How bad is orthorexia? The simple answer is this: any planning, thinking, worrying, counting, tracking, biohacking, etc. involving food that does not hurt your mental, physical, and emotional health isn’t bad for you. But in most cases, it does hurt, and understanding when that happens is the point of this discussion. In this post we’ll cover mostly the bad side to orthorexia.
Henceforth, orthorexia, disordered eating, and partial syndrome eating disorders will be synonymous, but I will only use orthorexia, even though there are some major differences. People with orthorexia don’t binge and purge or maintain an extremely low body weight, but they have similar traits to people with eating disorders and may be playing the same mental games with food; so in discussing orthorexia we’re also discussing other eating disorders. I will also discuss health obsession in general, which involves more than just an obsession with food. Let’s get started.
What is orthorexia?
Orthorexia is a term coined by Dr. Bratman in 1997 that means “correct diet.” He was an alternative medicine doctor who praised healthy eating like it was gospel. He realized though that most people just didn’t know what they were talking about, and that it was possible to have an unhealthy outcome from trying to eat healthy foods. He named the condition after the unhealthy relationship with food that people developed, which often involved attempting to eat “clean” or “pure” foods. The reason it’s unhealthy is because it can interfere with people’s social lives, interfere with their own lives, and ironically result in poorer health. People with orthorexia tend to interpret research on healthy eating with a bias, due to several reasons: body dissatisfaction, the desire to be immortal and achieve superhuman health, or to be in control of their lives, among other reasons. Unlike anorexia nervosa, people with orthorexia openly voice their lifestyles. From my personal observations of myself when I had orthorexia and of others today on social media sharing their orthorexia with the world, I strongly believe body dissatisfaction and a desire to be thin for women and lean but muscular for men is the most significant reason normal individuals become orthorexic. In contrast to anorexic patients however, a greater emphasis is placed on health and the quality of the food rather than the quantity. The mentality drives people to think that only the cleanest and best foods will result in “optimal” health, when in reality their bodies may have optimal functioning in a variety of environments.
Different manifestations of orthorexia in today’s online health communities
- The biohacking circles display a lot of orthorexia, and from just my observations, they tend to follow a ketogenic diet, which may not be sustainable long term. These individuals want to maximize their quality of life by maximizing their health. Cold showers, hormetic theories of ageing, grassfed butter, and minimizing advanced glycation end products (AGEs) in their bodies are a few of their passions. Most of these people don’t exercise that much, as they believe too much exercise can increase free radicals in the body and accelerate aging. They’re not just obsessed with food, but with everything that affects their health. Like patients with eating disorders, high self-oriented perfectionism may be common.
- Paleo: Often devout low-carbers, paleo dieters overlap with the crossfit and biohacking circles. They usually don’t follow a diet that would be considered paleolithic by our paleolithic ancestors, but they still eat lots of bacon, eggs, sausage, and low carb products anyway, while believing that carbohydrates are unnecessary in our diet.
- Veganism: Not all vegans are orthorexic, as many are more concerned with the ethical and sustainability aspects of our diet, but many vegans from my observation, like the biohackers, want to live long and healthy lives, while maintaining a slim physique. They tend to believe that all animal products are unhealthy for humans, and all protein can be obtained from plants. Their heroes are endurance athletes like Brendan Brazier and any vegan who decides to workout and has a decent physique. I started in this crowd with the raw foodists, the ultimate clean eaters, who only ate algae, seaweed, B12 supplements, raw fruits, vegetables, and nuts, while becoming more and more gaunt.
Traits among the orthorexic
- Perfectionism: this is actually a trait found in all eating disorders. It involves setting very high standards and becoming upset when standards are not met. Unrealistic expectations ultimately lead to these people’s downfalls. I’m a perfectionist, but only recently stopped looking for the perfect or optimal diet. There is none.
- Ability to rationalize any belief: orthorexic individuals may sound very knowledgeable, but they may be searching for information that confirms their hypotheses. Biohackers will argue that sugar consumption increases advanced glycation end products which can increase diabetes risk or the oxalates in spinach can wreak havoc on your teeth, and vegans will try to show that saturated fat causes insulin resistance and cite Dr. Dean Ornish’s research as evidence.
- Food rules and avoidance: common in other eating disorders as well, this trait involves avoiding “forbidden” foods that one believes may hurt their health or other rules regarding the consumption of food, such as filling up the stomach only 80% during meals like the Okinawans. Some people are very good at explaining why certain food rules are beneficial, but their views may not consider long term effects that have any basis in longitudinal studies (many of which don’t exist and won’t ever thus the discussion is pure speculation).
- Impaired social life: Orthorexics may still have a social life, but not in the same way as other people. When I had orthorexia I never felt as if my social life was impaired, but in reality, I couldn’t do a lot of things that people do. I didn’t want to do them, so it worked out fine. Others however may feel tempted to socialize and may feel awkward denying ice cream, pizza, and other foods at parties and other social events.
- Logical fallacies involving fat shaming: Orthorexics may discount nutritionists or other health professionals with real credentials for being overweight, and be more likely to believe a hippie’s advice if they have a more attractive physique. They may also be more likely to trust someone who displays impressive feats of athleticism, like a fruitarian doing an L-sit, something that five-year olds can do with some practice.
When orthorexia becomes bad:
Socially: For Dr. Bratman, the man who coined the term, orthorexia became an undesirable way to live when he realized that he was thinking about eating sprouts during normal conversation. When food becomes so important that you miss out on living the way you want to, it obviously signals that something needs to change. When I studied abroad in Peru freshman year of college when I was on the raw food diet, I consumed less food than usual because I tried to eat only fruit. I lost some weight and was hungry because I couldn’t deviate from my raw food plans and enjoy the local cuisine. I never went out to eat either during my diet, except once at an overpriced raw food “restaurant.” Let’s call it a health-freakaurant instead. Not being able to do what others did however did not bother me one bit. For others however, social life is an important part of health and being unable to have a healthy social life with fellow human beings may cause psychosocial stress. I have a feeling though that most orthorexics don’t really care what others think and are committed to making adjustments in their social life to maintain their focus.
Poorer health: Just as obviously, when your hair is thinning or you feel as if your health is suffering, you may eventually realize that your diet isn’t perfect after all. Some people hurt their bodies so much from dieting that they need a recovery plan to restore their health back and are often put on hormones carelessly by their doctors. Hypothyroidism, amenorrhea, low testosterone in males, weight gain, lethargy, brain fog, cracked lips, cold hands and feet, and low body temperature are just few of the symptoms that people who diet excessively often develop. Of course it’s up to the individual person to accept that their health is deteriorating and change. Oftentimes, orthorexics will rationalize a symptom as being a good thing and ignore reality. Raw foodists for example believe that their amenorrhea means that the body is completely detoxified and no longer needs to eliminate toxins from the body through regular periods.
Misguided beliefs: People should be free to do what they want, I guess, so it’s hard to argue against a fruitarian mother who seems to be starving her child. Misguided beliefs are a core element to the diverse orthorexic lifestyles out there however. This is a huge point of contention to any orthorexic, because the orthorexic can rationalize most of his beliefs, but when he fails to do so, he’ll ignore what he does not understand anyway. It’s so difficult for me to explain this, but I haven’t met a single orthorexic or biohacker, vegan, or any health-obsessed nut who can convincingly explain to me that their lifestyle is going to improve their health. I thought I knew it all when I was vegan, and even my future self wouldn’t be able to convince me that I was a moron. Sure, some people will have reasons for doing things that are warranted, but when it comes to diets, usually they’re extreme, and these are never warranted. In addition, the extreme dieters have subconscious reasons for continuing their diet that aren’t easy to identify.
Ketogenic diets (essentially zero carb diets except for vegetables) for instance are popular among the biohacking and anti-aging enthusiasts because they believe a lot of age-related diseases are related to impaired insulin signaling; thus by reducing insulin in their bloodstream as much as possible, they may avoid those diseases and live much longer. This belief is unsubstantiated because weight gain can still occur in these diets easily, which can increase fasting insulin levels and prediabetes. Oops.
And of course, as I mentioned, excessive “clean” eating eventually can result in adrenal fatigue, infertility, lower thyroid function, and other health problems that shorten peoples lifespans. The misguided beliefs were the cause of that.
Well, that’s the bad and part of the ugly. In the next post I’ll cover the (potential) good of being orthorexic, but more realistically, the benefit of being concerned with diet at all. Changes in diet can improve our health in many ways; the problem is that going to an extreme as in orthorexia can hurt it. So how much is too much? That’s what we’ll ultimately get to in the next post, and where things will start to get complicated and philosophical. Cheers.