Extreme Eating

Alright everybody, eat your vegetables. Now eat ONLY vegetables. Now, eat ONLY vegetables that have just been picked -- and then make sure you chew each mouthful at least 50 times.

Steven Bratman started out on a sensible diet. He ended up suffering from a new disorder -- "orthorexia nervosa", or an unhealthy obsession with healthy eating.

Bratman, a doctor who specializes in alternative medicine, has single-handedly added a new page to the annals of America's obsession with food and diet.

A 25-year veteran of the communal kitchens and vegetarian co-ops of America's natural food movement, Bratman is now campaigning against what he calls excessive dedication to increasingly strict diets that can leave the body starved for basic nutrition.

"I am not really presenting this as a medical issue, but I want people to reconsider what they are doing," Bratman said in an interview.

"Most of America would do better by improving their diet, there's no doubt. However, in the realm of health food, there are lots of people who would do better by going the other way, by loosening up."

Bratman -- a graduate of the University of California, Davis medical school who coined the term "orthorexia nervosa" in a 1996 article -- knows whereof he speaks.

As a cook and organic farmer at a large commune in New York state in the 1970s, Bratman was a self-described "extreme eater" who found himself in a hotbed of new age food theories contested by people in opposing dietary camps.

Meat was bad, that much was agreed. But beyond that lay a complex set of often contradictory pronouncements on what constituted "good food".

Chopped vegetables? Forget it -- destroys their natural energy fields. Honey? Poison, pure and simple. Garlic and onions? Best avoided -- unhealthy effect on the sex drive.

Amid a cacophony of competing menus, Bratman quickly forged his own dietary regime, eating only vegetables just plucked from the ground and chewing each mouthful 50 times.

"After a year or so of this self-imposed regime, I felt light, clear headed, energetic, strong and self-righteous," Bratman wrote in an account of his experience.

"I regarded the wretched, debauched souls around me downing their chocolate chip cookies and fries as mere animals reduced to satisfying gustatory lusts."

Bratman says that, like many orthorexics, he became increasingly inflexible about his dietary restrictions, urging others to follow his lead and punishing himself when he strayed to the cupboard of forbidden foods.

"It is almost impossible to become orthorexic without believing in one dietary theory or another," he said. "They are pseudo-religious."

Bratman says he ended up on the road to a full-fledged eating disorder, similar to the anorexia and bulimia which can drive sufferers to starve themselves in an impossible quest to achieve a slim physique.

He eventually dubbed it "orthorexia" -- after the Greek for "correct appetite" -- and in 2000 wrote a boo entitled "Health Food Junkies: Overcoming the Obsession with Healthful Eating" published by Broadway Books in New York.

While orthorexia has not been officially recognized in treatment books on mental illness, the term has sparked Internet discussion threads and support groups, and been hailed by no less an authority than the Journal of the American Medical Association.

"I suspect that orthorexia is a far more common eating disorder than anorexia nervosa and bulimia," Dr. Adriane Fugh-Berman wrote in a JAMA review of Bratman's book, adding that he "makes an excellent case for the term orthorexia nervosa to enter the medical lexicon."

Holly Hoff, a program director at the National Eating Disorders Association, said that while orthorexia had not yet officially joined the ranks of established eating disorders, it was increasingly an area of concern.

"The key issue in any eating disorder is when a person's attitude toward food, weight or exercise is significant enough to change how they live their lives," Hoff said. "If they are thinking about it for the majority of the day, then that is something to be concerned about."

Bratman's warning on the dangers of overzealous dieting comes amid a profusion of popular theories on the risks and benefits of various eating programs.

Old standards like macrobiotic diets, which typically encourage locally grown, seasonal organic foods, now vie with a raft of diets that range from simple to simply dangerous.

Fruitarians, for instance, insist on eating only raw fruit and seeds, which they deem "the highest moral level of nutrition," while "paleodiet" enthusiasts believe that modern humans should eat nothing but fruit, fish, nuts and lots of lean meat just as their hunter-gatherer ancestors did.

One health diet is so strict it bans food entirely. The Breatharians say humans can exist purely on light -- a claim that has been extensively debunked.

Bratman says most of these diets, if pursued rigorously, can lead to orthorexia -- which, like many eating problems, can be much more about psychological control than it is about any specific food.

But while obsessive compulsion plays a role in many orthorexia cases, it is not the only warning sign. Simple food allergies can lead some people to orthorexia as they cut out food group after food group in an effort to stay healthy, while self-esteem and "dietary identity" can also play a role.

"Some people need to belong," Bratman said. "They can say: 'I know I am a raw food vegetarian, so I know who I am."'

Despite the growing popularity of the concept, there are currently few treatment options for orthorexics. Bratman says he got over his natural food obsession with the help of a
Benedictine monk who helped him to see the joys of Chinese food and ice cream.

Also, "being able to laugh at yourself helps a lot," Bratman said.

But he added that one of the chief warning signs of orthorexia -- caring more about the "virtue" of a food thn the pleasure you get from eating it -- should not be ignored.

"Eating for pleasure is part of human life," Bratman said. "Any move to give that up should be seen as a very dramatic and radical change."

By Andrew Quinn
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