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Eating Disorders Health Center

Orthorexia: Good Diets Gone Bad

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If you answered yes to two or three of these questions, you may have a mild case of orthorexia. Four or more means that you need to relax more when it comes to food. If all these items apply to you, you have become obsessed with food. So where do you go from there?

Treatment involves "loosening the grip," Bratman tells WebMD. "I begin by agreeing that the diet is important, but also saying, 'Isn't it also important in life to have some spontaneity, some enjoyment?'"

For most people, he says, making the change is a big step. "It doesn't happen in just one session. Once people recognize it, it's still very hard to change. It's been so long since they've eaten spontaneously. They don't know where to start. It's very tricky."

Bratman notes that sometimes orthorexia overlaps with a psychological problem like obsessive-compulsive disorder. Still, he thinks orthorexia "is its own illness as well."

He has not conducted human studies on the disorder, Bratman says, "because I'm personally more interested in affecting social change than creating a new diagnosis that you bill insurance companies for." He says he imagines his book will create controversy -- especially among diet gurus. "I'm just trying to bring people to the middle," he says.

Skeptical of Bratman's theory is Kelly Brownell, PhD, co-director of the Yale Center for Eating and Weight Disorders. "We've never had anybody come to our clinic with [orthorexia], and I've been working in this field for at least 20 years," Brownell tells WebMD.

Without research to back his theory, Bratman is simply another guy trying to make a buck off the health-conscious public, Brownell says. "They invent some new term, a new diet, a solution to a problem that doesn't even exist. The burden should fall to the authors to prove that what they're saying is correct before they start unleashing advice on the public. These authors should be held accountable."

Well-known columnist Dean Ornish, MD, founder and president of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif., also has doubts. "I've never seen [orthorexia] in my clinic. Most people have the opposite problem; they don't care enough about what they eat."

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