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What is Orthorexia Nervosa?
By, Brooke Finnigan
Orthorexia Nervosa is a term coined by Dr. Steven Bratman, who first
published his insights to the readers of Yoga Journal in 1997.
Bratman, a physician who utilizes dietary medicine in his practice,
and, a long time proponent of the health food movement, wrote about
his experiences, and how the impulse to be healthy can be taken to dangerous
extremes.
In Bratman's experience, a person struggling with Orthorexia Nervosa
is someone obsessed with nutritional and physical purity, frequently
to the point of emaciation. The goal, says Bratman is, " to
feel pure, healthy and natural."
You won't find Orthorexia Nervosa in the Diagnostic Statistic Manual,
(DSM IV TR), yet, but his work is being taken seriously by
those in the eating disorder community. Especially as more people turn
to alternatives in nutrition, and more of those alternatives become
extreme.
For example, one of the biggest health food fads right now is the raw
food movement, (which is limited to fruits, vegetables, and legumes).
Adherents of the raw food movement, like celebrity Demi Moore, believe
that cooking food saps it of all nutritional content, and that a diet
that consists only of raw fruits, vegetables, and legumes, is the key
to perfect health. An even more extreme branch is fruitists, or fruitarians.
As the name implies, they eat only fruit and fruit like vegetables,
(tomatoes and cucumbers).
Whether a Jenny Craig adherent or a Fruitarian, people are attracted
to structured food regimens for similar reasons. Restricting or altering
food intake gives one a sense of internal control. This behavior is
a coping mechanism to avoid other, more painful issues. In other words,
by fixating on fat count, we don't have to be aware of the emotional
duress we're feeling about work, school, or important relationships
in our lives.
"Orthorexia begins, innocently enough, as a desire to overcome chronic
illness or to improve general health," says Dr. Bratman. "But because
it requires considerable willpower to adopt a diet that differs radically
from the food habits of childhood and the surrounding culture, few accomplish
the change gracefully. Most must resort to an iron self-discipline bolstered
by a hefty dose of superiority over those who eat junk food. Over time,
what to eat, how much, and the consequences of dietary indiscretion
come to occupy a greater and greater proportion of the orthorexic's
day."
While the motivation is slightly different, the rituals around food,
the strong need for control, the obsessive ideation, and the harmful
belief that life will be better when the person achieves their goal,
adds up to archetypal eating disordered behavior. Dr. Bratman says,
"Orthorexia bears many similarities to the two well-known eating disorders
anorexia and bulimia. Where the bulimic and anorexic focus on the quantity
of food, the orthorexic fixates on its quality. All three give food
an excessive place in the scheme of life."
And just as the motivations and underlying behaviors are similar between
Anorexia Nervosa and Orthorexia Nervosa, so is treatment. Getting help
for Orthorexia involves working on setting boundaries, development of
interpersonal skills, and healthy esteem. Attention to creating more
nurturing coping skills is necessary, as is acknowledging and working
through the emotional pain that leads people to have an unbalanced relationship
with food and themselves, in the first place.
By
taking the emphasis off food and onto emotions, a person who once struggled
with Anorexia, or Orthorexia, can put food back into its rightful place,
and live life feeling healthy, in mind, body, and spirit.
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