interested, please email: emmygenz@mac.com. (This notice will be removed at some future time.)

Shortly after Dr. Bratman's article came out, I made a "pointer posting" on two of the internet's alternative diet listgroups identifying the "Health Food Junkie" article, encouraging others to read it, and providing a number of representative and relevant quotes from the article. On the Raw-Food list, my posting attracted little reaction. On the Veg-Raw list, the reaction was much stronger. A few people on Veg-Raw became very emotionally defensive, and some sharply criticized the article. (I responded on the list to the criticisms received there.) One could say that the article struck a "raw" nerve--perhaps some raw-fooders recognized themselves as being orthorexic/obsessed with food? ;-)

As a result of the internet discussion of Dr. Bratman's article, the following clarifications of the concept of orthorexia are given here to address the misconceptions and misunderstandings that seem to have arisen about it.

• Orthorexia is a long-term behavior pattern, not short-term. When one switches to a difficult/restrictive diet, one must pay considerable attention to food and related matters until the new dietary regime becomes habitual. Such a transition period may last for weeks. After the new diet is a habit, however, attention to food should then decrease to a very low level. Paying attention to food for a few weeks during a dietary transition is not orthorexia; constantly obsessing on food over the long run IS.

• In order for orthorexia to be a disorder, all that is required is for it to have a significant, negative impact on an individual's life. A person does not have to think of food 100% of the time to be orthorexic. (Even those suffering from severe anorexia nervosa, for example, think of many things besides food.)

• Adherence to strict religious food disciplines is also not orthorexia. Religions are based on love (at least in theory), so religious food disciplines are (in theory) also based on love, hence are not pathological (orthorexia is a pathological fixation on food). In contrast, the motivations for rawism promoted by some extremists--fear/hatred of cooked food, mucus, protein--when they become obsessive, can indeed become pathological. In short, love is not pathological, while fear, hate, and extremism, ARE pathological when they form one's ongoing basis for behavior.

Close attention to diet is obviously needed and appropriate under the following circumstances:

• For a short period, while one is transitioning to a new diet. After the new diet becomes habit, your attention to dietary details can/should be reduced.

• Those who are are following a (nearly 100% raw) diet as part of a program for healing from serious illness may need to strictly follow the diet for an extended period. However, per the above, once the diet becomes habit, then attention to the details can be reduced. Also, once a person's health improves sufficiently, one may be able to be a bit less strict regarding the details of diet. Note also that attention to diet motivated by health is not pathological unless it is obsessive and/or based on predominantly negative motivations (e.g., fear of cooked foods, mucus, protein; other pathological motivations include obsessive fear of illness, aging, death).

• One is established in a diet (it is habitual), it requires little thought, and one is not emotionally attached to the diet as a badge of self-identity.

• When one is stable in good health, then one may be able to make occasional exceptions to the usual dietary regime with limited or no antagonistic side-effects.

Before discussing the middle path (moderation) in raw food diets, let us first examine the extremes:

Cult of Indulgence. This is any purely or primarily hedonistic diet in which your eyes, nose, and tastes select the food you eat, regardless of any other criteria such as how the food affects you, and so on. It is sometimes called the "see-food" diet ;-) --you see food (any food that appeals to you), and you eat it. [Side note: although it emphasizes the sensual appeal of foods, "instinctive eating," in theory at least, is not part of the cult of indulgence, as it emphasizes selection of original human foods, and eating until one gets a "stop signal."]

Cult of Discipline. This is any diet that is, figuratively, loaded with dogmatism, rules, and/or negative motivations. The effect of difficult rules and powerful dogma is to remove all the fun of eating. Instead of being a pleasant experience that nurtures you, eating becomes an exercise in stress and/or ego, as the eater tries to conform to the rules and dogma of the (usually restrictive) "ideal" diet. An example of the cult of discipline would be a 100% raw diet that is motivated primarily by strong/obsessive fear (of cooked food, protein, or mucus), and which places extreme importance in details--e.g., is the food good enough? (100% organic? fresh? local? in season?), did I combine correctly? am I chewing the food sufficiently?, etc. Such obsessive concern with details promotes stress rather than nourishment.

The above example of 100% raw could be replaced by 100% cooked, where the food must be prepared by a skilled macrobiotic chef, and the person dogmatically believes that macrobiotics is the "one true way," and all other diets are inferior/harmful. The point here is that the cult of discipline is not limited to raw. I would also point out that one can be 100% raw or 100% macrobiotic and not be caught up in the cult of discipline. To avoid the cult of discipline, one must have positive motivations and attitudes, realistic expectations, and love oneself enough to see clearly that their total health (physical, mental, and spiritual) is far more important than any dogma--vegan, rawist, or macrobiotic.

The Middle Path. This is the way of moderation, of common sense, and is open and honest. In this path, diet is a tool for good health, and health is always considered to be more important than dogma/ideology. Here diet has a small place in life (whereas it is life-controlling for the orthorexic) and is regarded as simply a support function. This is the philosophy of "eat to live" rather than "live to eat."

If you backslide on the middle path, rather than doing penance in the form of fasting, it would be better to simply do a self-analysis and see what lessons can be learned from the episode. Then put the matter out of your mind, but do remember it if you feel drawn to backslide again. (Note: you might find that keeping a journal or diary of your experiences is helpful--it can remind you of the negative impact on your health that occurs when you backslide.)

The middle path, the path of moderation, is a relatively even path. Those who binge-fast or binge-starve are not following the middle path. Rather, they are like a yo-yo going from the cult of indulgence to the cult of discipline. Some people might find it necessary to pass through such a "yo-yo" stage in their transition to the middle path. However, it is desirable to avoid that--if possible--and go directly to the middle path. (Note that avoiding a "yo-yo" stage may be easier said than done--progress in life is usually not a smooth, even process.)

It should also be noted that occasional short fasts are suitable for many people, and may be beneficial (where they are not contraindicated). Thus fasting can be a part of the middle path, if done sanely and in moderation.

The middle path is not a rawist path or a cooked path. On the middle path, one experiments to find what works best. You let your body tell you how much raw/cooked to eat. Good health is what counts, not blindly following dogma and trying to be 100% raw (or 100% cooked, or 100% anything). Remember: your health is more important than any dogma! (Note: those who adopt raw for healing may need to be nearly 100% raw for some time. If it is done in the name of health, without obsessive fear, it is still the middle path.)

In closing, let me mention again that the Health Food Junkie article is excellent (one of the most thoughtful pieces of writing on obsession and extreme diets I have read), and I would encourage every raw-fooder to read the article in the interest of taking stock of their own behavior.

After I posted the notice regarding the "Health Food Junkie" article on the internet listgroups, the following question was asked. As the question and answer are of likely interest to others, I present the following edited Q/A. The text of the question is used with the permission of the person asking, and the name of that individual will not be published.

Question: Thanks for letting us know about this article. It sounds a lot like me, I must admit. Does this mean I should now start eating cooked foods? I'm not sure what to do, and I am certainly extreme in my eating habits (wanting to eat 95% raw vegan food).

Response: No, you don't have to eat cooked food. You can eat 95% raw and still be mentally healthy--but some effort may be required to maintain balance and mental health on a high (%) raw diet.

What to do? Don't let food rule your life, as orthorexia occurs when food dominates your life, or, figuratively, "eats you." View diet as a tool for health. Aim for high (%) raw if you wish, but don't obsess about it. If you find it appropriate to eat some cooked food, don't feel guilty about it, and don't go on a fast simply as penance for past dietary "sins," or in an obsessive search for dietary purity.

Don't let your diet determine your sense of self-worth. Don't make diet an important part of your self-identity. "I'm a worthy, though imperfect human being, surrounded by other, similar human beings" is the attitude, not "I'm a 100% raw vegan surrounded by 'inferior' consumers of cooked foods or animal foods." In my opinion, the latter attitude is based in ego and hatred, and is what (unfortunately) drives some extremists. Such negative attitudes also promote social isolation (a real problem for rawists), and polarize one's experience of society by dividing it into "us" ("good" rawists/vegans) versus "them" ("bad" meat-eaters or cooked-food consumers). The egotistical elitism that divides society into "us" versus "them" directly contradicts the compassion that is supposed to be at the heart of veganism.

Another way to look at the above is that "I'm a person" should be first in your mind, not "I'm 100% raw," or "I'm a vegan." Those are just dietary labels: your status as a human being is more important than dietary dogma (i.e., what your lunch is). This point might seem unnecessary, but in my opinion, the email lists (Raw-Food and Veg-Raw) have seen some prime examples of extremists who appear to place dietary dogma above the rights, humanity, and even the existence of other people. People come first, before dietary dogma--unfortunately, certain extremists appear to think it should be the other way around!

Let's return to the question of what to do here. Examine your attitude toward diet, and your personal relationship with food. Does the judged quality of your diet by itself play a large role in determining how good you feel about yourself, in the same way that daily body weight determines how an anorexic feels? (It should not--your feeling of self-worth should not be determined by your diet.) If you go off your diet, do you later do "penances" like fasting to "atone for your dietary sins"? (You should not.)

Do you think people with other diets, or no particular diet, are mere animals behaving unconsciously toward food, or are less than fully human? (You shouldn't.) Do you think that someone who eats meat is a murderer because "meat is murder"? (You should not--others have the right to choose their diet. Those who regard themselves as superior to others because they eat a "better lunch" are practicing "lunch-righteousness.") Does your diet make you feel superior in any way to those with other diets? (It shouldn't.)

Has your diet become your religion, or a functional substitute for religion? (It should not.) Are you looking for happiness, or the meaning of life, in your diet--i.e., on your lunch plate? (If so, you won't find it there.) Do you think that your diet is the one true way, the only good or "natural" diet on the planet? (If so, you are suffering from delusions, or are in denial of reality.) Is food the most important thing in your life? (It should not be.)

An honest self-evaluation like the above can be very helpful in clarifying our personal relationship with food.

The ultimate thing to do here is to change one's attitude toward food and self if one has orthorexic/anorexic/bulimic behavior or attitudes. Such behavior and attitudes are far more common in rawism than some of the "experts" or "role models" are willing to admit.

I hope the above clarifies things some. Thanks for your question!

--Tom Billings

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