Shawna Collins describes orthorexia and considers whether it should be an official medical diagnosis.
Recently, orthorexia—a ‘new’ eating disorder—gained considerable attention through various news outlets and feature commentaries on websites for the National Eating Disorder Association, Eating Disorder Hope, (USA), and the National Eating Disorder Information Centre (Canada).
The term orthorexia was coined in 1996 by Dr. Steve Bratman. It is a term used to describe individuals who become obsessed with clean or healthy eating. In many cases, these people do not perceive their eating habits as problematic because they are eating healthfully. The goal in introducing this term was to help people understand when their ‘healthy’ eating might not be as healthy as they assume. Indeed, the National Eating Disorder Information Centre explains that any prolonged obsession with eating healthy can lead to eating disorders.
According to the National Eating Disorder Association, many individuals who develop orthorexia, start out trying to get healthy. They make ‘healthy’ choices – exercising regularly, eating plenty of fruits, veggies, and lean meat, cutting out or eliminating bad fats, sugars, and carbs. However, overtime these behaviours become impulsive and restrictive–so restrictive in fact, that they begin to undermine health. In some cases, the obsession with food becomes so severe it “can crowd out other activities and interests,” and “impair relationships.” Persons with orthorexia become “socially isolated, because they plan their life around food.” Lastly, in severe cases persons with this disorder can “lose the ability to eat intuitively – to know when they are hungry, how much they need to eat, and when they are full.”
Interestingly, Eating Disorder Hope and Orthorexia: An Obsession with Eating Pure highlight the role of social media in increasing the prevalence of orthorexia in North America. Here, society bombards its citizens with non-fat, low-fat, low-sugar, and no-calorie food choices. Television shows like My 600lb Life, The Biggest Loser, and America’s Next Top Model demonize obesity and venerate the slim body. Celebrities such as Kelly Clarkson and most recently Selena Gomez are condemned for gaining weight. Social media sources connect weight gain with emotional imbalances frequently posing the question: are they okay? Thus, weight becomes associated with morality. In plain terms, how much a person weighs somehow provides a direct correlation to one’s moral compass and moral worth.
Arguably, however, those who suffer with orthorexia are simply persons who embrace a body image and lifestyle that society promotes. Their need to lose weight, and to look a certain way (a slender body for women and a toned physique for men) is what North American society celebrates. These so called ‘healthy’ images of women and men permeate yuppie culture and contribute to a perceived moral obligation to obtain a certain kind of body.
In the months leading up to the new year, there were many commercials promoting New Year’s Resolutions having to do with weight loss. Weight Watcher’s commercials featuring Oprah Winfrey, proclaimed 2016 “The Year of Our Best Bodies.” Dr. Bernstein Diet and Health Clinic, Jenny Craig (a weight loss program), Goodlife Fitness (a fitness company), and Special K (a cereal brand) also began airing new commercials preaching about the benefits of feeling good in one’s own body, not counting calories, role modelling ‘good’ behaviour for loved ones, ‘pushing’ oneself and working hard, and eating healthy. This rhetoric can function as a way to promote the ‘ideal’ North American body and to strengthen the narrative links between weight and morality.
While there is no debate surrounding the potential danger of orthorexia, at this time, orthorexia is not an official medical diagnosis. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders and the Canadian Mental Health Association both recognize only three types of eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder. The exclusion of orthorexia is purposeful as there is ongoing debate about orthorexia as a gateway to anorexia nervosa. Persons with anorexia, typically women, drastically restrict their food intake so as not to gain weight.
Should orthorexia be a stand-alone eating disorder? One could answer “yes” to this question, since there are both weight and mental health components to this condition that are distinct from anorexia. The problem with creating an official diagnosis, however, is that this would result in the medicalization of socially prescribed behaviours. This is problematic insofar as it potentially casts blame on individuals for society’s ills–for acting on what society actually prescribes. Instead, we should recognize, critique, and alter harmful and degrading social messages.
Shawna Collins is a graduating honours history student at McMaster University.