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The Bizarre Eating Disorder People Can Develop Around Healthy Foods

It masquerades as concern for a healthy diet.

Lauryn Lax knows the exact day that her relationship with food changed, and the overwhelming preoccupation with fat grams, carbohydrates and protein that has consumed most of her life began. 

She was in sixth grade, and one day during recess at the private school she attended, the school’s most popular girl asked Lax and a few other girls how much they weighed. Of the group, Lax was embarrassed to learn she weighed the most, though she was not overweight. 

“I resolved that day to get on a healthy diet and lose 10 pounds,” says the now 26-year-old who lives in Austin, Texas. “It slowly developed into an obsession.” 

Lax first eliminated all junk food from her diet, started running and began setting specific food and exercise rules and routines. Each day she tried to eat less than the previous day and took comfort in her growling stomach. She also continuously increased her exercise. Physically, she began to not look like herself, and became pale, developed a rash on her legs and her hair started falling out. 

While still in middle school, Lax was diagnosed with anorexia nervosa, and later orthorexia nervosa, and has spent much of her life in treatment to re-establish her relationship with food. 

In 1997, Dr. Steven Bratman, author of Health Food Junkies, first defined orthorexia nervosa as an unhealthy obsession with eating healthy. 

Individuals with orthorexia have such a preoccupation with eating as healthy as possible that they often develop their own, often distorted, rules about food, says Karin Kratina, a nutrition therapist in Gainesville, Florida, who has been treating people with eating disorders for more than 30 years. Eventually, the food rules take precedence and interfere with the person’s day-to-day life. 

Unlike most eating disorders, where the pursuit of thinness is the “underlying and obvious motivating variable,” in orthorexia, most often, the “underlying variable is the pursuit of health or purity, organicness, [and the] sense that everything needs to be clean, whole and pure,” says Sondra Kronberg, director of F.E.E.D. (Facilitated Eating Events and Direction), an outpatient program of the Eating Disorder Treatment Collaborative, based in New York.

Orthorexia often starts with a healthy value system about food, but how much it interferes with someone’s life is what makes it unhealthy, Kronberg explains. Adding elements of exercise and compulsion makes the disorder more extreme, and eventually negatively impacts health. 

Because orthorexia is not classified in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), it is difficult to determine how many people have the disorder, says a National Eating Disorder Association spokesperson. Orthorexia diagnoses usually fall into the “Other Specified Food Eating Disorders” category, along with other eating and feeding disorders. 

Even though it’s difficult to track orthorexia diagnoses, those treating individuals with eating disorders say they are seeing an increase in patients with orthorexia, particularly among teenagers and tweens, as today’s food culture continues to shift and healthy eating is emphasized. But many of these nutrition professionals question how “healthy eating” is interpreted. 

Food Culture and Healthy Eating 

In today’s seemingly food-obsessed culture, terms like gluten-free, veganism, organic, Paleo, chemical-free, clean eating and eat local commonly fill conversations and media reports. And, all this talk about food and what is supposedly healthy can negatively impact people predisposed to developing an eating disorder, like orthorexia. 

Individuals with rigid, compulsive and anxious personalities are not always able to sift through the mainstream, and often contradictory or incorrect, information about food, Kratina says. This leaves “eating healthy” up to interpretation, as individuals pick and choose what they consider healthy foods and establish their own sets of rules. 

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