All over the web and social media every day, people discover Orthorexia like a radical new find, not realizing that Stephen Bratman came up with the term in 1996.
OK, so like anything it takes time to go main stream. I get that, and it’s finally getting there. But looking back it has been slow. It still doesn’t get anywhere near the attention that other disorders get. To put things in perspective “Orthorexia” gets around 345,00 search results (11th July 2015). “Anorexia” gets around 25,500,000.
But at the same time we know they are very different. We have heard headline stories about fatal Orthorexia. But as a previous sufferer I have to agree that whilst the eating disorders have many things in common, and can co-exist, they are driven by very things; Orthorexia tends to be less driven by body image, and on the whole, Orthorexia doesn’t do as much long term damage. Whilst Anorexics will eventually break down and struggle to function, Orthorexics can technically live and function some kind sustainable life, sometimes without people noticing the condition. This isn’t to say that it isn’t serious, it is. Just because it isn’t killing as many, doesn’t mean it ain’t a problem.
Also, from what I’ve seen, Orthorexia can manifest itself on a whole broad spectrum of severity. It can start off harmless, a keen interest in being healthier and end up life devastating. Whereas other eating disorders are a little bit more clear cut. (You are either regularly trying to throw up – or not, for example).
What am I getting at?
I’m just interested to look at Orthorexia in the bigger picture of eating disorders, and think about where it stems from.
A lot of people have related Orthorexia to OCD for example.
“Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly.”
OCD can manifest itself in an extremely wide range of symptoms, and on a spectrum of severity. OCD is driven “by the fear of consequences, no matter how unlikely the risk.”
That need for control, risk management, thoroughness, and perfection, does have so many overlaps with that term we are calling Orthorexia – it just so happens Orthorexia is about food.
When you begin to consider the overlaps with OCD, and the key differences which separate out Orthorexia from other disorders, it seems clear to me why Orthorexia is different, and perhaps why labeling Orthorexic behaviors was a natural evolution to the increasing variety occurrences of OCD we are seeing in society today. In the OCD cycle (ocduk.org) we can certainly see that we can overlay Orthorexic obsession (eating pure etc.) into the more generic “obsessions” depicted. Note that obsessions lead to anxiety, not the other way around.
Whilst we now have a very effective label for these eating habits, and the extreme development of obsessive clean eating symptoms we see today, my view it isn’t as new as we thought it was. For a long time, there has always been a minority of people who were super keen on health. We can’t pinpoint the moment they became Orthorexic or we deemed them to be.
But when I say development of symptoms, we do have to note structural differences – I’m not saying the Orthorexia and OCD are exactly the same. The biggest aspect to note, is that Orthorexia is about “righteous eating”. There isn’t much righteousness in OCD from what I can tell. Whilst the origins of both are debated (genetic/environmental/psychological or a combination), I think there are definitely strong psychological aspects (beliefs, personality, and attitudes) which bring out the righteousness in people with Orthorexia.
But again is righteousness that new?
We all know many people who are a “bit OCD” about how they look. There are women who can’t leave the house without make-up, and just the idea causes them huge anxieties. We have a name for this, it’s called extreme vanity. (Note this is a different obsession to the body image phenomena we see in Anorexia). People can also be proud and almost righteous abut what they wear and how they portray themselves because they view it as defining themselves so much.
We all know someone who is a “bit OCD” about money and how they spend it. Every penny is considered, they always get the best price, no spend is anything but absolutely necessary. Saving and frugality is something which never leaves their mind, even though is can be quite unjustified (they may not be in financial difficulties). It’s just their way of staying in control, and aligned to a value they hold close to their identity. They can certainly act righteously when they see other’s spending frivolously, or behaving in a materialistic manner.
Fear of dirt and germs is another one, and one which has been recognized as a common symptom of OCD. We all know people who can’t get dirty. Or have a genuine fear of exposing themselves to germs, or perceived conditions of lesser cleanliness. The idea of forgetting to wash their hands literally scares them. Or cleaning rooms and objects meticulously on an overly regular basis is a common chore. Crumbs on the table are just a big ‘no’ to them. It’s not always righteous, but I’m confident you could find examples where this is directly linked to people’s pride in their standards.
Then we have exercise. There are people who can’t go a day without doing something. It is who they are, the idea that they may lose the progress they have achieved or become any less fitter than they are gives them huge anxiety. Many Orthorexics suffer from this form of OCD. It goes hand in hand with food and health. But it can also be completely isolated, without a name to label the behavior (other than Gym Freaks). We all know people like this to some extent, do you know any who are perhaps a bit righteous about their fitness routine?
I don’t want to take away anything from more traditional occurrences of OCD either. It is a serious condition. I know experts on OCD may be a little concerned by my most liberal use of the term in relation to conditions which may seem less extreme / more common compared to cases of OCD which are diagnosed formerly, or have a bigger impact on people’s lives.
But regardless, we all have thrown the term around loosely at one point because we haven’t had another word to use. All I’m doing is stepping back and taking a bigger view of the puzzle. What can we learn to help us overcome both OCD and Orthorexia alike? What are the patterns? Is Orthorexia truly a special case in it’s own right?