Orthorexia nervosa, a term coined by the American doctor Steven Bratman1 in 1997, is a derivation of anorexia nervosa based on two Greek words, ortho (right, correct) and orexis (desire, appetite – for food). It refers to a syndrome involving a manic fixation with ‘healthful’ eating.2 In a similar vein to religious fanatics, for whom any deviation from their collective view amounts to heresy, orthorexics organise their whole existence around nutritional issues and are constantly concerned about them. Their sole interest in life is the quality of food. Their relationship with food becomes a way of life, a system of values or beliefs3 as restrictive as a monastic rule, to the point where the initial benefit (eating good products, respecting nature and their own organism) turns into a vice, an addiction. Such a shift towards excess can then have the most contradictory of consequences: In the quest for good health, orthorexics may engage in dietary restrictions that undermine exactly what they intend to protect and that may even prove life threatening.
This eating disorder is believed to affect between 1 and 3% of the population, mostly women. Despite the popular use of the term ‘orthorexia’, it does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the key reference book on mental disorders. However, the authors are considering including it in the next edition.4 Until then, this condition is best described as a set of “anxiety disorders with a phobic dimension of fear of dangerous food and an obsessive-compulsive dimension of devising protective mechanisms”.5
A semantic analysis may prove beneficial to understanding how an orthorexic’s mind works. Indeed, eating harbours great symbolic intensity, and the words and pictures we use to define what we should ingest or banish from the menu speak volumes about our relationship with the world. We can thus qualify orthorexia as a deregulation of representation. For addicts of ‘healthful’ food, a form of travesty comes into play, as they invest eating and drinking with parasitic significations and images that are inopportune and overly burdened with meaning. The convert becomes confused, since choosing a type of flour, chopping a vegetable, timing steam cooking or calculating various daily nutritional values take on a sense of existential importance. This is a sign of dysfunction, which is even more apparent in their discourse about food. As Kelly6 points out on the subject of fasting, the words of some diet gurus can have quite an impact: “[…] if the leaders are championing fasting I think people could be led to believe food is dangerous from the rhetoric alone.”7
Deities and demons of ‘healthful’ food
The first metaphorical field that comes to mind relates to religion. As citizens of a secular, consumerist society, orthorexics look to their plate for the sacred aspect missing from their lives. There is a plethora of personal accounts of orthorexia, all of which turn to the religious lexicon to describe a form of alienation. This is true of Liz, who thinks that her husband has orthorexia and she sees food as a form of primary domestic cult; or Dave, who imagines that at any time, God may point a finger at him and condemn him to death, a threat that only ‘healthful’ food can fend off, as a sword and shield. Ruth, meanwhile, confesses that her ex-husband lived according to a superior dietary law and anyone who would not follow it would be threatened with divine wrath and cancer, for good measure.8
When we listen to orthorexics, we may perhaps detect anguish or a metaphysical void that drives them to see meal preparation as a spiritual exercise, somewhat like prayer. The words of Emily Hope Avent, an ex-orthorexic, do not contradict this, but serve to emphasise the powerfully addictive nature of such a disposition. From her point of view, food is as powerful as a drug or a spiritual experience.9 If we were to follow the religious logic and give ‘healthful’ food a sacred aspect, straying from the correct diet would be comparable to a fall in the biblical sense of the word, a loss of divine grace that would require redemption, penitence and, therefore, increased attention to one’s diet. Of course, gratitude for food, the act of blessing a meal, is a traditional component of spirituality – except that believers thank their god for having something to eat, full stop. Orthorexics, on the other hand, turn food into a divinity rather than thanking the divinity behind the food.10 Through their restrictive and maniacal practice, they subscribe less to religion as a relationship between humans and with God, and more to religion as an ascetic discipline about maceration and self-negation, a breviary of frustration. Orthorexics banish pleasure and embrace the path of nutritional puritanism, no doubt on a crusade against our societies of overabundance.
Deriving from religion, the confessions of fanatics of ‘healthful eating’ sometimes verge on the metaphorical field of demoniacal possession. Obsessions with nutrition thus seem to play the role of a perverted Socratic daïmôn (demon), in the sense that the inner demon of dietetics orders sufferers to eschew pleasure and avoid prohibited food. Jordan Younger does not mince her words: After a wild party with her friends, she told them that she was tired of this life of nocturnal excess; and while she admitted that her excuse had an element of truth in it, she also says that her “inner food demons were really what kept [her] from having fun that night.”11 In her contribution on Bratman’s website, Laura suggests that thinking of oneself as allergic to a particular type of food leads to the development of a “food demon mentality”, which radically classifies allergenic food in the moral category of “bad food”.12
One of the greatest difficulties in treating orthorexia stems from sufferers’ dualistic thinking. Hence, their lexicon is organised into opposing categories, such as pure/impure, allowed/forbidden, healthy/unhealthy, etc. Moral condemnation is never far away. Thus, Dana Anon admits having been martyred during her childhood by parents who saw meat-eaters as murderers and who divided society into despicable people and those who upheld nutritional purity. Sally no longer dares to discuss the choices of her orthorexic sister-in-law, as the latter sees herself as enlightened and reacts with violent counter-attacks to any questioning. Lindsay, aged 16 and in remission, admits it took her a long time to give up the morbid reflex of labelling all food as good or bad.13
In conclusion, a fanatic of healthy-eating is impervious to Paracelsus’ lesson that only the dose of something determines whether it is poisonous – for orthorexics, it is all or nothing. Food cannot be seen as a pharmakon, both a possible remedy and a potential poison at one and the same time.14 This is why dualism structures the discourse of nutrition obsessives, and why a macrobiotic diet has sometimes been a gateway to serious disorders. Applying the Taoist yin and yang principle to food, and installing a metaphorical framework that sets opposites against each other, macrobiotics can give the credulous the illusion that, by being in control of every single parameter of their diet, they are in control of their life. Such a dualistic rigour, in that it brings order and method, has a powerful effect on an anxious temperament. In her book, Jordan Younger admits that, at the height of her orthorexia, she often thought and reacted in an obviously binary mode. The idea of food macerating in her stomach terrified her and she saw a liquid detox as the only alternative to rotting. She associated nourishment with the categories of failure or success – eating something prohibited was a sign of moral weakness, while sticking to the diet was a priceless victory.
As revealed in the writings of former orthorexic Steven Bratman, this dualism ultimately structures whole swathes of social and mental life. In their obsessive search for perfect nutrients, ‘correct eaters’ set food against society; they make their peace separately and withdraw from the world, or even aspire to completely silencing their own organs, in an intense desire to be nothing but a pure spirit, free from the weight of the body.
To end this overview of the orthorexic imagination, let us consider one last set of metaphors they might call extra-sensory nutritional perception. Worshippers of healthy eating do indeed seem to benefit from powers of sight that verge on clairvoyance. They see everything, notice everything and effortlessly penetrate the most intimate layers of matter. This power evidently stems from long-standing practice and requires considerable endurance, starting with the kind developed in supermarkets. Ex-vegan Jojo Bizarro says he is happy he no longer reads labels obsessively to check that food products are exempt of poison. Alicia no longer even sees food: Her gaze only perceives the nutrients and levels of sugar, vitamins and minerals in a product. If she deviates even slightly, she panics and starts to scrutinise everything she eats with an eagle eye (“[…] I eat like a hawk.”).15 Jordan Younger also breaks down and disperses food into its elementary components, as orthorexia means no longer just consuming a variety of food, but rather ingesting the exact, ideal proportion of allegedly vital nutrients. When, in the early stages of her recovery, she dared to cook a fillet of salmon, she admittedly savoured it with obvious pleasure, yet always bore in mind that behind this piece of solid food lay an armada of vitamins and minerals.16
The most inspired or hardened orthorexics claim to have clairvoyant-like vision. Some vegetarian orthorexics perceive flesh-based vibrations in meat and refuse to eat any dishes from a kitchen where these vibrations have left their mark. Others maintain that simply chopping a vegetable destroys its etheric field.17 Once more, Bratman recalls from his own experience what is perhaps the most telling story. One evening, after enjoying time in the company of his friends, he realised that he was focusing on an avocado on the table in front of him. He knew that the fruit was ripe. He did not simply content himself with knowing this: He saw it. He pictured the green colour of its flesh, how much vital energy it radiated. He also fretted about it, as he was certain that the next day it would be too late – the time of perfect ripeness would be gone; he thought about the green, shiny cells inexorably turning brown, and squeezed the avocado again and again, realising that he was accelerating its ageing process and making the need for refrigeration even more urgent. He could take no more and went to put the fruit in his refrigerator. The guests saw it as a sign that the evening was over. Within a few minutes, everyone had gone. Bratman found himself alone with his avocado. It obviously had less advanced conversational skills than his friends did. Sadness ensued.18
Such deregulation of all meanings is how orthorexics become their own worst enemy. They are at once the architect, warden and prisoner of the penitentiary that confines them. They invest food with too much signification and burden it with overly heavy metaphors, to the point where it takes on an inappropriate role and traps the individual in manic behaviour. The help of friends, family or professionals, and working on representation can bring an initial breath of fresh air to enable an orthorexic to escape this vicious circle. Having recovered from orthorexia, Jordan Younger summarises it in an exquisite tautology that sounds like an announcement of rebirth: “Food is food. Food fuels us, we should enjoy it, and we should not let it get in the way of our lives.”19
Am I orthorexic?