Orthorexia and Picky Eating--the New Eating Disorders?

I have a friend who will only eat short pasta, like penne. Another friend sticks to long pasta - linguini, spaghetti. I thought that was a bit bizarre until I read about Heather Hill, 39, whose diet consists entirely of French fries, pasta with butter or marinara sauce, vegetarian pizza, cooked broccoli, corn on the cob, and cakes and cookies without nuts.

Ms. Hill isn’t alone. New findings indicate that there may be hundreds, if not thousands, of adult picky eaters. To get a handle on the numbers, Duke University and the University of Pittsburgh have launched a national public registry of adult picky eaters. Respected publications like JAMA and Psychology Today are recognizing another new eating disorder, orthorexia, an obsession with healthy eating. That may not sound bad, as obsessions go, but those who carry good intentions too far can face serious risks.

Eat the right foods to keep your bones strong.

Kristie Rutzel, 27, dropped to 68 pounds when she was in the grip of her fixation on healthy eating - at one point she ate little more than raw broccoli and cauliflower. Neither adult picky eating disorder nor orthorexia is included in the Diagnostic and Statistical Manual (DSM), the American Psychiatric Association’s “bible” of mental disorders. Once a disorder is listed, treatment is often covered by insurance and it’s easier for researchers to get grants to study it. Here’s what we know so far:

* What is Adult Selective Eating? Like kids, adult picky eaters limit themselves to an extremely narrow range of foods. Unlike those who suffer from anorexia nervosa or bulimia, adult picky eaters are seemingly not worried about calorie counts or body image. But so far, researchers don’t know if adult picky eaters just haven’t outgrown childhood patterns or if their eating habits are a new twist on obsessive compulsive disorder. Some may be “supertasters,” with an abnormally acute sense of taste that turns them off certain foods. Many appear to have had unpleasant childhood associations with food.

* What is orthorexia? Identified in 1997 by Colorado physician Steven Bratman, MD, orthorexia is Latin for “correct eating.” Here, too, the focus isn’t on losing weight. Instead, sufferers increasingly restrict their diets to foods they consider pure, natural and healthful. Some researchers say that orthorexia may combine a touch of obsessive compulsive disorder with anxiety and warn that severely limited “healthy” diets may be a stepping stone to anorexia nervosa, the most severe - and potentially life-threatening - eating disorder.

What do they eat?

* Adult picky eaters: Food preferences tend to be bland, white or pale colored - plain pasta or cheese pizza are said to be common foods along with French fries and chicken fingers. Some picky eaters stick to foods with a common texture or taste.

* Orthorexics: Those affected may start by eliminating processed foods, anything with artificial colorings or flavorings as well as foods that have come into contact with pesticides. Beyond that, orthorexics may also shun caffeine, alcohol, sugar, salt, wheat and dairy foods. Some limit themselves to raw foods.

Check out this mobile phone app that guides healthy food choices.

What are the risks?

* Health consequences: Limiting your diet to only a few foods - because you’re a picky eater or have a long list of foods you deem unhealthy - can lead to potentially dangerous nutritional deficiencies. At its most extreme, a diet limited to only a few foods perceived to be healthy is described as orthorexia nervosa and can lead to the same emaciation and health risks seen with anorexia nervosa.

* Social Isolation: Being an adult picky eater can take an enormous social toll. Out of embarrassment, these folks avoid dining with friends or co-workers. Heather Hill tries to hide her eating habits from her children for fear that they will pick them up. Going to extremes in an effort to eat only healthy foods can also be socially isolating and can undermine personal relationships.

How are these disorders treated?

* Adult Selective Eating: Techniques that have proven successful in treating kids who are picky eaters - learning assertiveness skills and systematically trying new foods - are being used on adults, but it’s still too soon to know whether they work.

* Orthorexia: Cognitive behavior therapy designed to change obsessive thought patterns regarding food is usually recommended.

Keith said:

Absolutely not, but I am suggesting that if this were the kind of place where dysentery is common, perhaps our society wouldn't have this other problem. Truly a disease of privilege. Still, I'd rather deal with obesity and "picking eating disorder" than eat mud cakes and rice.

(Secondly, I was responding to the OP generally, not your post.)

Cockzombie said:
wait- I'm expected to take you seriously to define what are and what are not eating disorders? RIght.

maybe you didn't read the entire article- or you think pasta with butter, mac and cheese, and chicken nuggets healthy?

Cockzombie said:
I will say though, that I doubt you are suffering from "orthorexia" (which is the emphasis on a diet that IS, by definition, healthy.) given that in one of your more recent public blogs you were excited about scoring some free crack.

Clidna said:
A diet that is, by definition, healthy, and took the girl spoken about in the article down to 68 lbs.? Orthorexia sound like a mixture between OCD and anorexia. Yeah, that sounds healthy. Not a disorder at all.

Mantis said:
Orthorexics: Those affected may start by eliminating processed foods, anything with artificial colorings or flavorings as well as foods that have come into contact with pesticides. Beyond that, orthorexics may also shun caffeine, alcohol, sugar, salt, wheat and dairy foods. Some limit themselves to raw foods.

Raw diets are very, very healthy. Plus, someone who eats raw most likely pays much more attention to their diets than other people. This doesn't sound like a disorder, and medical professionals haven't declared it as one.

Mantis said:
Absolutely. And I could see how for some people who are suseptible to eating disorders could be triggered by a raw diet. It could make some people go there, without a doubt. But is it it's own disorder or a subset of anorexia? The medical community is saying so far that it is not it's own diorder. That could change, and I hope it does so that differnt treatment options are explored for anorexia and other eating disorders. But for now it is not a disorder.

Necia said:

Right. This orthorexia thing isn't an attempt to pathologize normal behavior; it's an attempt to describe a variety of eating-disordered behaviors, "disorder" being the key word here. Cutting certain foods from your diet is not in and of itself a problem; it is a problem when doing so hinders you from living life. Going on a diet is not in and of itself a problem; starving yourself is.

I get frustrated when people look at the basics of a mental health problem, draw a direct parallel to "normal" behaviors that seem similar to the hallmarks of that problem, and conclude that the problem is therefore normal and therefore not a problem. It happens with depression all the time: "Everyone gets sad. That's normal; that's not a problem. Popping pills so you'll never be sad is wrong/lazy/self-indulgent/weak." Feeling sadness is totally normal. Depression has some similarities to the common feeling of sadness. But they're not the same thing. Having a beer every now and again and being a fall-down-drunk alcoholic have alcohol in common, but they're not the same thing. And following a particular dietary regimen and orthorexia have food and food choices in common, but (wait for it!) they're not the same thing.

Mantis said:
Orthorexics: Those affected may start by eliminating processed foods, anything with artificial colorings or flavorings as well as foods that have come into contact with pesticides. Beyond that, orthorexics may also shun caffeine, alcohol, sugar, salt, wheat and dairy foods. Some limit themselves to raw foods.

Raw diets are very, very healthy. Plus, someone who eats raw most likely pays much more attention to their diets than other people. This doesn't sound like a disorder, and medical professionals haven't declared it as one.

SnakePlissken said:
Any drug you ingest in any form figures into your diet. And plenty of them contain carcinogens, especially crack cocaine. That being said I believe the point she's making is that through your ingestion of such items you are doing the exact same thing as those "typical fat and lazy" people, just in a different way.