Have you ever thought about the virtue of your food? Maybe you have thought about how healthy it will look to others on instagram. You can imagine others envying your healthful choices, all while the mounting likes are boosting your confidence and encouraging your dietary choices. Would you want a piece of cake that is suffocated inside impure sugary frosting or lightly seasoned steamed kale with a sweet potato? Making healthful choices versus becoming consumed with your food are two very different situations. In one a person is taking care of their bodies so they can function most effectively. In the other a person is possibly experiencing orthorexia nervosa. Having a healthy diet does not make someone orthorexic. However, having a restrictive diet and obsessive food related behaviors can lead to orthorexia. The obsessive nature of orthorexia is damaging to someone's health and social relationships. Orthorexia nervosa, also known as the obsession with healthy eating, is changing the way eating disorders are being defined, due to the person's obsession being with quality of the food rather than their weight or thinness, and is expanding the knowledge of fad diets' harmful effects on one's mental health.

Any eating disorder can be extremely harmful. Whether someone suffers slightly or extremely, it can still be life threatening. Anorexia Nervosa is a psychiatric disorder that is defined by a chronic fear of gaining weight, self-starvation, and a severe distorted body image. Bulimia Nervosa is an eating disorder that is characterized by regular binge eating and then purging. While eating disorders are commonly associated with an obsession with thinness or weight, orthorexia differs. Orthorexia is an eating disorder where the obsession is with the quality or pureness of the food the person is ingesting, and not necessarily the caloric intake or amount of food. Over time, the person's diet will become more and more restrictive and lead to malnutrition.  Steven Bratman, MD, coined the term "orthorexia" in 1997. Originally he used the term to communicate with his patients that were health obsessed in a harmful way. However, over time, Bratman and other nutritionists/dieticians started recognizing the eating habit as a genuine issue. Even though the disorder is not recognized as a clinical diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), orthorexia is serious problem that is increasingly affecting more people.

Orthorexia lies in an area that is difficult to define. The difference between someone who lives a healthy lifestyle and has a well balanced diet versus someone who is consumed by their own healthy habits is what makes this disorder toxic. This disorder is stimulated by the desire to obtain optimal health. Orthorexic people experience a, " fixation on food quality  --  a combination of the nutritional value of food as well as its perceived purity" (Koven, Abry) that leads them to omit entire food groups and have nutritional deficiencies. People who suffer from this obsession often experience intense frustration when their food habits are disrupted. If they go on vocation and can't get there normal brand of yogurt, panic or uneasiness begins to set in.  They become revolted by food that is impure, such as someone who offers them a Cheez-it. The question of how someone could possible consume processed food haunts them. Orthorexic people also suffer from self-hatred feeling and guilt when they deter from their regimented diet. Even if they enjoy the taste of pizza, the heaviness of the guilt that weighs on them is not worth the brief satisfaction of the impure food.

When people spend such an obsessive amount of time worrying about their food that it begins to consume their lives and hinder their social relationships, they are likely to be experiencing orthorexia to some degree. The nutritional issues may not be apparent in individuals initially because they appear to just be making healthful lifestyle choices. However, social issues can be more apparent to the friends and people surrounding someone who struggles with the disorder. Slowly the person will begin to go out to eat less and not join in social situations that they cannot control the food. Often people pull away from socializing and begin putting all their time into food planning and researching. It is important to recognize orthorexia even though it is not a clinical disorder yet. As McNeilly writes, "let's not forget that the term 'anorexia' was first used a full 80 years before it was included in the DSM -- we cannot continue ignoring an eating disorder because we refuse to understand what it is." Recognizing this disorder is the first step to treating individuals who are struggling with it.  

        There is a large debate whether orthorexia exists. On one side of the argument there are supporters that believe orthorexia is a harmful mental disorder that can be problematic and dangerous. The other side of the argument is the opposition. This is the group of people that think orthorexia is not a serious disorder and in some cases deny the existence of the eating disorder entirely. Author Jefferey Jaxon is a specific example of someone who is against orthorexia. He claims, "if you turn your back on low quality, corporate food containing known cancer causing toxic additives and a rich history of dishonesty rooted in a continuous 'profits over people' modus operandi, then you may suffer from a mental illness" in the article he wrote (Jaxon). The largest issue that many people similar to Jaxon have is that they believe orthorexia is a pseudoscience label created by companies that sell unhealthy foods. It is a way for them to attempt to regain business during the current healthy food trend.  While the opposition may have a point that large industries try to manipulate citizens of society by creating a plethora of diseases and disorders, they forget to consider the issue with becoming obsessed. Whether someone is obsessed with something deemed healthy or unhealthy, bottom line is an obsession is still an obsession and the affected patients need help. It doesn't mean that medication is an answer or healthy eating is wrong; it means a consuming obsession is an issue that needs helpful attention.

        An interesting topic that has influence on orthorexia is fad dieting. A fad diet is defined as a "weight-reduction diet[s] that either eliminate[s] one or more of the essential food groups, or recommend[s] consumption of one type of food in excess at the expense of other foods" (Segen's Medical Dictionary).  Humanity's obsession with being thin has driven fad diets to be people's "go-to" answer to be thin. Generally, people are looking for a way to get skinny or lose weight in the quickest and easiest way possible, even if the method seems crazy. Even though fad dieting has strange regiments, people still continue to try them for fast results. One example is the "Vinegar Diet" popularized by British poet Lord Byron in 1820. This diet consists of people drenching their food in sour vinegar to the point that it would be unappetizing and drinking vinegar diluted with water (Semiatin 45). In 1954 one of the more disturbing fads diets became popularized, The Tapeworm Diet. Tapeworms are parasitic and help consume the food's fat and nutrients while they live in the person's intestines. Thankfully, this diet faded after people found out that they grew up to 20 feet long and caused dementia, seizures, and/or meningitis. Fad dieting is an issue because it is a temporary fix that can lead to distorted eating habits. Initially, these extreme diets will cause weight loss, however, as soon as someone stops the restrictive diet they will likely gain the weight back.

Even though fad diets are not the sole cause of Orthorexia, they often encourage people to slowly become consumed by their diet and even turn to orthorexic behaviors. Doctor Rebecca Reynolds finds many parallels between the two. One example is that both eating habits restrict large groups of food completely and strictly allow only a certain type of food.  The media also has an impact on orthorexia. If you think about the shows, movies, and commercials you see in your daily life, how many times do you see actors or models eating? Many times people are not shown eating and when there is food shown they are usually not consuming it. In magazines there will be food, however, there are also typically articles pertaining to how to get a "hot body" or a "quick slim."  Eating disorder researchers have found that, "Representations of feminine beauty in the mass media may reinforce the desirability of extreme thinness, thereby fueling drive for thinness to a disordered level." (Harrison, Cantor 47). All the media around us influences people everyday in many ways. Until the thinness of someone and their superficial beauty is stopped being used to determine their worth, women and men will feel the need to restrict their diet and lifestyle to fit the current standard of what being "beautiful" is.  

Beauty is such a personal feeling yet is defined by a huge standard definition. People tend to define beauty by what the media tells them beautiful is. However, beauty is a combination of qualities that is pleasing to the person viewing. It cannot be defined by one prototype because humans are not mass produced Barbie and Ken dolls. Several years ago thinspiration swept across all boards of social media with pictures exposing visible ribs, collarbones, hips, and thigh gaps. Now fit shaming is gaining popularity instead. With the movement to accept all body types, no matter what curves you have, is blossoming, people with naturally skinny bodies have been being criticized. With "fitspiration" being a current trend on social media, there is more thought going into what you are eating and what physical activity you regularly do. Some believe that, "This sets the table for a cycle of obsession and guilt: obsessing about superfoods, workout goals and body ideals, and guilt every single day you fall short of your ideal." (Birch) and leads to more cases of orthorexia. With social media's beauty standard being strong and fit, orthorexia is becoming more prevalent in women and men.

        Orthorexia is transitional disorder because it embodies qualities of multiple known disorders. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM, eating disorders can be defined by three categories: anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified.  According to the Mayo clinic, anorexic individuals have an abnormally low body weight and tend to restrict their diet to very small intakes of foods. Bulimic individuals can either be purging, where they normally self-induce vomiting or abuse drugs such as laxatives, diuretics, and enemas to rid themselves of extra calories, or nonpurging where they rid their bodies of calories through fasting, strict dieting, and excessive exercise. The latter category includes binge eaters or other dysfunctional eating habits. Orthorexic individuals do not fall into the categories in the DSM perfectly. All the named disorders just listed do however share qualities or being a perfectionist and anxious.  Mainly, "the biggest difference between someone who is driven by a goal of a perfect diet and someone who is battling anorexia or bulimia is that anorexics and bulimics are motivated by weight loss" according to Kathy Kater, a specialized psychotherapist. (Mathieu 1510-12)

Some medical professionals have been debating if orthorexia should be classified as an obsessive compulsive disorder rather than an eating disorder. While it is very arguable that all eating disorders have glimpses of the obsession seen in obsessive compulsive disorder patients, orthorexia does specifically because victims have an obsession with food planning and controlling what they eat. MD and professor of psychiatric and behavioral sciences at Baylor College says, "There is a heavy genetic element" in disorders however the "obsessions are varied as the creativity of the human mind" (Mathieu 1510-12). The issue with Anorexics and Bulimic individuals is that they feel pressure from society to be thin. While the problem with orthorexic individuals is that their obsession with food begins to hinder their ability to act in everyday society activities normally. OCD and orthorexic individuals differ because orthorexic individuals can not be easily helped with medicine because often the individual believes medicine is not pure and fears ingesting it.

Many times when someone develops orthorexia they also lose their natural instinct of understanding hunger. Unlike people who aren't affected by this disorder, they eat primarily for "health reasons" and not for hunger or enjoyment of taste. Overtime this happens because orthorexic people will ignore their physiological hunger and fullness cues in order to abide to their regimented diet. An interesting theory that coexists with orthorexia is the Restraint Theory (a restrictive system of rules for healthy eating). This theory is used to explain the disconnection that is formed between hunger and eating in individuals who eat based on external messages rather than natural hunger cues (Herman, Polivy, & Vartanian, 2008). Amanda Borgida in her dissertation says, "On the basis of restraint theory, cognitive manipulations of hunger have a strong negative effect, in that these manipulations take precedence over physiological hunger states and can lead to dangerous dietary restrictions and malnourishment." (Borgida 30). Orthorexia individuals can cause lasting effects on themselves if not helped. The obsession with a restrictive diet disrupts their natural instincts as humans, to understand hunger cues.

Like all disorders and diseases, orthorexia needs to be cured. If someone goes untreated they will become significantly unhealthy and experience malnutrition. Just as anorexia and bulimia are treated seriously, this popularizing disorder should be also. People surrounding you everyday can be affected by this harmful disease and not realize it due to there being little awareness on the subject matter. Even though there are people who oppose the existence of the disorder, there are many individuals who have experienced orthorexia first hand and can attest to the harmful side effects. Fad dieting trends may be popular but they are not helpful to people's knowledge about correct ways to nourish their bodies. As many people know but don't want to believe, weight loss that lasts needs a lifestyle change not a 10 day juice fast. In no way does orthorexia claim healthy eating is a disorder. The term orthorexia is used when people become obsessive with their dietary habits and it consumes them. Overall, orthorexia is changing the way eating disorders are seen by the public because it is not a traditional eating disorder that focuses on the thinness and weight of an individual but the purity of the food they eat. 

