Organic foods, whole grains, vegetables — these are all good and healthy things. But what happens when you become obsessed? According to Time magazine, the Washington-based Eating Disorders Coalition wants “orthorexia,” a controversial diagnosis characterized by an obsession with avoiding foods perceived to be unhealthy, to have a separate entry in the bible of psychiatric illness, the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Virginia native Kristie Rutzel stopped ingesting anything processed, then restricted herself to whole foods and eventually to 100% organic. By college, the 5-ft. 4-in. communications major was on a strict raw-foods diet, eating little else besides uncooked broccoli and cauliflower. She weighed just 68 pounds. When she first sought help for anemia and osteopenia, a precursor of osteoporosis triggered by her avoidance of calcium, her doctor had never heard of orthorexia. “You should be trying to eat healthy,” she remembers him telling her. He couldn’t quite grasp that he was talking to a health nut who believed there were few truly healthy foods she felt were safe to eat.
As the list of foods that are bad for us continues to grow (trans fats and high-fructose corn syrup are the latest evils), eating-disorder experts are increasingly confronted with patients like Rutzel who speak of nervously shunning foods with artificial flavors, colors or preservatives and rigidly following a particular diet, such as vegan or raw foods. Women may be more prone to this disease than men, keeping a list of forbidden foods and obsessing over how food is prepared. Many choose to go hungry rather than eat anything less than wholesome.
On Wednesday, the first draft of DSM-V was published online, and orthorexia wasn’t included. Tim Walsh, a professor of psychiatry at Columbia University who led the American Psychiatric Association’s work group that reviewed eating disorders for inclusion in DSM-V, says that they need more “significant data” about the disease.
Most doctors think a separate diagnosis is unwarranted. Orthorexia might be connected to an anxiety disorder or it might be a precursor to a more commonly diagnosed condition, says Cynthia Bulik, director of the eating-disorders program at the University of North Carolina at Chapel Hill. “We don’t want people to be mislabeled and not get the care they need because they’re actually on the slippery slope to anorexia,” she says.
