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One of my patients recently told me the story of when she began yelling at her pregnant friend, “You are killing your baby!”  What had the friend done that was deemed so horrible that it warranted such a harsh reaction?  She had ordered a smoothie in the mall food court.

Dr. Steven Bratman coined the term “orthorexia” to mean an unhealthy obsession with healthy eating.  While orthorexia is not an official medical diagnosis, a movement exists among practitioners that perhaps it should be.  Being a dietitian and not a doctor, I have no business diagnosing anybody with anything, let alone with a condition that does not officially exist.  Having said that, I do occasionally get concerned that a patient’s well-intentioned pursuit of healthy eating has crossed the line from constructive to destructive.

In such cases, the patient usually recognizes, on some level at least, that something is amiss.  Consider the woman in the preceding example.  She used terms like “fear” and “obsession” to describe her relationship with food and admitted that her attitude towards food was negatively affecting her friendships.  Because she was so forthcoming about her concerns, we were able to have an honest talk about the matter and discuss what she wants to do about it.

Unfortunately, not all “orthorexic” patients realize they might have a problem.  I find that these patients tend to have an expectation that I share their black-and-white views regarding nutrition, and when they discover that I do not they are stunned.

The way I look at it, humans often risk their health for the pursuit of pleasure.  Smoking is a blatant example, but plenty of more subtle examples exist.  Consider somebody who drives to the movies, thereby risking a debilitating or even fatal car accident for the sake of enjoying a film.  Consider those who love the bustle of urban life so much that they forgo the better air quality and lower crime rates of the countryside in order to live in the city.  Countless other examples abound.

Why, then, is it so hard to understand that the vast majority of us choose to sometimes eat less healthy foods for cultural, social, or financial reasons, or simply because we like the taste?  If I took the stance that these factors should have no bearing on food choices, then I would be out of touch with the vast majority of my patients and therefore an ineffective dietitian.

When the pursuit of healthy eating becomes so all-consuming that the pleasurable aspects of eating are shunned as second-class citizens, other areas of the patient’s life can suffer.  Whether orthorexia is ever adopted as an official diagnosis or not does not change the fact that this phenomenon exists.

The good news is that help exists too.  If you are reading this blog and saying to yourself, “I can relate to this,” consider speaking with your doctor about it and asking to see a dietitian who can help you to find a better balance in your relationship with food.

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