Health food junkies:Orthorexia

T here’s a fine line between being careful about what you eat and constantly worrying about the ‘purity’ of your food. Experts say that with more and more people becoming health conscious, there’s also a growing number crossing the line to an unhealthy obsession with the ‘right’ and ‘pure’ food.

A few years ago, nutritionist Naini Setalvad went over to a friend’s place to help out with an exhibition. She had left early and assumed she would grab a bite at her friend’s home. But when breakfast was served, Setalvad didn’t eat.

“There were puris and parathas and other fried and unhealthy foods,” she recalls. “I was very particular about what I ate and fried puris were a definite no. I would have liked just a toast, but that wasn’t an option.”

When she left her friend’s place at 11.30am, she decided to buy a healthy snack. She crossed the street, and just outside the shop, she fainted.

“Luckily, I didn’t collapse in the middle of the road, but it was alarming nonetheless. My body was so used to a meal at a certain hour, and because I didn’t get what I thought was ‘healthy’, I paid a price,” she says.

Setalvad was suffering from a condition called orthorexia nervosa, an eating disorder that is affecting well-to-do and well-read men and women in their 30s and 40s. In 1997,

US-based doctor Steven Bratman identified the condition and explained, “The term is derived from the Greek ‘ortho’, which means ‘right’ or ‘correct’, and is intended as a parallel with anorexia nervosa. Orthorexia nervosa refers to a fixation on eating proper food.

It begins innocently enough, as a desire to overcome chronic illness or to improve general health… [and] eventually reaches a point where the sufferer spends most of his time planning, purchasing and eating meals.”

Five almonds, not eight
Those suffering from other eating disorders such as anorexia nervosa and bulimia focus on how much food they eat, while orthorexics fixate on the kind of food they eat. They aren’t necessarily skinny, say experts. Though not as dangerous as anorexia and bulimia, Bratman says that in rare cases, this focus may turn into a fixation so extreme that it can lead to severe malnutrition or even death. However, a 2004 study conducted in the University of Rome to determine the disorder’s prevalence found that 6.9% of the people surveyed exhibited orthorexic behaviour — a higher percentage than anorexia and bulimia combined.

Dr Richa Anand, dietician at LH Hiranandani hospital in Powai, says she is seeing a growing number of orthorexic cases — eight to 12 cases a month — though most are milder forms of full-blown orthorexia. “People don’t come for help as much as they do to brag about how they’re eating the ‘healthiest’ or the ‘purest’ food, or to obsess about whether they’re feeding their families right,” she says, adding that these are educated people who have researched the internet to identify the healthiest foods and have enough time — and money — to ponder at length about the best organic foods and the like.

Neeti More* is in her early 30s. Once her kids leave for school, she organises lunch and then starts planning a tea-time snack and dinner. She talks to her friends on the phone, but never makes plans to meet them. On the few occasions she does socialise, she skips meals. She doesn’t allow her children — aged 8 and 4 — to go for birthday parties, because, she says, “I never know what they’ll end up eating”. She gets worried that her husband sometimes eats eight almonds instead of the usual five in the morning.

When she travels — even on vacations abroad — over 30% of her luggage consists of healthy, organic foods. More wouldn’t admit she has a problem. “I’m only looking out for my family. And there’s nothing wrong with wanting to eat healthy,” she says.

More might not believe she is obsessive, but dieticians warn that such a controlled and restricted diet can be harmful. “Fad diets that recommend cutting out fat, carbs and animal products are dangerous. Orthorexics may end up not eating anything when the ‘right’ food is not an option and lose out on a lot of essential nutrients that way,” says dietician Rittika Gupta.
When it affects social life

Rishabh Sen* spent a lot of time and effort shedding his adolescent chubbiness, and in the process, became particular about what he ate. But at 19, he realised he was growing taller and was too skinny. He approached a dietician and asked for a healthy diet to help him put on weight. She suggested egg yolks, dry fruits and ghee on chapattis. Sen rejected the plan.

He didn’t mind eating 11 egg-whites, but wouldn’t touch a single yolk, even though his cholesterol was normal. He refused fruit juices because they’re “unhealthy without fibre”.

Thanks to his restricted diet, he even has a marginal vitamin deficiency, but can’t bring himself to change his eating pattern. Months of counselling have had some effect though. He can now eat a handful of nuts and dry fruits without feeling as if he’s “abusing his body”. 

One of the things Sen realised was that he had stopped hanging out with his friends at the college canteen. “What’s the point? All you get there is unhealthy food,” he says. Like Sen, orthorexics isolate themselves. Anand explains: “This obsession affects your social life. You stop going out for fear of what you will have to eat. You end up spending a disproportionate amount of thinking about the purity of your next meal. Food should not be associated with so much stress.”

Psychologist Anjali Chhabria adds that orthorexics are more prone to anxiety and depression, without even realising why they’re worrying. “Counselling such patients is tough, as most live in denial — even proudly encouraging their friends to give up entire categories of food — until a family member brings them for counselling,” she adds.

Setalvad too admits that she used to take off during the festival season every year, just to avoid visiting friends. “Since most of my friends entertain outside, I just stopped going. But that has changed once I realised I was harming myself,” she says. “For the first time in over 10 years, I’ve eaten everything in the past two weeks. I’m not sitting with a plate of kakdi-tamatar while my friends relish delicacies.”

She says she’s realised that if you’re careful about your meals, you don’t have to worry about making an exception once in a while. Your body gets stronger when you eat healthy, she explains.

“So in case you don’t have an option, don’t starve yourself. Anything unhealthy that you eat once in a while will get flushed out of your system in a day.”

*Name changed on request