Can We Become Addicted to Healthy Eating?

It's not rocket science to figure out why we're so unhealthy. Two of the leading culprits are physical activity and diet. We don't move enough and we eat too much fatty, sugary and salty food -- in other words, unhealthy food. Most of us could use a good dose of healthy eating. So a serious dedication to a healthy diet is a good thing. Right?

Imagine someone who begins following the Atkins diet, which restricts carbohydrates. He may eventually cut most carbs from his diet. While restricting carbs may be healthy for some people (and that's debatable), a diet with limited carbs is definitely not healthy. Then he takes it a step further and only eats organic and natural foods. He begins obsessing over ingredient labels -- rejecting processed foods, preserved products and animal products. His diet is then limited to only a few "safe" foods, such as fresh organic fruits and vegetables. Soon he finds it impossible to shop at the local grocery store, eat at restaurants or even eat at friends' houses. Has this person taken healthy eating to an extreme by trying to avoid foods perceived to be unhealthy?

First described more than 15 years ago by Steven Bratman, this type of obsession with healthy eating has been called orthorexia nervosa. You might think an addiction to healthy food is a good fixation. But as with anything, too much of anything, whether healthy or unhealthy, is typically not good for us.

At present, orthorexia is not a medical disorder, and no consensus exists on its definition and criteria -- but it's gaining increased medical, research and media attention. The recent interest in this healthy food addiction has been fueled by the profusion of foods marketed as healthy and organic, increased research on the topic (most of which has been published in the last five years), the media's often conflicting dietary advice, and health care professionals' increasing awareness of this potential issue. In short, orthorexia is a new and controversial concept, and no consensus exists regarding its definition, criteria, symptoms and treatment.

Nonetheless, emerging research is revealing that for some people, healthy eating turns into an obsession. Orthorexics are believed to obsessively avoid foods which may contain artificial colors, flavors, pesticides, genetically modified ingredients, unhealthy fats, too much salt or too much sugar. The way of preparation, kitchenware and other tools used are also part of the obsessive ritual. They obsess about how food was processed and prepared. They devote a great deal of time to planning their meals and purchasing and preparing their food. Yet, they don't enjoy their food and rarely stray from their diet for any reason.

Most of the research on orthorexia, however, is limited in scope and focuses on how to measure it and who may be at risk. Although few reliable studies exist, preliminary research reveals that the general population shows about a 1 to 7 percent prevalence of orthorexia, with health care professionals, athletes and artists potentially at greater risk. Preliminary research also suggests individuals with orthorexia may have obsessive-compulsive tendencies, be malnourished, have mood disturbances and be socially isolated.

Until further research is undertaken and a consensus of its definition and criteria has been achieved, orthorexia will remain an intriguing concept. The following "yes" or "no" questions (modified from the Bratman Test) may help determine if you or someone you know is taking healthy eating to an extreme:

1. Do you spend a lot of time each day thinking about your diet?

2. Do you plan your meals several days ahead?

3. Is the nutritional value of your meal more important than the pleasure of eating it?

4. Has the quality of your life decreased as the quality of your diet has increased?

5. Does your self-esteem get a boost from eating healthfully?

6. Have you given up foods you used to enjoy in order to eat healthy foods?

7. Does your diet make it difficult for you to eat out, distancing you from family and friends?

8. Do you feel guilty when you stray from your healthy diet?

9. Do you feel at peace with yourself and in total control when you eat healthfully?

10. Do you eat only healthy foods?

If you answer "yes" to five of the above questions, it may be time to relax more about healthy eating. If you answered "yes" to most, if not all, of the questions, you may have turned healthy eating into an unhealthy obsession.

There's nothing wrong with wanting to eat nutritiously or to eliminate certain unhealthy foods. But healthy eating may become harmful when people's thinking or behavior becomes so rigid they jeopardize their physical and mental health and relationships with other people.

Ultimately, orthorexia is an issue that merits further research and discussion. However, in the meantime, we shouldn't be too quick to label people as suffering from orthorexia until a consensus is reached in the health and scientific community on its existence and potential criteria. The bottom line is that making healthy food choices should be simple -- not anxiety-producing. If someone is experiencing anxiety or obsessing over healthy eating, that is something he or she should address with a health care professional.

Heather A. Hausenblas, PhD, is a faculty member in the College of Health Sciences at Jacksonville University. She is an internationally renowned physical activity and healthy aging expert, an award-winning researcher, and an author. She is a regular contributor to both local and national media outlets. Her research focuses on the psychological effects of health behaviors, in particular physical activity, across the lifespan. Dr. Hausenblas is the co-author of five scientific books, and she has published more than 90 scientific journal articles. She is a mom to three young boys, and she enjoys exercising outdoors, spending time with family and friends, and coaching and watching her sons play sports. She resides in Jacksonville, Florida with her husband and boys.