Pathology of Food Aversion

"Phenomenologically, orthorexia seems real enough, even though it may be culturally bound and may have an upcoming expiration date."
"As a cyberpathy, orthorexia lures the digital flaneurs in search of non-conventional health advice and colonizes their imagination with promises and cajoling, micronutrient formulas and 'biohacks', and aspiration/inspiration content."
"The orthorexic will eliminate harmful or potentially unsuitable substances from the diet according to a logic that shifts with the winds of the food faddism du jour. Hence, the obsession with cleanses, juices, veganism, or raw and organic food."
"Most [orthorexics] must resort to an iron self-discipline bolstered by a hefty sense of superiority over those who eat junk food [quoting holistic medical practitioner Steve Bratman in 1997]."
Cristina Hanganu-Bresch, associate professor, University of the Sciences

Some doctors believe orthorexia — a seemingly growing obsession with “extreme dietary purity” or clean eating (no sugars, carbs, dairy, meat or animal products) — should have its own separate, standalone diagnosis in psychiatry’s official bible of mental disorders. Getty Images

"We don't yet know what it is [the definition of orthorexia nervosa]."
"[Lacking formal diagnostic criteria understanding its prevalence is difficult -- estimates] are all over the place."
"[Being a vegetarian or vegan places people at higher risk of the condition which has overlaps with anorexia nervousa]. If somebody has this apparent obsession with eating 'clean' or healthy food, what's the motive behind that behaviour?"
"Are they trying to reduce their fear that they're going to get sick? Is it more of a socially sanctioned eating disorder, where it becomes a socially acceptable way to restrict what you're eating to try to lose weight. Or is it some other motive entirely?"
"The results of our review suggested there might be different types of people who show these types of behaviours an that they may already fit into established categories of psychopathology."
"I think we should have a very high threshold for calling this truly abnormal, or a mental disorder. When they [health professionals] ask someone, 'How do you eat?' and the person says, 'I eat really healthy', maybe you should ask a few more questions."
Dr. Jennifer Mills, associate professor, York University

Defined as a pathological fixation on consuming 'pure' foods, orthorexia nervosa studies have recently focused a spotlight on extreme reactions among food purists to various food groups they have been convinced are harmful and must at all costs be avoided. Not eating them in moderation, but completely avoided. That group includes all carbs, all dairy, all meat and animal products, gluten, starch, anything with pesticides or herbicides used agriculturally. In short any food source purists place into the category of forbidden, in favour of natural, organic, 'clean' foods.

You might well ask what is left to be consumed in the elimination of all food sources that ordinarily grace our dinner tables. Social media channels have become the source of transmission for these anti-food messages that appear to have so much resonance with people who embrace the threat potential of forbidden food. Dr. Hanganu-Bresch recently authored a report published in the journal Medical Humanities where the condition is referred to as a "cyberpathy", representing a condition of privilege, as she would have it, digitally transmitted.

The very idea of "healthism" is to convince believers that people are solely responsible for their health. The message is that those who fail to commit to 'healthy' eating behaviours can blame themselves when they become ill. Of course, there's truth to that. Certain categories of food are best avoided, if at all possible, and for the most part that would be processed foods, fast-foods, a focus on high-fat, high-sugar, high-salt foods that have been manufactured to the point where they no longer have their original nutrients, are energy-dense and unhealthy eaten constantly.

A health focus on eating whole foods and eschewing highly processed foods represents a reasonable view of healthy eating. This is moderation in play, not extremism. The no-holds-barred outright rejection of major food groups is unnatural and potentially harmful to the human body, risking malnutrition while cutting out vital and essential minerals and vitamins needed for the body to remain in a healthy, energetic condition. Orthorexia is becoming such an increasingly popular choice for the food-fixated that it may yet find a place in the Diagnostic and Statistical Manual of Mental Disorders.

Orthorexia nervosa is now recognized as a self-induced condition universally, but it lacks a consensus on  how it can be positively diagnosed, much less treated. Its prevalence among the general population will remain a question mark in the absence of formal diagnosis criteria. Dr. Jennifer Mills, associate professor at York University, co-authored a paper on orthorexia in the journal Appetite recently. She and graduate student Sarah McComb reviewed published articles up to 2018.

Their takeaway is that gender and self-esteem appear unrelated to orthorexia nervosa, in a surprise contrast to traditional eating disorders tending to be more prevalent by far among women than men. For orthorexia, the gender mix appears fairly even, with both men and women demonstrating symptoms. They point out as well that people who begin with a vegetarian or vegan diet are at higher risk of developing orthorexia.

In addition to which their review concluded that those ending up with orthorexia share certain personality traits; perfectionism, anxiety, poor body image, and a history of disordered eating. Just like, in fact, anorexia nervosa, excluding the emphasis on attaining a pitiably thin body conformation, and exchanging that goal for 'health' purposes uppermost in mind.

WARNING SIGNS & SYMPTOMS OF ORTHOREXIA

• Compulsive checking of ingredient lists and nutritional labels
• An increase in concern about the health of ingredients
• Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
• An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
• Unusual interest in the health of what others are eating
• Spending hours per day thinking about what food might be served at upcoming events
• Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
• Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
• Body image concerns may or may not be present