Orthorexia nervosa, or an obsession with "healthy" or "pure" eating, is generally considered a type of eating disorder, even though no formal definition exists. Clinicians have been saying that this unhealthy obsession with healthy food has been increasing the past few years, and I wouldn't be surprised if that was the case. Becoming more aware of what we eat (which is good) has also fueled the worries of those who aren't sure what to eat. Everyday, it seems, some new research adds another item to the litany of things we should and shouldn't eat.

How could you not be anxious?

Steven Bratman originally coined the term "orthorexia" in the 1990s, after himself suffering from the condition, and explains it as follows (excerpted from a Smithsonian Blog on the subject):

“Orthorexia begins, innocently enough, as a desire to overcome chronic illness or to improve general health,” he writes. “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.”

I started to twitch just a bit when Bratman says "willpower." Because it's not willpower. It's fear. And fear is a remarkably strong motivator. Sufferers of orthorexia aren't avoiding foods because they're "better" or "stronger" than those Oreo-loving, Cheez-Whiz guzzling "normal" folks. It might seem that way--when I was restricting, I often used words like "strength" or "willpower" as so-called motivation. Yet these words cloaked what was really going on: I was afraid to eat. It's a pretty bizarre concept, when you get right down to it, and my brain understood it much better when I thought I was super-strong because I could exist on a diet of lettuce and air.

A sub-headline on a MomLogic blog post about orthorexia explained it much better: Obsessive-Compulsive Driven Disorder. Although I've never been obsessed with food in a strictly orthorexic way, I do have OCD and anorexia, and I know quite a bit about food obsessions. I wouldn't call anorexia the same as OCD, but there does seem to be a significant amount of overlap, both in personality traits and the percentage of anorexics who also have OCD. And orthorexia also seems similar to OCD, with the obsessions focusing on quality of food rather than calories and fat grams.

But Bratman says there is one main difference between anorexia and orthorexia:

"Someone with anorexia does not see her/himself as emaciated, but as fat. Where someone with orthorexia is aware of their extreme thinness but is fine with this, as long as they feel pure."

Except there are well-known cases of non-fat-phobic anorexia, especially in younger children and non-Western countries. So I'm not sure this difference holds up. Another similarity is the fact that both disorders seem to be largely egosyntonic- their illness is giving them the "desired" outcome.

In the end, both disorders can be deadly and debilitating. We need to learn more about orthorexia so that we can start to define it and devise treatments for it.

I remember when the OCD first struck. Sure, there had been plenty of signs of anxiety and obsessionality before then, but on one December day of my ninth grade health class, my OCD came crashing down with a thunk. We were learning about AIDS, and I promptly freaked. Freaked is, perhaps, an understatement. I had an anxiety attack so intense that I ran to the bathroom, threw up (not intentionally, I was just so anxious that I couldn't keep my breakfast down), and washed my hands. Twice.

And that was the beginning of that.

I wasn't especially anxious about AIDS before this incident. I mean, I was a little bit, but nothing even remotely crippling. A little anxiety can be a good thing in terms of disease prevention. It might make you think twice before sharing a needle or having unprotected sex with a stranger. But this was the mid-90s, and the second round of AIDS hysteria was picking up. The second round was more a This-Can-Happen-To-YOU kind of moralizing, and news pieces on TV and in magazines only confirmed what I was already afraid of. It wasn't just a random 15-minute video in health class, these fears were all around, all the time. Every article, it seemed, only confirmed my nagging fears that people were simply germ-spreading machines. I was smart to be worried. I was right. Why weren't others so worried? What was wrong with them?

Granted, most people I knew weren't scrubbing their hands in Ajax and puking from anxiety, but still.

The last line in a Guardian UK piece called "Pure food obsession is latest eating disorder" got me thinking along this line. The article looked at the seeming rise in rates of orthorexia, or an obsession with healthy eating. The last quote of the article, by nutritionist Deanne Jade, was what stuck with me:

"And just look in the bookshops – all the diets that advise eating according to your blood type or metabolic rate. This is all grist for the mill to those looking for proof to confirm or encourage their anxieties around food."

This quote reminded me of the beginnings of my OCD: everywhere I turned, my fears were confirmed. I couldn't convince myself that this was not a smart thing to be worried about--or, at least, so worried about. I was aware that my behaviors were bizarre and my fears overwhelming, but when you see all of this hysteria all around you, it's kind of hard to realize that you have an actual brain disease.

Is this rise in orthorexia a bit more complex than this? Of course it is. There has been an increase in a wide variety of specialty foods that allow people to custom build their diets. For those with real dietary limitations, this is great. But it also has allowed those who have food anxieties to avoid anything anxiety-provoking. And as someone with plenty of food anxieties, I can attest that any magazine will confirm my fears of becoming fat or of eating too much or of not eating the "right" foods in the "right" quantities at the "right" times.

A little anxiety over food isn't necessarily bad. Roaches don't add flavor, and neither does Salmonella. But considering how much we are all fanning the flames, it's little wonder that the severe, clinical fears are only rising.