Health Food Junkies: Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating Hardcover – Jan 2 2001
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About the Author
Dr. Steven Bratman suffered from orthorexia nervosa himself, and, in the process of overcoming it, became the first physician to diagnose the problem. He is currently the medical director for Prima Health, a book publisher, and is the author of The Alternative Medicine Sourcebook. He lives in Colorado.
David Knight is a writer. He lives in Colorado.
Excerpt. © Reprinted by permission. All rights reserved.
Healing through nutrition is one of the pillars of alternative medicine.
“Let your food be your medicine,” the saying goes, and during my years of
medical practice, patients have often begun their conversation with me by
asking whether they can be cured through diet. I feel obliged to nod
wisely. Although I am a conventionally trained M.D., I have been involved
with alternative medicine since long before medical school, and a sacred
reverence toward the healing power of diet is part of the job description
of holistic physicians like myself. However, I am no longer the true
believer in nutritional medicine I used to be. My own experience, as well
as what I have seen happen to many of my patients, has affected me deeply.
Too often I’ve seen the search for cure through diet become a disease
worse than the original problem.
This book is about that disease, which I have named orthorexia nervosa. If
you do not suffer from orthorexia yourself, the odds are high that a
friend of yours does. Do you know anyone who seems
to think constantly about choosing healthy food, who proselytizes some
dietary theory supposed to cure all illnesses, who acts superior to other
mortals who don’t worry so much about eating? Have you run across
raw-foodists and macrobiotic followers, or people who talk about food
allergies, candida, or eating right for your blood type? I’d be very
surprised if you haven’t. Fascination with healing diets is increasingly
There have always been recommendations regarding the healthiest food to
eat, but in recent decades the obsession over healthy eating seems to have
escalated out of control. In more and more people it seems to be taking on
the characteristics of an eating disorder like anorexia or bulimia.
However, unlike these other eating disorders, orthorexia disguises itself
as a virtue. Anorexics may know they are harming themselves, but
orthorexics feel nothing but pride at taking care of their health in the
best possible way.
I know how this feels, because I’ve been there myself. I’ve been at
various times a raw-foodist, a total vegetarian, and a macrobiotic
follower, and although I learned a lot from those experiences, it finally
dawned on me that there is a dark side to dietary virtue. Similarly, as a
holistic physician, I used to prescribe pure diets to my patients and only
gradually came to understand that I wasn’t necessarily doing them a favor.
It’s not that I don’t support eating healthy food; it’s only that when
healthy eating becomes an obsession, it’s no longer so healthy.
The good news is that orthorexia is not as difficult to cure as
alcoholism, heroin addiction, or anorexia. The first section of this book
tries to help the health food junkie admit that he or she really has a
problem. The next section turns to some of the most common dietary
theories that instigate orthorexia and shows that they are not the first
and last word on health. Its purpose is to weaken the grip those theories
can have on one’s mind. Finally, the third part of this book gives
specific advice on how to overcome orthorexia and learn again how to eat
without obsession. It really is possible!
What Is Orthorexia?
Twenty years ago I was a wholehearted, impassioned advocate of healing
through food. My optimism was unbounded as I set forth to cure myself and
everyone else. This was long before I became an alternative physician. In
those days I was a cook and organic farmer at a large commune in upstate
Like all communes in those days, ours attracted food idealists. I had to
prepare several separate meals at once to satisfy the unyielding and
contradictory dietary demands of those who inhabited our old Shaker
village. The main entrée was invariably vegetarian. How-
ever, to placate a small but very insistent group, on an end table placed
at some distance there could always be found a meat-based alternative.
Actually, since at least 30 percent of our vegetarians refused to
contemplate food cooked in pots and pans contaminated by fleshly
vibrations, our burgers had to be prepared in a separate kitchen. The
cooks also had to satisfy the vegans (non-dairy vegetarians), who looked
on cheese as poison, as well as the non-garlic, non-onion,
Hindu-influenced crowd, who believed that onion-family foods provoked
For the raw-foodists we laid out sliced raw vegetables in endless rows.
Once, when a particularly enthusiastic visitor tried to convince me that
slicing a vegetable would destroy its energy field, I felt so hassled that
I ran at him wildly with a flat Chinese cleaver until he fled. Meanwhile,
the macrobiotic followers condemned the raw vegetables for different
theoretical reasons, and also set up a hue and cry over the serving of any
“deadly nightshade” plants such as potatoes, tomatoes, and eggplants.
That wasn’t all. Those who preferred choosing fruits and vegetables based
on seasonal availability clashed violently with others who greedily
demanded grapefruit in February.
Besides these widely varying opinions on which food to serve, there were
as many theories on the method by which it should be prepared. Nearly all
our food fanatics agreed that nothing should
be cooked in an aluminum container, with the exception of our gourmet
cooks, who explained that given our limited budget, only aluminum pots
could spread the heat satisfactorily.
Everyone agreed that when steaming vegetables, only the minimum amount of
water should be used, in order to save precious
vitamins. The most severe enthusiasts would even hover around the kitchen
toward the middle of food preparations and lay hands on the greenish
liquids swirling at the bottom of the steamer. The
matter of washing vegetables, however, remained swathed in controversy.
Some commune members knew for a fact that the most nutritious portions of
a vegetable lived in the skin. Others felt that a host of evil pollutants
inhabited the same location, requiring exuberant scrubbing to detach. One
visitor explained that the best policy was to dip all vegetables in
bleach, giving out such a powerful line of
reasoning for this course that we risked adopting the method on the spot.
Luckily, we were out of bleach at that moment, and by the time we
purchased some, the visitor—and the theory—had departed.
The extremism of the above stories seems to be an inevitable complication
of dietary theories. The crowning example in my memory occurred at a
seminar held at the commune, led by a famous macrobiotic counselor I shall
call Mr. Lux. An audience of at least thirty-five listened with rapt
attention as Lux lectured on the evils of milk. “It slows the digestion,”
he explained, “clogs the metabolism, plugs the arteries, dampens the
digestive fire, it causes mucus, respiratory diseases and cancer, and even
sludges the soul so it can’t see clearly.”
At that time a member of the commune by the name of Matt lived in a small
room upstairs from the seminar hall. He was a sometimes recovering
alcoholic who rather frequently failed to abstain. Although he was only in
his fifties, Matt’s face showed the marks of a lifetime of alcohol abuse.
He had been on the wagon for nearly six months when he tiptoed through the
Matt was a shy and private man. However, upon returning from the kitchen
with a beverage, he discovered that there was no way he could reach his
room without crossing through the crowded seminar. The leader noticed him
Pointing to the glass of milk in Matt’s hand, Lux boomed out, “Don’t you
realize what that stuff is doing to your body, sir? Class, look at him! He
is a testament to the health-destroying properties of milk. Study the
puffy skin of his face. Note the bags under his eyes. Look at the
stiffness of his walk. Milk, class—milk has done this to him!”
Bewildered, Matt looked at his glass, then up at the condemning faces,
then back to the milk again. His lower lip quivered. “But,” he whimpered,
“but this is only milk, isn’t it?”
In the Alcoholics Anonymous meetings with which Matt was familiar, cow’s
milk was practically mother’s milk, synonymous with rectitude and purity.
“I mean,” he continued to the unforgiving students, “I mean, it isn’t rum,
By focusing single-mindedly on diet and ignoring all other aspects of
life, alternative practitioners like Mr. Lux come to practice a form of
medicine that lacks a holistic perspective on life. This is ironic, of
course, since holism is one of the strongest ideals of alternative
medicine, at least as widely mentioned as healing through diet. It would
be more holistic to take time to understand the whole person before making
dietary recommendations and occasionally temper those recommendations with
an acknowledgment of other elements in that person’s life.
Unfortunately, patient and alternative practitioner too often work
together to create an exaggerated focus on food. Rather than heal the
person, this unbalanced emphasis can lead to a disease in its own right,
the disease I call orthorexia. I know this disease well, because for many
years I was one of the most extreme health-food
fanatics you can imagine. In fact, I’ve come to think of it as a true
eating disorder, not as life-threatening as bulimia and anorexia nervosa,
but definitely in the same family.
To express this realization, I coined the term “orthorexia nervosa.”...
Top Customer Reviews
Now, I've been a macrobiotic myself for years and I was not arguing for MacDonalds, just saying that to complement a mostly-vegetarian diet with small amounts of good quality "forbidden" foods is not a "sin".
I was so shocked by the out-of-proportion reaction of this apparently very open friend that I begun questioning my beliefs. And my conclusion was the same as Dr. Bratman: friends, it's all very well to eat healthy food but let's get real, food is food and if we were not so spoiled for choice we would eat whatever was available as our ancestors always did. I'm deeply appreciative of the positive way macrobiotic guidelines have helped me improve my diet but macrobiotic people (me included untill this friend's overzeal shocked me out of it) do tend to become fanatic and semi-religious about food.
Does it seem reasonable to argue that while dairy food is "poisenous" (no matter that being used by humans for millenia) strange (and delicious, but that's not the point) food from Japan is vital for your well-being? Now, does this seem to you to have something to do with Macrobiotics being invented by a Japanese and that dairy food was unknown in Japan before being introduced by us, "barbarians"?
Same applies to fresh fruit: I like fresh fruit and no only do I eat it daily as I eat it raw, the way nature provides us with it. Does this sound a bad habit to you? It would if you were macrobiotic because fresh fruit is too "Yin" in the macrobiotic view and thus creates an inbalance in anyone who eats it.Read more ›
I owe it to Dr. Bratman that I now know when my eating disorder truly began. Though I am now bulimic, orthorexia nervosa was my "gateway" disorder for over a year. I had no idea. I had always been taught that eating disorders were about diets and wanting to lose weight--I simply wanted to eat healthily. I wasn't interested in macrobiotic or raw food diets as Dr. Bratman describes, but I read the UC Berkeley School of Public Health Wellness Letters religiously, I researched everything I ate at the USDA nutrient data lab, and I counted every (milli)gram of fiber, protein, alpha omega three fatty acid, and polyunsaturated fat. I am not OCD. I just wanted to eat right. After all, what's wrong with taking care of myself? What, you want me to eat pizza and chips? How can you rationally endorse that?!
And the essence of an eating disorder is the inordinate concentration on food to begin with. Internalizing article after article about "The War on Fat" and "America's Obesity Epidemic" made me all the more zealous. I think this book is essential reading, especially now, especially for people who see diet and exercise as the solution to life's ills. I fear all the attention and moralization on food in our culture will send more susceptible and naive individuals like myself into this stupid, threatening obsession.
Kudos to Bratman and Knight for bringing to light the true harm in our food. It's not McDonald's. It's that some of us can attach so much moral weight and identity to such a relatively unimportant thing.
a magazine article, he got some confused responses. " 'I would like to use
the orthorexia you describe to cure my knee pain,' one caller said. 'I've
already cut out all deadly-nightshade vegetables, grains, sugar, caffeine,
meat, and nuts. Do you think I should go on a water fast one week each
But as most of us can guess from its similarity to anorexia, orthorexia is not
an idealistic dietery theory but rather describes a problem: unhealthy
obsession with healthy diet. "To be perfectly honest, I intended the term
somewhat tongue in cheek, as a kind of sassy way to surprise clients who were
proud of their obsession and make them think twice about it," the author
Dr. Bratman is a conventionally trained M.D. and an alternative medicine
practitioner who himself spent many years adhering to idealistic, healing
diets such as macrobiotics (a complex diet that involves balancing yin and
yang, but you cook the food) and raw foods theory (never eat cooked foods).
Other sections deal with food allergies, the zone diet, candida, supplements,
tablets and magic substances (super blue-green algae, barley magma, sheep
thyroid, pregnenolone, ciwujia, spirulina, kombucha tea, and royal jelly among
many others). He maintains respect for many of these diets. He also says,
"Food allergy treatment can be a powerful healing approach that at times
appears to reduce symptoms dramatically in practically any illness." He does
not believe alternative medicine is a joke, and has success stories to tell
from his practice.Read more ›
Most recent customer reviews
The author portrays some unconventional diets in terms which can only lead one to believe result from very cursory readings and no independent corroboration. Read morePublished on Oct. 12 2001
Many diet gurus are selling more than a lunch: the philosophy that underlies their "ideal" diet can become more important than whether the diet works or not, and may... Read morePublished on Feb. 19 2001
Dr. Bratman assumes that because he had some sort of eating problem, everyone else who eats in a healthy manner does as well. Read morePublished on Feb. 8 2001