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What is Orthorexia Nervosa?

Differences Between Anorexia and Orthorexia

By Brooke Finnigan

Orthorexia Nervosa is a term coined by Dr. Steven Bratman, who first published his insights to the readers of Yoga Journal in 1997. Bratman, a physician who utilizes dietary medicine in his practice, and, a long time proponent of the health food movement, wrote about his experiences, and how the impulse to be healthy can be taken to dangerous extremes.

In Bratman’s experience, a person struggling with Orthorexia Nervosa is someone obsessed with nutritional and physical purity, frequently to the point of emaciation. The goal, says Bratman is, ” to feel pure, healthy and natural.”

You won’t find Orthorexia Nervosa in the Diagnostic Statistic Manual, (DSM IV TR), yet, but his work is being taken seriously by those in the eating disorder community. Especially as more people turn to alternatives in nutrition, and more of those alternatives become extreme.

For example, one of the biggest health food fads right now is the raw food movement, (which is limited to fruits, vegetables, and legumes). Adherents of the raw food movement, like celebrity Demi Moore, believe that cooking food saps it of all nutritional content, and that a diet that consists only of raw fruits, vegetables, and legumes, is the key to perfect health. An even more extreme branch is fruitists, or fruitarians. As the name implies, they eat only fruit and fruit like vegetables, (tomatoes and cucumbers).

Whether a Jenny Craig adherent or a Fruitarian, people are attracted to structured food regimens for similar reasons. Restricting or altering food intake gives one a sense of internal control. This behavior is a coping mechanism to avoid other, more painful issues. In other words, by fixating on fat count, we don’t have to be aware of the emotional duress we’re feeling about work, school, or important relationships in our lives.

“Orthorexia begins, innocently enough, as a desire to overcome chronic illness or to improve general health,” says Dr. Bratman. “But because it requires considerable willpower to adopt a diet that differs radically from the food habits of childhood and the surrounding culture, few accomplish the change gracefully. Most must resort to an iron self-discipline bolstered by a hefty dose of superiority over those who eat junk food. Over time, what to eat, how much, and the consequences of dietary indiscretion come to occupy a greater and greater proportion of the orthorexic’s day.”

While the motivation is slightly different, the rituals around food, the strong need for control, the obsessive ideation, and the harmful belief that life will be better when the person achieves their goal, adds up to archetypal eating disordered behavior. Dr. Bratman says, “Orthorexia bears many similarities to the two well-known eating disorders anorexia and bulimia. Where the bulimic and anorexic focus on the quantity of food, the orthorexic fixates on its quality. All three give food an excessive place in the scheme of life.”

And just as the motivations and underlying behaviors are similar between Anorexia Nervosa and Orthorexia Nervosa, so is treatment. Getting help for Orthorexia involves working on setting boundaries, development of interpersonal skills, and healthy esteem. Attention to creating more nurturing coping skills is necessary, as is acknowledging and working through the emotional pain that leads people to have an unbalanced relationship with food and themselves, in the first place.

By taking the emphasis off food and onto emotions, a person who once struggled with Anorexia, or Orthorexia, can put food back into its rightful place, and live life feeling healthy, in mind, body, and spirit.

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