Are you 'orthorexic'? If your life is consumed by obsessive healthy eating, you just might be

by Colby Cosh

DR. Steven Bratman sighs when asked to be interviewed about his book Health Food Junkies: Overcoming the Obsession With Healthful Eating. "I don't like to spend too much time talking about the book, because it's not selling very well," he says from his home in Ft. Collins, Colorado. In a world where almost everyone seems to be anorexic, bulimic or obese, there may not be room for concern about the few people trying too hard to eat right. Nonetheless, Dr. Bratman believes these people exist. Twenty years ago, he was one of them.

Today Dr. Bratman is a respected M.D. who is a consultant and writer on alternative medicine, helping doctors and patients distinguish real remedies from pseudo-science. But back then he was a mere cook for a commune in upstate New York, one where every New Age dietary theory imaginable was followed by at least one resident. Vegans, raw-foodists, macrobiotic eaters--Mr. Bratman cooked for everyone on the spectrum. His worst mistake was in trying to outdo them all.

"When I wasn't cooking, I managed the organic farm," he has written of his commune days. "This gave me constant access to fresh, high-quality produce. Eventually, I became such a snob that I disdained to eat any vegetable that had been plucked from the ground more than 15 minutes. I was a total vegetarian, chewed each mouthful of food 50 times, always ate in a quiet place (which meant alone), and left my stomach partially empty at the end of each meal." After some months of this, Mr. Bratman felt strong and rather smug. But he came to realize he was spending all his time and energy planning meals and avoiding foods that would "defile" him. His life had become one-dimensional and he was making himself a nuisance by lecturing his "weaker brethren" on their nutritional perfidy.

Since becoming a physician, Dr. Bratman has seen many people like his own young self--and some who are worse off--flirting with disaster by depriving their body of vital nutrients. The fads of his youth, far from disappearing, have survived and grown in number: there are even "Breatharians" who believe food to be wholly unnecessary. A few years ago Dr. Bratman coined the phrase "orthorexia"--merging Greek ortho-, meaning righteous, with the stem familiar from "anorexia"--to describe a pathological attachment to dietary theories.

"I never intended the term to be a serious diagnostic entity; you wouldn't go to a hospital with 'orthorexia,'" he says. "It's informal, like 'workaholic.'" The idea has nonetheless stirred controversy: a Yale University physician sniffed in one critique that "We've never had anybody come to our clinic with orthorexia." Yet fanatical attachment to dietary theories can indeed be hazardous. Macrobiotic diets caused a string of deaths in the 1960s and had to be modified; "metabolic" treatments for cancer, usually involving fasting, occasionally turn disastrous; and vegetarians and vegans must monitor themselves for certain vitamin and mineral deficiencies. In September, an Armenian couple in Surrey, England, were convicted of starving their nine-month-old daughter to death on a "Fruitarian" fruit-only diet.

"People become orthorexic by falling in love with a dietary theory," says Dr. Bratman. "They run across an idea like macrobiotics or raw-foodism, and embrace it like a religion. We're not talking about common-sense rules of healthy eating, but theories which reject whole classes of foods and make spontaneous eating [impossible]...There's a personality type, an obsessive type of person who is prone to embrace them in a quasi-religious way." This can result in an enticing sense of moral superiority, sometimes coupled with the euphoria associated with partial starvation. But orthorexia also brings crippling feelings of unworthiness after the inevitable slip-ups, when the true believer succumbs to a cookie or a pizza. "There are similarities with anorexia," he says. "An important one is that anorexics feel like they've done something evil when they gain weight, something morally wrong rather than merely unhealthy." Similarly, the sure sign of an orthorexic is that he associates unhealthy eating with a sense of sin.

"I won't deny that there can be value in an ascetic lifestyle, that there's a long tradition of it," he says. "But orthorexics aren't aware that they are missing out on or renouncing anything." As a result, orthorexia creates a cocoon of denial around itself, like alcoholism. Which may be another reason Dr. Bratman's book is not selling the way he would like it to. "The people who would benefit from my book all think I'm crazy," he says. "Some people tell me it's helped them, but more commonly I hear from people's partners and spouses, saying, 'Oh my God! You described my husband perfectly!'"