Orthorexia is a controversial subject and it’s a complex issue, so I can’t do it justice in a single post. For those not familiar, some argue that patients can become dangerously obsessed with health to the point where they develop a fixation that becomes a cause for legitimate concern, a disorder rather than a natural interest in health and wellness. Some researchers link it with underlying medical conditions like obsessive compulsive disorder, while others argue it can stand on its own although it is part of the larger family of anxiety disorders.
For people with orthorexia, fixations around food are extremely common. Foods are divided into good and bad, and the patient may go to great lengths to restrict diet and assign virtues or flaws to foods in given categories. Some patients are also obsessed with additives, supplements, exercise, and other aspects of diet and lifestyle.
There’s a profound difference between being interested in how you live and focusing on what makes you feel good and entering a potentially dangerous zone, and there’s also an important distinction between what some people label as orthorexia and what is actually a genuine allergy or food intolerance. Someone who prefers to avoid dairy because it makes her gassy isn’t orthorexic any more than someone who chooses to take nutritional supplements to address a calcium deficiency. Likewise, a person with a severe nut allergy isn’t exhibiting symptoms of a disorder when she asks a series of careful questions about the ingredients in a meal; she’s protecting herself from the risk of serious injury or death.
But what about people who restrict their diets to the point of malnutrition? Who decide on a handful of ‘safe’ foods and will eat only those, who prize specific body types and attempt to force their bodies to conform to them even if it’s not realistic or healthy? Is this just a form of anorexia, or is it a distinct medical condition? That’s a subject of debate, and a lot of interesting conversations are happening about it. Notably, in a society as obsessed with health, wellness, and weight specifically as ours, an appearance of caring about health can be an excellent cover for the early stages of anorexia, where a patient may in fact be praised for being ‘aware’ and losing weight instead of scrutinised for signs of mental illness.
However the medical establishment’s opinion on orthorexia settles out, it’s undeniable that a lot of people have extreme anxiety about food and their bodies. And it’s clear that this isn’t going away, and that in some cases it becomes unhealthy. These things don’t occur in a vacuum, and I’d argue that the way society talks about food, food policy, and health is a major contributor to the rise in food anxiety and to increasingly dangerous fad diets and other plans that people engage in with claims that they are ‘healthy.’
There’s always been a push to label some foods as good and others as sinful, but it’s gotten much worse in recent years. The list of what you’re allowed to eat has narrowed extremely, and it’s accompanied by harsh judgments; you’ll be judged for eating fats, for consuming fast food, for drinking soda, for eating ‘empty calories.’ That judgment implies not just that you’re ‘not taking care of your body,’ but that you are a fundamentally bad person who should feel bad, and living in that climate can push people to make unsound health decisions because they want to avoid judgment or because they internalise this messaging and believe that they can redeem themselves (again with Christian rhetoric in conversations about food) if only they eat and do the right things.
People claim that discussing food policy is done in the interest of health and wellness, and that may well be true for some. But it carries a whiff of other things along with it, like the desire to eliminate fat people and to attribute all social ills to food, as though we could solve all our problems by eliminating certain foods and getting people to eat the next big superfood; everybody eat quinoa, it will save the world[1. And, of course, jeopardise native populations who can no longer afford it for their own purposes despite the fact that they’ve been consuming it for thousands of years.]. Or it’s acai, or chia. There’s always a food magic bullet to be pointed at, the next good thing, and there’s always a pitfall, the next bad thing; butter, animal fats, carbs.
In this climate where the list of what’s good and bad constantly shifts and so much moral weight accompanies what’s on your plate, it’s hard to eat a balanced diet and lead a balanced life, because everyone seems to have something to say about what you’re eating and why. It’s not surprising that some people respond to that pressure by developing highly disordered eating habits, and that often those habits go unnoticed or even praised because they appear to focus on health and wellness. It seems absurd to be worried about someone who refrains from eating certain foods ‘for health reasons,’ for example, even when that list is a mile long and appears to exclude some key nutrients that the person needs to survive.
This is a difficult thing to tackle, too, because discussing concerns about disordered eating can be a loaded proposition. Many patients are not ready to hear those concerns and may lash out, especially if they’re being reinforced by society at large and other friends or family. It can start to feel like a form of concerntrolling that’s just as bad as telling people what not to eat for health reasons; how do you reach out to people affected by food rhetoric in a way that still supports their autonomy as human beings?
And how do we find a way to talk about food policy as a genuine issue without reinforcing these attitudes? Because there are people going hungry, experiencing malnutrition, and not having access to the food they need right now, and this is something we urgently need to address.