Editor’s Note: In “Hey, Health Coach,” Sarah Hays Coomer answers reader questions about the intersection of health and overall well-being. Have a question? Send her a message (and don’t forget to use a sleuthy pseudonym!).
This article contains content related to disordered eating and diet behavior.
Hey, Health Coach,
My girlfriend is obsessed with clean eating. She basically lives on vegetables, raw nuts and free-range chicken. We can’t really go out to eat anymore, or, if we do, she just watches me eat. It’s depressing. Is this orthorexia? How do I talk to her about it?
— Concerned
Dear Concerned,
It sounds like you care a lot about your girlfriend and are struggling to figure out how to help her. The desire to eat “clean” is not uncommon, especially with so many conflicting messages in popular culture about what to eat and value judgments placed on people’s dietary habits.
Eating well can be a wonderful goal with significant health benefits, but can become unhealthy if a person restricts their diet too much, develops obsessive behavior or limits other areas of life. As you mentioned, difficulty eating out or unwillingness to try new restaurants is one area in which quality of life can be compromised.
I can’t diagnose your girlfriend, but I can offer information about orthorexia and how to approach the topic with a loved one, according to experts.
Orthorexia nervosa isn’t a clinical diagnosis officially listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). The National Eating Disorder Association defines it as “an obsession with proper or ‘healthful’ eating.” The term was coined by Steven Bratman, M.D., in 1997 to describe people following extreme diets who:
Limit their food based on quality rather than quantity
Experience malnutrition and/or impairment of daily functioning
More widely recognized eating disorders, such as anorexia or bulimia, tend to focus on how much food is consumed, while orthorexia is characterized by an obsession with the nature of food. People with orthorexia might fixate on the purity, origin or nutritional value of food to extremes that begin to degrade their physical or mental health.
As orthorexia doesn’t appear in the DSM, there’s some debate about whether it is, in fact, a clinical disorder and, if so, how to define or diagnose it. More research is needed, but experts have identified a number of consistent signs and symptoms of the disorder.
