Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
2 Jan

Orthorexia Nervosa and Dietary Obsession

carrotI talk a lot around here about honing self-discipline, avoiding temptation, and the like. Yet, I also (let the record show) merrily encourage the importance of “sensible vices,” those splendid morsels (culinary or otherwise) of personal indulgence. We at MDA approach the pursuit of health as, undoubtedly, a worthy and wise endeavor. The pursuit of perfection, however? Well, that’s just no fun, is it?

For an increasing number of well-intentioned, health conscious individuals, some researchers say, the pursuit of healthful eating is taking an ominous turn toward clinical obsession, an as-yet unofficial eating disorder condition labeled Orthorexia nervosa. I thought it was time to explore the subject and ask you to weigh in with your thoughts.

Dr. Stephen Bratman, a holistic physician and practitioner of dietary medicine, initially proposed the condition in 1997, and simultaneously coined the Orthorexia label, from the Greek words “orthos” for correct and “orexis” for appetite.

Unlike those with anorexia or bulimia, orthorexics obsess over the quality, not quantity of their food intake. The condition develops with a continuing and increasingly more rigid pursuit of dietary purity. Some begin with food restriction based on genuine medical recommendations (e.g. allergies). Others begin with common health and ethical priorities, such as organic food, vegetarian or vegan diet, and/or raw or macrobiotic preparation. (Orthorexia is not applied to dietary restriction for religious purposes or to short term dietary focus for long term changes, whether they be for medical treatment or personal choice.)

For most of us, “sensible vice” (and not-so-sensible vice) indulgence might result in a pang of conscience. For those with orthorexia, however, a “slip” induces genuine psychological distress and, according to Bratman, a series of penitent measures, including days of fasting for a “transgression” as small as a chocolate chip.

Though orthorexics may start out with “normal” dietary goals, they gradually escalate their pursuit and narrow the criteria for “acceptable” food so severely that their social, mental, and (finally) physical health suffer. Although orthorexics enjoy proselytizing about their dietary views, it is common for sufferers to increasingly isolate themselves because of their fear and disgust of impure foods they will encounter. As their obsession grows, orthorexics spend more time planning their dietary regime and less time enjoying the things and people they used to spend time with. Their radical restriction can eventually cause various forms of malnutrition. In extreme cases, orthorexia, Dr. Bratman reports, results in anorexia and even death.

Bratman created a questionnaire based on the criteria he’d established for the disorder. (The test is intended as one tool to help assess risk for the condition, but it does not, by itself, determine diagnosis.)

The Bratman Test for Orthorexia

- Do you spend more than 3 hours a day thinking about your diet?

- Do you plan your meals several days ahead?

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

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

- Have you become stricter with yourself lately?

- Does your self-esteem get a boost from eating healthily?

- Have you given up foods you used to enjoy in order to eat the ‘right’ foods

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

- Do you feel guilty when you stray from your diet?

- Do you feel at peace with yourself and in total control when you eat healthily?

“Yes” to 4 or 5 of the above questions means it is time to relax more about food.

“Yes” to all of them means a full-blown obsession with eating healthy food.

Researchers continue to study the condition and debate about the necessity of a formal diagnosis. Though psychologists and physicians agree that sufferers’ obsession is, ultimately, connected to personal mental health, some researchers are also pointing to the power of recent cultural changes surrounding food in the U.S. and Europe. They say that conflicting nutritional information, food recalls and the conclusive labeling of foods as “good” or “bad” have problematized our relationship with food. It seems, once again, that we have created more choices and pitfalls for ourselves than ever.

Researchers stress that the line between health consciousness and targeted obsession differs from one individual to the next. They encourage people to make diet related choices that are in keeping with both recommended health guidelines and personal enjoyment of life and social relationships.

So, now we turn it over to you:

When do earnestness, discipline and conscience (normally our best attributes), lead us down a slippery slope? Though you may not see your own experience in this picture, what does this research say to you about the culture of food and diet in our society? Lastly, what do you think of Dr. Bratman’s test for orthorexia? Shoot me a comment.

malias Flickr Photo (CC)

Further Reading:

A Case Against Cardio

If You’re Gonna Cheat, Do It Right

Ridiculous Health Claims

Sponsor note:
This post was brought to you by the Damage Control Master Formula, independently proven as the most comprehensive high-potency antioxidant multivitamin available anywhere. With the highest antioxidant per dollar value and a complete anti-aging, stress, and cognition profile, the Master Formula is truly the only multivitamin supplement you will ever need. Toss out the drawers full of dozens of different supplements with questionable potency and efficacy and experience the proven Damage Control difference!

Subscribe to Mark’s Daily Apple feeds

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Orthorexia sounds like a very undesirable mental health issue. To be so consumed with every little detail about what we put into our bodies to distraction, is indeed a terrible every day hindrance.

    J Lehman wrote on January 2nd, 2008
  2. If you ask me, some of the questions are silly. Perhaps the need more refinement For instance:

    – Does your self-esteem get a boost from eating healthily?
    Yes, I feel better about myself and my body when I’m eating healthy foods, rather then junk food. So what?

    – Have you given up foods you used to enjoy in order to eat the ‘right’ foods
    Yes… Sadly I gave up cake and cookies I used to enjoy every day as a kid (I have my occasional vice, mind you). Is giving up junk food a clinical disease now?

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

    Doesn’t everyone who tries to eat healthy in America feel even a little bit of difficulty when your family goes to the local Italian restaurant or your friends go to Bert’s Burger Shack and Pub.

    Taking care of our bodies in a society where excess and neglect does indeed take some sacrifice. Though I don’t think I fit the bill for this disorder, I’m sure some of my peers think I’m a bit whacko for my healthy lifestyle. This poses the question: Am I crazy because I’m not like (most) everyone else?

    Moe wrote on January 2nd, 2008
  3. Good point Moe. Though, I certainly know a few people who might be Orthorexia nervosics.

    When I was a kid, my best friend’s mom was a health food pedant. Of course, he rebelled and became a junk food junkie because of it.

    I’m not sure a health food obsession needs to be classified as an official disorder. It’s just a clear example of the problems with taking things to an extreme. The same goes for over-exercising (roiding), hardcore fundamental religious fanatacism, and guys who bass fish way too much.

    Roland P. wrote on January 2nd, 2008
  4. I was wondering about the same things as Moe. I very much enjoy baguette bread with Nutella, or chocolate cake and coffee-flavoured ice-cream, but ‘giving up’ on that was kind of a prerequisite to put my health and weight back on the right track. And like everyone who has to face weight problems (if I ‘eat like everyone else around me’, a.k.a junk food and/or in too high quantities, I just put on weight, period), I unfortunately have to exert constant vigilance, plan my meals, etc. (Planning days in advance is another matter: I do it, but because I need to know what to write down on my shopping list, else I just end up buying too much or getting tempted by crap. ;) Also, my diet indeed makes it difficult at times to eat out with friends/family, when the only alternatives I’m given are “shall we go to McDonald’s or do you prefer Burger King?”. So I too had to answer yes to several of these questions.

    On the other hand, my healthy choices are also foods that I enjoy. The other way would just be running for Martyrdom of Year 2008. I guess *this* might have a place in the list?

    Kery wrote on January 2nd, 2008
    • I was an anorexic, and I have fallen into the “perfection” zone when it comes to eating. So this is a good reminder to me to be easy on myself. However having said that, I have a child with Autism and another one who is affected somewhat but doesn’t fit the diagnosis. I have to do GAPS diet in order to heal our leaky gut. In that sense, I DO have to be perfectionistic to a degree, otherwise my children won’t be healthy. I HAVE to change their food so that someday, they CAN eat the things they want to. So it’s a slippery slope, it really is. I did obsess, and my life was miserable. Meanwhile I am trying to learn how to cook and cook well for my kids and hopefully they will learn to enjoy real food.

      Julie wrote on January 7th, 2012
  5. Great points Moe and I totally agree with you statements on the questions.

    Reminds me of the “tests” to see if you have a drinking problem. I drink only a few times a year most years, but on two occasions had 4 or 5 beers when I did. Acccording to the tests I’m a binge alcoholic because I consume more than 3 drinks in one night.

    Kevin Burnett wrote on January 2nd, 2008
    • Good Lord! Who comes up with these tests?
      one has to wonder!

      Carla wrote on July 6th, 2010
      • Well it would take one to come up with all those silly questions…right?

        Primal Palate wrote on May 22nd, 2011
  6. I think anyone who reads this site on a regular basis and follows at least some of the guidelines, challenges, opinions, and directives given in most of the posts would have to score at least a YES on 4 to 5 of these questions. I have noticed since I have read this blog on a daily basis that my thoughts have been much more focused on the negatives of what I should not eat at a restaurant,at a dinner party, and fix for myself. I have been made aware of all sorts of dietary pitfalls, pratfalls and taboos as well as many things I should or could be doing to make my body more healthy and ageless. I guess we should just embrace one balance but then I already thought I had that until this article.

    tim wrote on January 2nd, 2008
    • I was thinking just that Tim. I seriously could answer yes to many of these questions.

      Guess what? I have never felt so healthy in my life! My skin fo example, thanks me for it on a daily basis!

      Carla wrote on July 6th, 2010
  7. This is deeply interesting to me as when I was diagnosed with an eating disorder, I “officially” got ED-NOS (not otherwise specified) but my counselor told me I was a textbook “Orthorexic.” I think the difference between me (then) and what you all are saying (“I eat healthy so do I fit the questionarre”) is that, given an “unhealthy” food I would choose to starve rather than eat it. (I mean literally starve – not just skip a meal) And I was so rigorous in my specification as to what “healthy” meant that it basically limited me to eating only what I myself bought and prepared in an environment that I completely controlled. I refused to eat so much as a single taste at friends’ homes. I was so rigid that I lost an extreme amount of weight, lost my period and compromised my health. Never was my goal to be “skinny” like, say, a traditional Anorexic but only to be “healthy” However, the net result was the same. And traditional outpatient eating disorder therapy helped me overcome it. New Year’s eve I actually ate an entire meal that I didn’t cook (in front of people!) – that’s something I would never have done a year ago.

    I am glad that (so far) none of you can really relate to Dr. Bradford’s description. It means you haven’t taken your healthiness to an extreme. But I do, firmly, believe that Orthorexia is a valid disorder and ought to be made official in the DSM. It’s a fine line but, like anything, it’s all about the extremes.

    charlotte wrote on January 2nd, 2008
  8. Don’t forget that in psychology, something is really only considered a disorder if it’s screwing up your life in some way. Being inconvenienced and finding it challenging to eat healthfully in modern society is a bit different than entirely withdrawing socially for fear of encountering “bad” food, or imposing penance on yourself like a medieval monk for the slightest food transgression.

    Mentally healthy people know that having a plate of potato skins on a rare night out at the bar is not an occasion for purging and fasting, though it’s no cause for self-congratulation either.

    Questionnaires like this are used as one step of evaluating a patient that has come to a psychologist because they have a problem and their life is not working in some way. Identifying the specific nature and roots of the problem is step two. Evaluating the patient individually is also part of it.

    It’s kind of like BMI- it makes a decent tool for evaluating broad population trends when you can’t do detailed testing for bodyfat percentage or waist circumference, but a completely lousy one to base an individual evaluation on alone.

    LabRat wrote on January 2nd, 2008
  9. So the big question is, how many people have this? Because it does sound like a real disorder, but it also sounds like a disorder that could be misdiagnosed ad-nauseum if it gains any popularity. I feel I’m right in claiming a gross number of children are diagnosed with ADHD who are simply active children. The same could easily happen to people who are simply “very health concious.” In other words, you refuse to eat non organic veggies at your friend’s and consequently your friends hold an intervention to make you deal with your Orthorexia.

    Bert Q. wrote on January 2nd, 2008
    • That is biggest concern, is that when we start telling our youth (or even start hinting) that eating healthy in this day and age of junk food is bad for you, we begin to walk a very fine line, as you ponted out with adhd/add and overmedicated our future generations during their developmental years with drugs unstudied for that purpose or not studied long enough, anything out of balance is unhealthy but to me nothing about taking care of the vessel I was given to travel through my life with, we may have lengthened our life span since cave an days but we don’t know why,yet we have more disease rampant on this planet than ever recorded, now is the time for us to take back control of the food industry so it isn’t so difficult to find healthy food without preparing everything at home unless you live in a big enough city that has health food restaurants, I do spend way more time on diet than I would care too, but that is because it isn’t easy to get where I am, I have to drive a ways to get to nearest health food store, just worried they will begin to use this as a new reason to dope our children and keep them eating junk food.

      ann wrote on July 1st, 2010
  10. Anyone trying to improve their health can answer yes to most of those questions. The questions aren’t “extreme” enough to really get a good idea of what’s going on with the person.

    Crystal wrote on January 2nd, 2008
  11. Its hard to say if this is a real disorder, its a good avenue for a self-fulling prophecy. It sounds like another thing to be worried about. Its like “I am a health food nut! i must be abnormal! gahh i am orothrexic!”. and you know so what if you are, the real question is, are you hurting yourself. So what if your pre-occupied with health food. i though i must be disordered, but i need to look at my life, i am in culinary school, of course i am supposed to think about food! and heck we all need to eat, its not exactly like alcoholics because one can abstain from drinking, but we will always need to eat. with anorexia and bulemia, your really risking your life, but if you just focus a lot about eating healthy, i dont see how that is too much cause for concern. I just also must question what are the “treatment” options. for most eating disorders they suggest anti-depressants and inpatient treatment, but would that work for so-called “orthrexics”?

    Hungry Waif wrote on January 2nd, 2008
  12. I knew someone like this, for whom eating healthy wasn’t just important, but a debilitating obsession. People stopped wanting to associate with this person because she couldn’t just settle down and enjoy life–or let other people enjoy theirs–without counting every scrap of carbohydrates, fat, protein. I think it progressed to some kind of athletic anorexia, though, because in the end she was only counting calories and exercising obsessively, and her hair was falling out.

    Kaitlin wrote on January 3rd, 2008
  13. A few thoughts from me – a licensed clinical psychologist:

    1) Tests need to be normed and empirically validated before being useful. Until validation occurs, they are just a collection of questions that you might otherwise see while reading “Cosmo” in the grocery line (not that I do that :).

    2) I would be surprised if this “condition” makes it into the DSM anytime soon. There is usually a long list of new “disorders” to be considered for the newest DSM edition and most of them do not make the cut – thank goodness.

    3) I really do not care about labels anyway. If a behavior pattern or thought pattern is sigficantly impairing life’s activities then it is worthy of being addressed IMHO.

    4) I am sure that Pfizer or Eli Lilly will find a way to treat to Orthorexia.

    primalman08 wrote on January 3rd, 2008
    • so true, the scariest truth being #4, I have heard that some peolpe treating this “disorder” are using heavy psychotropics such as can be found in some treatment of ocd, i do not get it, i am not about to poison my body with those things to make me well, please, even our kids know better, having had to deal with adhd/add phenom and all it’s new drugs, who will they come after next to dope

      ann wrote on July 1st, 2010
  14. This is a VERY interesting article and while I agree that the “tests” are rather vague, I think it’s something to be aware of. As I was reading the article, I was astounded at how closely this matched the escalation of my strict eating habits over the past year. Recently, I have realized how much it has effected my daily life and social interactions and it’s not something I want to continue. Charlotte’s comments are spot on- these are the exact struggles I go through everyday in trying to plan out my meals, especially when I’m off my routine. The first step is recognizing the issue and I think increased awareness will help people realize that they are damaging not only their physical but mental health.

    9er8er wrote on January 8th, 2008
  15. There are some misconceptions about what specific behaviors are characteristic of someone having an eating disorder. I want to suggest an anonymous tool from the Center for Eating Disorders for any readers who may have questions about eating disorders. http://www.eatingdisorder.org/about_eating_disorders/resources/quiz.php. As the most common eating disorders are Anorexia Nervosa and Bulimia, this is a good place to get more information on other eating disorders and the right treatment for them.

    CEDquiz wrote on January 23rd, 2008
  16. thanks for sharing this very informative news

    olivia wrote on July 6th, 2008
  17. I posted a blog on this subject – feel free to read!

    http://lifeconundrums.blogspot.com/2008/09/orthorexia-latest-trend-in-disease.html

    The Transient wrote on September 21st, 2008
  18. My sister-n-law is so obsessed with all this we no longer have a relationship with her and my brother and neices because they have to prepare all their meals. They stay away from us because of it.

    galepowell wrote on January 29th, 2009
  19. Wow. What a very interesting blog. Thank you very much for this. I hate to admit this, but this really hits home because – I DID answer yes to almost every one of those questions. :(
    I’ve always considered myself to have an eating disorder (although, obviously never diagnosed) – but mainly more an obsession over food. I feel that I’ve finally found the way I want to live (low-carb) but, admittedly, all I do is read about low-carb living, research recipes and research “healthy living”.

    Sometimes I really do hate it – because I can’t enjoy any kind of food that I don’t consider “healthy” for me. I know it also really annoys my family, my husband, my friends – when all I want to talk about is my diet.
    But – I have OCD too and so that, of course, really makes me obsess even more.

    Anyways. Thank you very much for this blog. :)

    Keri-Ann wrote on June 25th, 2009
  20. I can appreciate what everyone has said. I think if you are to the point of a disorder I think you would know it. Right after I had my daughter I felt compelled to start excercising and eating healthy. My goal was to set a good example for my children because of the epidemic of obesity in children these days. Anyway, I got into the best shape of my lift via excercise and eating right. I educated myself on nutrition and do think I am the better for it. I was very proud of myself and when I reached my goal I stopped trying to lose and worked on maintaining (didn’t want to be anorexic). This was when I really started to notice an obsession. Counting calories has become my life. It affects everything. If I go to a restaurant that doesn’t provide nutrition information I panic. I use to be ok with indulging every once in a while until over a weekend I put on five pounds and then calculated all I would have to do to get it back off. Indulgence then became a big no no. When I am served at people’s homes or restaurants and nothing is within in my guidelines it takes everything in me to not have a breakdown. This is not normal! I hope this disorder becomes recognized by the medical field. My goal to set a good example has completely backfired. My six year olds and 3 year old have all asked my how many calories are in their food. If I don’t change I hate to think of what will happen when puberty hits. Please pass this information on as America so frequently lets the pendulum go to far and this needs to be addressed as much as eating healthy. The key is balance.

    Carrie wrote on June 2nd, 2010
  21. A very big THANKS to Mark for sending me this entry. I had originally read to current articles on the subject and thought that I, and many fellow MDA-ers, were being chastised for intelligent decision making as it pertains to food. A read of this entry and a re-read of the Guardian News (UK) article makes a real case for this condition.

    My hope, however, is that this (like many mental/emotional ailments) could be remedied through therapy and not through medication.

    I do have to add that this might be 1 of a very small number of entries from the archives that I missed… back to reading!

    http://www.NaturalNews.com/029098_orthorexia_mental_disorder.html

    http://www.guardian.co.uk/society/2009/aug/16/orthorexia-mental-health-eating-disorder

    Keith wrote on June 30th, 2010
  22. While the particularly obsession being described might be more prevalent given the overload of dietary information nowadays, the disorder doesn’t actually require a new label, as it clearly falls under the established diagnosis of OCD (which, contrary to popular belief, can consist of many other obsessions along with or in place of germophobia).

    Ann wrote on July 5th, 2010
    • (That should be ‘particular’…)

      Ann wrote on July 5th, 2010
  23. I can understand why there is such debate on this topic.

    It really depends on how you look at it; it can definitely have a negative impact on one’s life when one takes ‘dieting’ to the extreme, using diet as a punishment, and eating foods that don’t nourish your body and result in physical and emotional damage.

    But if you look at it from the perspective of, say, someone eating primally, the exclusion of grains and sugars is in place to improve health and wellbeing, not to punish yourself.

    If you know that your body reacts negatively when you eat certain foods, is it not then understandable that you would avoid them?

    So, theoretically, if you enforce certain dietary guidlines in order to improve your health (mental and physical – a poor diet is closely linked to mental illness), then there is no harm in being ‘obsessed’ with food.

    But if diets are in place as a form of punishment, with no benefits, and harm resulting from a diet, then this perhaps is cause for concern.

    Great post, Mark.

    Jazz wrote on July 6th, 2010
  24. hahahahhahahahhahaha…….

    Anonymous wrote on November 27th, 2010
  25. I think the issue he is describing is probably real. However, his test questions suck. If you don’t grocery shop more than a few times a week and don’t keep a well stocked freezer, you have to plan your meals several days ahead. If you switch from a standard Western diet to any other diet, you have to answer 5, 6, 7 and 10 in the affirmative. That’s 5 for anyone who is proud of making an effort to improve their health. Bratman’s test is built in stigmitazation for any attempt to deviate from uncontrolled eating.

    Compare this to the DSM guidelines for any Personality Disorder. There are very few of the diagnostic requirements that aren’t obviously problematic in and of themselves – and it’s virtually impossible to combine multiple diagnostic features and still be able to characterize that individual as healthy.

    With Bartmann’s test, anything but random consumption of foods is potentially unhealthy. How backward is that?

    Jim wrote on January 18th, 2012
  26. As a recovering EDNOS sufferer now so frustrated that I’ve begun to binge and become a junk food junkie, I think that this is an understated and quite common phenomenon.
    I definitely agree that there are points to advocate in living Primal. At the end of my restrictive/orthorexic phase which caused me to lose 2 stone in a couple of months, through the “gaining” process I went fat-phobic and had to eat most of my calories from carbs, cue hell for my immune system as I deprived msyelf of EFAs and even protein sources.
    However, as much as I can see the benefits of living Primal, my attempt did create extreme tension in relationships with family and friends. I never used to be a “fussy eater” as they put it but suddenly had to constantly consider the potential risks and negative health effects of every meal thrown my way-even relatively “healthy” meals such as a chicken or tuna pasta made me anxious, I started monitoring the GI of fruit, and cake was an absolute no-go zone EVER. Soon the same applied to bread, then dairy and so on.
    Of course, as with many obsessions it’s backfired and now I’m stuffing myself silly with muffins against my own will, except unlike most people I’m doing it with full awareness I’m gonna end up with diabetes if I keep taxing my body with these glucose surges.

    I think the difference lies mainly in your mental reaction-if you eat as clean as possible but have no problem with indulging in the odd slice of pizza or cake at a special occasion, if you can do these things free of guilt and anxiety, you’re probably free of orthorexic territory. If however you’re a bit like I am right now crappijg one over visiting my nan’s on the possibility she might ant mwe to have a slice of cake, feeling quite genuine fear and shame if I do and losing a night’s sleep as I have, you may want to see a doctor.
    Somebody mentioned above that they preferred to starve than eat something “unhealthy”? If we’re talking actual fasting rather than mild hunger, I’d definitely consider this disordered.
    Despite this, I’d also agree that it’s a bit silly to label ANY attempt at adjusting your diet as an eating disorder in itself. EDs are self-destructive coping mechanisms, personally I’d view trying to look after yourself through generally eating well and plenty of exercise without overstraining your body as some of the best things to cope you could do?
    I’d say questions 5-6 are redundant and foolish, hopefully Yeses, whereas 9 is a problem and 8 would have alarm bells ringing. If you can’t go out with for a family celebration or to socialise because it’d mean deviating from living Primal, there’s something wrong.

    Personally I’ve found that in my own life to live completely Primal is as abd as me going on a diet, especially given I’m in recovery from food-related anxiety and an ED. Realistically I cannot entirely cut out carbs as we don’t earn enough to get all of our requirements from lean protein and fat sources. However I have and always will be a healthy eater for the average teen, loving my fruit and veggies, my meat, poultry and fish and generally stayign away from the trans-fats or processed sugars except on occasion.

    Carrie’s hit the nail on the head. The key is balance, and I think you can’t go far wrong using the 80/20 or 90/10 rule. The problem is that when it comes to sensible choices, many in the Western population have that ratio the other way round!

    Wario wrote on February 2nd, 2012
  27. Another quick q, guys:
    I think from being a generally healthy teen I’m pretty damn insulin-sensitive. So much so that if I ate some sweets, I’d lose sleep over it, it’d take HOURS for my body to settle down. Yet my Dad or mates could do the same thing and then head right off to bed or get on with their day, no trouble.
    I’d put this down to them being more insulin-resistant but feel this could refeed my ED and give me a reason to look down upon the mere junk-laden mortals.
    I’ve had teratment for anxiety over this and whenever I do say I’ve lsot a night’s sleep over it my family put it down to me getting guilty over nothing, worrying too much, being hard on msyelf etc. Yet this is also a physiological response I can’t control. There are already a lot of nutrition-related discussions I’ve had that have alienated me from close lvoed ones. What’s really the best approach? Eat the damn cake just this once, let myself off and remember my uimmune system’s a powerhouse that can fight it off easier than most people-or forever avoid it because the one slice will give me diabetes, and risk offending my grandmother’s best efforts to please?

    Wario wrote on February 2nd, 2012
  28. Charlotte, just re-read your post. Wanna take back the criticism and say congrats on beating your ED! The fight continues for me.

    Wario wrote on February 2nd, 2012
  29. Answered a double yes to every test question..
    This really really sucks. I’ve been like this for 2 months now. I’m only 15 I hope it’s just a teen thing and it’ll pass..

    Paul wrote on March 13th, 2012
  30. Hello, I wanted to offer some insight as a former Anorexic, Bulimic, Anorexia Athletica. I am now a healthy Personal Trainer/Nutritionist who is becoming happier and healthier each year as I gain life experience and by reading, researching, trial and error. Thanks to Mark and others who were obsessed enough with their own nutrition to help spur the concept of Primal eating being our most natural way of eating. I have realized that each day is a new struggle, however I do find pleasure in eating! I feel the most important advice is:
    1. Read, learn, follow healthy sound science/mentors like Mark and stay motivated to be healthy not perfect.
    2. Do plan, practice, and calculate your fitness, nutrition needs until you feel it what our body needs. Don’t obsess over everything but organize the main things, and trust your body to guide you the rest.
    3. Don’t skip your recovery yoga, meditation, restorative days.
    4. If you truly need an ice cream have it enjoy and move on to the next healthy meal. One ice cream will not effect your health our body is designed to out last a lot of non ideal situations. However, all out bad eating for a weekend will cause inflammation, obsession and derail your quality of life.
    5. Take each day 1 at a time. Tell yourself today I will honor and respect my body. I’ll do my best to fuel my body with quality foods. I’ll use my muscles to get my todo list done. I’ll share my compassion with some one I care for today. I will make this day the best one I can.
    6. You have the choice to be obsessed. I can say it’s not worth losing 10 years of your life. That’s how long I struggled. So please take my tips to heart. There is nothing wrong with dropping bad habits for healthier habits, but just know your tip toeing an eating disorder. So stay focused on the deeper reasons why you love Primal eating (energy, glowing skin, supporting local farmers, cooking fresh for family, or feeling confidant as a role model).

    Lindsay wrote on April 17th, 2012
    • “Take each day 1 at a time. Tell yourself today I will honor and respect my body. I’ll do my best to fuel my body with quality foods. I’ll use my muscles to get my to do list done. I’ll share my compassion with some one I care for today. I will make this day the best one I can.”

      That’s really wonderful. I am going to make it one of my mantras.

      KariVery wrote on August 21st, 2013
  31. So many exclamations about the quality of the questions.

    But I find it a little hard to respond when I can say yes to all the questions. Before Paleo it was with Caloric restrictions, simply calculating constantly so I could be under my goal every day, obsessing over it constnatly…WHen I found Paleo / Primal, it made a lot of sense. I felt relieved, that this would be my out. But as I’ve followed it I’ve put on weight, and I’ve felt myself panicking and going back to the old ways in a sense, only this time calculating and muling over my Primal foods, finding myself occasionally laxing and eating something that’s primal but ‘too caloric’, and forcing myself to suffer the consequences.
    It’s suffocating, and I know I shouldn’t, but I keep doing it because I realize that I’m scared of gaining more weight, which I do so easily – Of being unhealthy in the eyes of others. I’ve gotten quite good at hiding any of this from my loved ones – At most they think I’m a health freak. I understand that I have an unhealthy obsession with food, and for others it is so easy to say ‘Just stop it.’ or ‘just eat like this’.
    But to me it isn’t that simple.
    It would be nice for life to be about more than what I eat next or what I shouldn’t eat next or perhaps if I should skip

    But every time I switch on a computer, read a magazine, or look at others, I seem to have the message strapped to my face that yes, I should care.

    And that I can’t quit doing so.

    It’s a big work in progress.
    But there you go. There’s another perspective.

    Marni wrote on June 29th, 2013
  32. I didn’t take the little test too seriously, but obsessing over food and/or exercise is a concern I have. I do that with a lot of things. But I’m an older dog now, and I’ve had to learn to solve a couple of OCD-type problems in my life — used to smoke, used to like to be intoxicated every day — and this is just another one. Maybe some people don’t lock on to things like that, but I do, and a lot of other people do, so I just put it down to the human condition.

    Right this minute I’m about 3 pounds from completing a life-changing event — going from overweight and out of shape to trim and active — and so I think it’s normal to be focused on “rightness.” I hope and expect for it to be taking up less of my attention six months or a year from now.

    But I have no expectation that eating can ever be completely spontaneous and thoughtless, and why should it be? I remember reading a NY Times article bemoaning the impossibility of keeping weight off, and the author wrung her hands over — my god! — weighing every day! walking for an hour! She expected a carefree life? Where’d she get that idea?

    Martha wrote on August 21st, 2013
  33. And while we’re on the subject, I think if you care about your diet at all, you are going to be diagnosed as mentally ill with that test. Why should I care more about pleasure than nutrition? Isn’t it a sign of adulthood to be concerned about the consequences of your actions?

    Martha wrote on August 21st, 2013
  34. http://impruvism.com/clean-eating/

    Would love to hear your opinion on this article Mark. It’s been floating around my facebook and instagram accounts all day.

    While I agree that moderation is a beautiful thing I think this guy way over simplifies eating/ sugar addiction as well as making some pretty bold claims about GMO’s, Naturopaths, Preservatives etc. He also has a list of references almost as big as his ego.

    Not going to lie I would love to see someone take him down with some solid evidence- based arguments to refute his claims.

    Carnivorous Sarah wrote on August 21st, 2013
  35. As one who had this label thrown at me soon after this whole issue began surfacing in various media outlets, I have to say my bit. Those questions are ridiculous at best, and most people who care about their health and well-being could easily answer ‘yes’ to most of them; so does that mean we possibly have a disorder? I think not.

    I have a rather long list of food allergies and sensitivities. While I don’t plan my meals way in advance, or sit around obsessing about food, I do make sure to carry something safe with me to eat if I’m going to be out for a period of time, and I have learned that it’s safer for me not to eat something that someone else has cooked – it’s not worth it when I have to pay for it with reactions that can last for days or even longer.

    I will go out to eat with close friends as they understand that I am there to enjoy the company, not necessarily to eat, and that I’ll be bringing something with me to nosh on. I have to be careful about spices and the like as well, so when people think I am being unnecessarily particular I have to bite my tongue sometimes, but I am only human and sometimes the mean, snide, ignorant remarks that folk can make can get on my nerves. Yes, a ‘little bit’ of something really can hurt me rather severely, thank you! And I would definitely go hungry for a while if there are no safe choices available at the time and I didn’t carry anything with me – which, thankfully, doesn’t occur often.

    People can be too quick to throw a label at something or someone without fully understanding the context / situation…

    Etana wrote on December 12th, 2013
    • I think this is a spectrum. IF it is affecting your life in a negative way, then yes it is probably some sort of eating disorder.

      If it makes you happy, it probably isn’t.

      However, this is also about context. To the average person who relishes in the ways of SAD, many of us can easily be seen to them as Orthorexia Nervosa.

      The problem is, if you want to follow the primal blueprint, an enormous amount of conventional wisdom, which comes from all angles from our external environment, needs to be overcome. And from the perspective of people who follow conventional wisdom, which is by convention… most people…. we would be seen as highly abnormal.

      I would answer yes to many of the questions, and quite frankly, I would be proud of it. But I also find this to be a large source of happiness in my life. I’m not one to poo poo psychological illness, it is very serious, but this disorder is such a slippery slope that people who are informed and take the extra steps to be healthy can be labelled as Orthorexia Nervosa.

      Agribusiness certainly will not complain that this disease exists.

      Slowneal wrote on October 31st, 2014

Leave a Reply

If you'd like to add an avatar to all of your comments click here!

© 2014 Mark's Daily Apple

Subscribe to the Newsletter and Get a Free Copy
of Mark Sisson's Fitness eBook and more!