Post # 1
So… I’ve been thinking about health and fitness a lot lately, and I’ve been thinking about orthorexia. For those not in the know, orthorexia was an idea proposed in the late 1990s. The term describes an disorder similar to anorexia or bulemia, in which the sufferer becomes obsessed with concepts of health. They might start only eating raw food, but eventually they might cut out entire food groups, and work out obsessively at all hours of the day and night, destroying their relationships and their body in the process.
I remember reading one woman’s story. She was treated for this after she started compulsively exercising for up to six hours a day and watching what she ate to the point where she had to be admitted to hospital suffering from malnutrition. She didn’t have an eating disorder in the traditional sense… she did not believe that she was fat. She believed that she was unhealthy, and became obsessed with the idea of controlling her health.
Here’s the question: firstly, do we believe that orthorexia is a real disorder? It seems to be very different from anorexia and bulemia. I suppose we could argue that the underlying issue is control in all cases… but how far do we take this concept? Is this far more trivial than anorexia and bulemia, and could it be insulting to sufferers of these illnesses to consider orthorexia in this way?
Secondly, does it matter that this woman’s behaviour is understood by society as not being unhealthy, per se? How should we understand this behaviour? At what stage does it become abnormal, and at what stage is it desireable? Does the fact that these people are acting in ways which are generally thought to be socially desirable (eating clean, working out) matter? In what way?
Post # 3
@Rachel631: I think it still is an eating disorder. It’s under EDNOS–Eating disorder not otherwise specified!
Post # 4
@BrandNewBride: It is indeed classified as such. But I’m not so sure it fits the pattern as well as the other disorders…
Also, a lot of the symptoms are things which are very common within the population…
I mean, I used to regularly exercise until I fainted or vomited, to the extent where it wasn’t a real workout until one or the other happened. But there’s a whole subculture where that is totally normal, and you’re a hero if you do that because you have “pushed through the pain barrier” and “shown your body who is boss”.
I’m not so sure this is orthorexia. And I’m not so sure that orthorexia is a cut and dried disorder in the same way as anorexia or bulemia, either… this type of thing… it isn’t normal… but it doesn’t seem to be serious enough to medicalise, if you see what I mean.
I wonder what this tells us about our social norms?
Post # 5
Orthorexia is a disorder, to me at least. It is similar to anorexia and bulimia, but because of the differences it probably does need a different name. Maybe not a different medical name, but different enough for the average person to better understand it.
It is not trivial at all. It probably should not be insulting to sufferers of anorexia or bulimia, because an eating disorder is an eating disorder. As long as these eating disorders are identified, categorized, diagnosed, treated and dealt with correctly, there should not be a problem. If the understanding and treatment of one disorder negatively affects the understanding and treatment of another disorder, then yes that would likely be insulting, and probably dangerous.
When a person spends so much time focusing on health that it becomes unhealthy, that’s a problem and is abnormal. When it becomes life threatening it is definitely abnormal and in need of treatment.
I’m not really sure how to answer the rest of the questions clearly, so I’ll stop here.
Post # 6
@Rachel631: How serious does something have to be to medicalize it? Someone can have a mild allergy, but it’s still a medical allergy. And who says it can’t be serious?
It’s one thing if someone is able to get all the nutrients they need despite sticking to a strict diet. What about when they aren’t because they are in a location that lacks enough organic options or something like that?
What if someone has to resort to using the food bank but they will only eat the organic options?
Post # 7
Sounds like an eating disorder to me, and you asked Is this far more trivial than anorexia and bulemia, and could it be insulting to sufferers of these illnesses to consider orthorexia in this way. I would say it is insulting to sufferers of orthorexia to suggest it is trivial and not a real disorder rather than insulting to anorexia or bulimia sufferers to consider it as an eating disorder. None of them are trivial.
Post # 8
@Rachel631: Regarding your second post, I honestly don’t think this says anything negative about societal norms.
For most people, throwing up is not the sign of a good and complete workout. They may understand throwing up if you are out of shape and it’s your first or second real workout, but after that they would see it as a problem. They would say that the person is working themselves way too hard and they need to stop pushing themselves too much.
There are sub-cultures for lots of activities and behaviors that are dangerous. That doesn’t mean the activity and behavior isn’t dangerous.
It is clearly a serious matter, which is why there is treatment for it, but because of how these medical things work, they need to understand it more to determine what to call it and what to consider it as.
Post # 9
@AB Bride: A good point. I’m not so sure that I know the answers.
The thing is, I’m also not so sure it’s necessarily an “eating” disorder, because eating is only a very small part of the bigger issue…
… or maybe the “eating” part is the point at which it starts becoming an issue?
I wonder this partly because I know lots of people who exercise to the point at which they are causing themselves physical harm. Many of them actually aren’t that concerned with what they eat, as long as they work out, but some are…
I suppose it was more of a philosophical question? I mean, I used to work out with guys who would make themselves ill through exercise. They would do full workouts in leg braces, take dangerous levels of codeine so that they could do a marathon, keep going even if their bones started to deteriorate…
I’m not so sure that’s normal. It’s certainly not healthy. But I’m also not sure it can be classified as a disorder. Also,everyone who exercises gets injured at some stage… at what stage is that damage normal, and at what stage does it become disordered?
I don’t have the answers, but it is an interesting concept to consider.
Post # 10
@Rachel631: I agree with a PP that is on the EDNOS spectrum. People with orthorexia can fit the diagnostic criteria for anorexia nervosa though in some cases. Also there are two diff types of bulimia – purging & non-purging type so someone with orthorexia could fall under bulimia non-purging type depending on their habits. This is something that would have to be looked at individually since these blanket terms really only cover so much and cases need to be looked at individually. There is also a lot of kick-back and debate in the psychology community about the diagnostic criteria of eating disorders bc there are people who suffer from anorexia nervosa or bulimia nervosa who do not fit the weight criteria of refusing to maintain 85% of healthy weight. This is especially seen with bulimia. There is also a lot of overlap with eating disorders so diagnosis is something that can be difficult. Anyway, I think like everything else it should be treated on a case by case basis.
Post # 11
@Rhopalocera: As it happens, this is not recognised as a disorder in the UK by most practitioners, and there is no treatment for it.
Of course, that doesn’t mean ot isn’t a problem! But I wonder…. does a thing only exist when you develop a name for it, in a sense? It’s almost as if naming a thing changes it.
Post # 12
@ErinC6: You make some very interesting points to consider.
I think what makes me pause for thought is that I know a lot of people whose exercise habits are not normal, but I wouldn’t say that they were underweight, necessarily, or that they had a problem with eating. I know some cases of orthorexia are to do with food, but many aren’t.
Also, where do we draw the line? I know plenty of hippies who have a brutally restrictive diet, because they are vegan, organic, raw food, paleo eaters, and the like.
I suppose I was thinking: at what point does it become unhealthy to try to be healthy?
EDIT: Also, correct me if I’m wrong, but don’t most ED sufferers do it to be thin, rather than because they have this very blinkered idea about human health?
Post # 13
It’s definitely an ED, and I think it’s getting more and more common as people are starting to pay more attention to their health. There’s a line between wanting and working toward being healthy and being obsessed with your health. It’s just as serious as the other EDs, for sure. And I think other people are less prone to noticing it. It’s not talked about like anorexia and bulimia are, and so people don’t even know that it exists. People who aren’t educated about orthorexia might see someone with the disease and think, “I wish I was that dedicated to my health/fitness!” It’s sneaky that way.
Post # 14
@Rachel631: Disorders exist even though they don’t have names.
For something such as this, naming it and categorizing it does make a difference in how people see it and how it is seen and treated in the medical field. But, even if it doesn’t have a name, behavior like this is usually taken on a case-by-case basis.
ErinC6 gave a great response that I agree with, by the way.
Post # 15
@Rachel631: Thanks for posting about this- I have my suspicions about a few girls I work with and never looked into the name for this. They’re the type who workout for hours before work, then take bootcamp at lunch, then a 5 mile run after work and all they talk about is what they eat, the suppliments they’re taking and the newest “medical” health fad (they’re currently not drinking any water except this really expensive magical “alkaline” water, to the point that they won’t even use ice from the office kitchen.) It seems completely physically and mentally exhausting to live like that… and honestly, they both look kind of freakish. They’re into “fitness modeling” as well (bodybuilding) and I don’t think I’ve seen either of them eat anything solid for weeks…they seem to exist on protein shakes and juices made with the holy water.
What I do find about them and other girls I’ve met with similar, eh, “habits” is that they seem hell-bent on converting everyone around them. I have also had friends with anorexia and they NEVER talk about food and would never wax poetic about their dietary “choices,” versus the other half seems really insistant in turning every conversation into one about Dr. Ozs new miracle food, or the best spin class in the city, or how you “really shouldn’t be eating that.” Is that a disorder, or just a REALLY annoying personality trait?
Post # 16
@Rachel631: The “thin” idea is something that can be debated. I was diagnosed with anorexia nervosa at age 9. I can tell you that my concerns were not vain, I could not have given two shits about my weight. My most recent relapse was at age 17/18. When I was 50lbs underweight and in the hospital, I did not think I looked good. I knew I looked like crap. It was about the control, self-hatred, numbers, etc (there are many studies that focus on the overlap between EDs and OCD). I would argue that most eating disorders are not about thinness (at least those that are long term). They are about control. Punishing yourself. Self-loathing. Now, this might not apply to all ED sufferers but this was definitely the case with me and many others I met in my recovery.
As for where to draw the line, I think with anything mental/emotional you have to really take into consideration how much it is affecting your life. Is it stopping you from doing things you want to? How much of your time is spent on it? IMO, that is the big difference between a hobby/part of your life and an obsession or disorder.