Is Trying to Eat Healthy Making You Sick?

In a country where 34% of the population is obese, where 2,500 people die every day of heart disease and more than half a million perish of cancer each year, cultivating an unhealthy focus on healthy eating seems impossible. Yet some are so fixated on purifying their bodies that they make themselves sick in the process. It's a condition known as orthorexia nervosa.

© Lucinda Levine

What Is Orthorexia?

Holistic physician Steven Brat-man coined the term orthorexia nervosa more than a decade ago. In an article published in the October 1997 issue of Yoga Journal titled "Health Food Junkie," he wrote, "Orthorexia begins, innocently enough, as a desire to overcome chronic illness or to improve general health. 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." Even if physical and emotional health begin to falter, the sufferer continues a harsh dietary regime. Eventually, the all-consuming drive for nutritional purity can become a kind of spiritual quest.

"I think it's a very real problem," says health and nutrition author and teacher Tom Monte of Amherst, Mas-sachusetts. "As the problem becomes clearer, the description will expand because we'll have a better understanding of its internal causes."

Monte cites among these causes an imbalance of neurotransmitters, leading to a decrease in joy and an excess of fear. The more severe this imbalance, he says, the more the orthorexic feels antagonistic toward the environment, becoming hyperaware of external impurities.

But orthorexia has its skeptics, too. It's a refusal to eat healthy that's a national problem, say these doctors and nutritionists, not the reverse. Kelly Brownell, PhD, codirector of the Yale Center for Eating and Weight Disorders told the website WebMD, "We've never had anybody come to our clinic with [orthorexia], and I've been working in this field for at least 20 years."

Those convinced that or-thorexia is real—and spurred by an internal imbalance—say certain dietary shifts may assist healing. Eating more leafy greens, for example, may support the liver. Other eating habits may exacerbate preexisting conditions, such as the way serotonin levels drop if complex carbohydrates derived from whole grains are eliminated from the diet.

It is possible that the orthorexic may have been given the message sometime in the past that they're not good (or pure, or perfect) enough, causing a sense of inadequacy and resentment that worsens their condition. Monte paraphrases the deep thinking of the orthorexic: "If I make the correct changes in my behavior, eat the food that I'm supposed to eat, I'm going to become a better person, more valuable, more loved."

Healing Extreme Eating

How then to approach such a complex disorder? Joshua Rosenthal, founder and director of the Institute for Integrative Nutrition in New York City, counsels individuals to look beyond diet as a source of health. "I encourage people who become overly obsessed with eating the 'right' food to see the impact on their life," says Rosenthal. "This condition can impede other important elements of life, including relationships, creativity and just feeling part of a community. I call these elements of life primary food—the parts that fill our soul and satisfy our hunger for living. You can eat all the kale in the world, but if you feel disconnected, how healthy and happy can you be?" To support flexibility, Rosenthal developed a diet he calls the 90-10 plan, in which healthy whole foods are eaten 90% of the time and the other 10% of the time people eat whatever they feel like eating.