Health Food Junkies

Laurie and Debbie say:

Our friend Lizzy lent us Health Food Junkies: Orthorexia Nervosa|Overcoming the Obsession with Healthful Eating by Steven Bratman, M.D. with David Knight. We’ve been aware of the concept of orthorexia (which means “eating by rules,” just as “anorexia” means “not eating) for some time, but neither of us knew that the term was coined by Dr. Bratman.

This is the contrarian premise of this book: Obsession with healthy diet is an illness, an eating disorder.

Bratman is an engaging and extremely thoughtful writer. One thing that sets his book apart from many comparable books is that he himself has been an orthorexic, and he has a lot of both understanding and sympathy for people whose dietary controls have overtaken other priorities in their lives.

“The life preserver that finally drew me out [of orthorexia] was tossed by a Benedictine monk named Brother David Stendl-Rast. I had met him at a seminar he gave on the subject of graititude. Afterward, I volunteered to drive him home, for the purpose of getting to know him better. …

The drive was long. In the late afternoon we stopped for lunch at one of those out-of-place Chinese restaurants. … the food was unexpectedly good. The sauces were fragrant and tasty, the vegetables fresh, and the egg rolls crisp.

After I had eaten the small portion that sufficed to fill my stomach halfway, Brother David casually mentioned his belief that it was an offense against God to leave food uneaten on the table. This was particularly the case when such a great restaurant had so clearly been placed in our path as a special grace. … He continued to eat so much that I felt that good manners, if not actual spiritual guidance, required me to imitate his example. I filled my belly for the first time in a year.

Then he upped the ante. “I always think that ice cream goes well with Chinese food, don’t you?”

Bratman is in favor of what we currently call “healthy eating.” And he (and we) are very aware that food allergies are real, and need to be taken seriously. His concern kicks in when what someone eats becomes the focus of their lives. At the time he wrote the book (2000), he was mostly vegetarian, taking a few supplements in pill form. At the same time, he has seen both professionally and personally how people can harm both their both physical health and quality of life by focusing obsessively on food intake and food choices.

In an exhaustive review of a variety of healthy diets, Bratman focuses on the contradictions between one health theory and another, and tells story after story about the dangers of each one, although he is careful to point out that just about any eating regimen (including the “beer and pizza” diet to which he devotes a chapter) can have enormous health benefits for a few individuals. In the end, he draws the reader to the conclusion that just about any healthy diet, carried into obsession, is very likely to become a danger to health itself.

Bratman lists seven “hidden causes” of orthorexia:

–the illusion of total safety
–the desire for complete ocntrol
–covert confirmity
–searching for spirituality in the kitchen
–food puritanism
–creating an identity
–fear of other people

He goes into each one in some detail, explaining what it is and how it makes orthorexia attractive.

The other major characteristic that sets this book apart from most self-help tomes, is that Bratman creates both a social context and a value system for his recommendations.

Life is meant for joy, love, passion, and accomplishment. Absorption with righteous food seldom produces any of these things, and if you find yourself regularly joyous about zucchini, in love with raw-grain pizza, passionate about amaranth, or proud of your ability to eat nothing but brown rice, your priorities are out of place. Remember, life is too short to be spent thinking about how healthy or unhealthy your diet is.

and

Which do you think really matters more: spending two hours with your child or devoting that two hours to cooking a macrobiotic meal? Listening to your friend or thoughtfully savoring the taste of an orange? Volunteering in your community, or fasting every Friday?

orthorexia, health food, health, healthy eating, Steven Bratman, body image, diet, eating disorders, food, Body Impolitic

16 thoughts on “Health Food Junkies”

  1. This sounds like it intersects with Michael Pollan’s critique of “nutritionism,” the idea that food is a collection of nutrients, and that eating healthy is primarily a matter of getting the right nutrients in the right amounts, rather than eating food as a source of pleasure and in continuity with tradition. One of his rules for healthy eating is to avoid any food that has a health claim on the package.

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  2. I can’t see that every human foible and stupidity has to be an illness. This orthorexia reminds me of the overly religious, all of us at some point are going to go over the top with an idea. If you press even the most healthy and rightgeous ideals too far, it’s liable to unbalance you at some point.

    This orthorexia is something people can get caught up in, but anorexia is a very serious condition and I think it is trivialising it to borrow from it in this case, I doubt whether it is likely to do anywhere near the harm that anorexia easily can. It’s fine to warn people of what can happen, but surely it doesn’t have to be lablelled ‘illness’ before it can be taken seriously, surely?

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  3. Interesting, thought-provoking, ire-raising post! Wow.

    I think I may be with wriggles on this one. Maybe because I’m a bit into eating healthy. I think of my trying to eat certain foods and not eat others as a gift to myself, because it means I am choosing health. There is never a perfect accord, in this life, however. There is always something that we will miss when we choose another road or food. There is not just one right way to fill one’s body — I think that is the beauty of your blog, that you try to live by that.

    I think it was the last two paragraphs that tipped the scales for me, so to speak, especially the line: “Listening to your friend or thoughtfully savoring the taste of an orange?” Why is it either or? We can make extra efforts to eat right and still enjoy our loved ones and hobbies. And this line: “Remember, life is too short to be spent thinking about how healthy or unhealthy your diet is.” Maybe he was trying to be ironic, or funny? Because life will really be a lot shorter if your diet is unhealthy!

    My feeling here is that this is going too far. Obviously there are people who go by rules to live their lives; some of them are just wired that way and it should not be treated like a moral issue. If it gives them comfort, what’s the harm? If it extends their life, and they derive pleasure from that very fact, from their ability to stick to their rules, then why doesn’t that count as important? There is not just one way to enjoy life, after all.

    And finally, this is not akin to anorexia, which actually kills.

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  4. I also had a problem with dismissing the idea of thoughtfully eating an orange, or being really excited about zuchinni. I regularly have long afternoons/evenings where I get together with friends, wander through the grocery store discussing food, and then we make a big fun meal together. The time spent being excited over heirloom tomatoes and french cheese, is also time spent sharing an interest with people I love, and spending time with them.

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  5. I don’t like the idea of making people right or wrong over their food choices. Am I saying that it’s “wrong” to put food in a right or wrong box….? Eek! So hard to be consistent. But then a foolish consistency has been rumored to be the hobgoblin of small minds…

    I’m not a fan of rules. My mother was so anxious about weight issues and nutrition in general when I lived at home that we never had white bread, peanut butter or jelly in the cupboard. So of course my first purchase when I moved out on my own was white bread, strawberry jam and peanut butter.

    When I began to recover my my own diet craziness, I ran into the idea of intuitive eating and tried to listen more carefully to what my body wanted. Surprisingly the body will express a very clear desire for what it needs–and what will make it feel better, be it mandarin oranges, Brussels sprouts…or cake baked from a mix with yogurt and fresh pears (looking forward to that last one tonight!). For me it’s easier to pay attention to and enjoy food when it’s what my body desires.

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  6. Bratman is talking about obsessions, based on the description of his book. I do agree with everyone who says that thoughtfully savoring the flavor of one’s food is a good thing. The kinds of rules and obsessions he’s talking about would, for most, get in the way of really enjoying one’s food.

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  7. I can`t leave out from consideration the greek ancient wisdom that you are living because of consuming not because for consuming the food. Many of us tend to forget this simple thing, first of all because some find the life empty without such pleasures. During my practice as one of the Toronto life insurance brokers I`ve met many extreme cases who either were obsessed by a new “healthy diet” or simply by eating everything what comes in their way. It`s always the hardest task to find a balanced way of living, to keep in check your desires.

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  8. Wriggles’ comment that the description of orthorexia reminded him or her of people who are overly religious in turn reminded me that there is a term for people whose religiosity has turned into an illness: scrupulosity.

    I don’t think all attempts to eat in accordance with health are orthorexia by any means. But I have definitely seen rigorous self-limitations justified by “health” concerns take over people’s lives, leaving sadly little room for other concerns. That is what I without yet having read the book would call orthorexia.

    It’s amazing how difficult it is to find the right words to talk about this. The sentence I wrote above with the word “health” in quotes sounds a bit like the kind of thing that people sneer when they think my celiac disease is all in my head.

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  9. Janet, just so. I’m eager to read his new book.

    Wriggles, I completely agree with you about medicalizing. One interesting thing about Bratman’s book is that although he invented and uses this medicalizing term, he doesn’t really talk about the behaviors that way, and he’s not recommending drug interventions, which is a relief. And you’re still right, and also right that anorexia is much more dangerous (which he also says).

    Everyone, yes, thoughtfully savoring the taste of a food is important; perhaps that wasn’t the best-chosen quotation to make the point.

    Susan, orthorexia can kill; there are a few examples in the book, and a particularly sad one on the author’s out-of-date website, http://www.orthorexia.com

    Lynne, very good point that this slides easily into being judgmental. Again, the tone of the book mitigates against that, but we all know how easy a trap that is to fall into.

    Lisa and Group Benefits, yes.

    Jill, I never heard “scrupulosity”; very useful. And I completely see the issue you raise in the last paragraph. This is hard to talk about because we’re so used to having it oversimplified, among other reasons.

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  10. I’ve got a lot of thoughts about this, not all of which i’m sure i can bring together enough to summarise.

    I’ve never liked the idea that you should deprive yourself of something that you like doing because you think it’s “unhealthy”, despite the fact that i see a lot of my friends doing that. However, i think defining that as an “illness” is… kind of circular, and not very helpful – it’s still based on an idea of “you shouldn’t do X because it’s unhealthy”, despite that being the very idea it seems to be trying to criticise…

    I think my fundamental problem is actually with the whole equation of “health” with moral goodness – which implicitly is a moral condemnation of people who are “unhealthy”. Also with the prioritisation of “health” over happiness or enjoyment. I’m vegetarian, but my reasons are ecological, not health-related, and i don’t see eating meat as an “absolute evil” (for example, if a friend had some meat that would go to waste if no one ate it, and couldn’t eat it all hirself, and i was short of money for food, i would probably eat some of it with hir rather than let it go to waste. Although, i actually don’t like the taste of meat much anyway, so part of my reason for being vegetarian is actually to give me a “good excuse” not to eat things which i don’t like the taste of, but which in mainstream culture it’s “not normal” not to like).

    I get “joyous about zucchini” (or courgettes as we call them in the UK – i always found it odd that two variants of English use the French and Italian names for a vegetable), because i really love the taste of them – also most vegetables, when treated right. Food is a massive sensual pleasure in my life. It’s self-deprivation of that pleasure which i think is “wrong”, and which i observe in far too many people (especially women) around me. (I’ve noticed that, among vegetarians/vegans, men usually give primarily ecological or animal-rights reasons for their dietary choice, while women usually give health as a primary reason.)

    As a child i was suspected of something akin to anorexia because of the amount of foods i refused to eat, and the very limited range of food i *would* eat (and other “rules” i set myself, such as not being able to eat one type of food if it was touching another type of food on the plate). This, however, was nothing to do with body image or health (I had absolutely no concern for either), but a typically autistic over-sensitivity to tastes and textures which i found disgusting or actually painful. (There are still some things, such as baked beans, which i literally can’t even look at, let alone eat, because of traumatic experience from childhood.) Would this have been classified as “orthorexia”? I’m not sure – it certainly was “eating according to rules”, at leat from a superficial standpoint.

    I knew one vegan whose veganism got gradually more extreme, eventually refusing to eat anything that wasn’t organic, totally cutting out all fats, all sugars, etc (and even trying to feed her cats on a vegan diet, which led to the death of one of them from kidney failure). Then again, she passionately believed all sorts of other irrational and mutually contradictory stuff, and i think she was basically an “acid casualty” (was taking serious hallucinogens regularly at the age of 14, etc).

    Amanda from Ballastexistenz wrote a post about this subject here: http://ballastexistenz.autistics.org/?p=236

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  11. Also (apologies for rambling), i think this sort of ties in with the slight problems i have with the slogan “health at every size”. While i’m not against it, i do find it somewhat problematic because it still puts “health” as a primary good – which i think is unfair to people who are “unhealthy” for no fault of their own (genetic reasons, after effects of a virus, etc… which, of course, shades into disability…)

    Dunno. I can’t quite put my finger on what i find so insidious about the whole “Health First” ideology prevalent in Western (both mainstream and counter-) culture. I think it offends my libertarian instincts somehow, but i’m not sure exactly how… maybe the vague suggestion of paternalistic “for your own good” thinking (only turned to oneself, rather than to others… which means as a libertarian i can’t condemn it per se, but perhaps can still criticize it…)?

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  12. This books sounds fascinating. I get that he’s talking about obsessed people, not just people who are interested in food. My mother in law has many things she “can’t” eat, some of which seem rational and others not. For example, she avoids all foods that are rich in fiber, and takes laxatives daily – that’s probably not going to kill her, but it’s not healthy.

    I picked up a brochure at a county fair once, from a Catholic group, describing “Scrupulous Anonymous”, an organization for those who have a problem with scrupulosity. Many of the saints lives would seem to be examples of this.

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  13. Lots of good comments, as always.

    There’s something I want to say that I’m having a hard time formulating. It’s about priorities, I suppose, and a skewing of the significance of certain behaviors. And it’s likely to come across as judgmental. I don’t believe there is One True Way for anything, and food carries different emotional significance for everyone.

    Still. Balance. Priorities. What *really* matters in the end?

    Eating for most people isn’t the point of life. When it becomes “too important” (a point that will differ for each person, depending on everything from profession to taste buds), it’s a problem. For some of us, eating is not important enough — I’m capable of taking both pleasure and spiritual meaning from food, but mostly I don’t, so I neglect myself badly.

    It’s the same with anything, really. You need a sense of proportion about everything. And our culture overemphasizes creating a good appearance and the gratification of the individual. Spending all your time obsessing over the most nutritious recipe may be as foolish as obsessing over the silkiness of your skin, the size of your house and bank account, the humiliation and defeat of your enemies. Or the polish on your prose.

    Whether we call orthorexia (or scrupulosity, or being a control freak) an illness or a sin or just a different way of doing things, these behaviors are out of proportion for most people.

    But for some people that over-emphasis is what works. I am aware of my own disproportionate literary obsessions and compulsions. For most people, reading books, the details of grammar and punctuation, and the lives of imaginary characters are just not that important.

    This feels incomplete and awkward, but I’ll let it stand. Maybe someone else can help me tease out the meaning.

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  14. I really appreciated the sympathetic and appreciative comments about Health Food Junkies! I’m a writer, not a self-help person, and so the comments about the tone and mood of the book really touched me! Thank you.

    I actually never intended to write more than my initial essay on this topic … but a publisher pushed me into it. What I enjoyed most was telling all the funny stories, and making gentle fun of myself. I never wanted to invent yet another disease, or criticize anyone, or even set a position.

    But the concept has now taken on a life of its own — very few people have actually read the book, but rather have reacted to what other people said, and then the process kept going. From what I gather, the idea of “orthorexia” has been helpful to some and hurtful to others. I can only hope the good parts outweighed the bad …. these days, I only write fiction. (Being a doctor is my day job …)

    Steve Bratman

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  15. Dear Steve Bratman,

    Really glad you liked our review. I certainly think that the good has seriously outweighed the bad.

    Where does one find your fiction?

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  16. I do believe, Orthorexia is commonly more of a product of psychological distress oppose to real physical danger. However, in some cases, weight loss becomes a significant feature, and all the risks of anorexia apply. Eating the compatible Healthy will work best to a person.

    “delusion is pulling in your stomach when you step on the scales”

    :D

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Body image, health