JOSE, Calif.. ó During a recent trip to the Half Moon Bay,
Calif., farmers market, Johnny Righini didnít suffer a panic
attack or chastise his mother when she bought nonorganic
produce. For Righini, this moment of self-restraint marked
another small victory in his struggle to overcome a
pathological obsession with eating "pure" foods.
in his early 20s, Righini dedicated himself to vegan and raw
food diets, thinking they offered a healthy way to recover
from years of anorexia and bulimia. But he took those
restrictive diets to extremes, agonizing, for example, over
fruits and vegetables losing their "life force" each
minute after being picked.
says his "twisted thinking" was a symptom of
orthorexia, an eating disorder that is increasingly on the
radar of health professionals.
didnít obsess over calorie counts, as he did with anorexia.
He pored over ingredient labels ó then rejected food with
labels as being too "impure." He found it impossible
to eat out at restaurants or other peopleís homes or to be
around people eating fast food. He even tossed out food his
mother brought home from a supermarket.
as I restricted myself from food, I restricted myself from
people," he said. "If they were eating something my
orthorexic mind didnít approve of, I would get physical
shakes and panic attacks."
disorder experts say there is nothing wrong with wanting to
eat nutritiously or to eliminate certain foods. But healthy
eating becomes harmful when peopleís thinking or behavior
becomes so "extremely rigid" they jeopardize their
physical and mental health and relationships with other
people, said Jennifer Lombardi, executive director of the
Eating Recovery Center in Sacramento.
diet or dietary restriction that causes a person to be unable
to celebrate and socialize with food comfortably is going too
far," agreed Leah Hopkins, a clinical dietitian at the
Monarch Cove Eating Disorder Treatment Center in Pacific
not surprising that people fervently latch onto health food
trends, especially here in Northern California, where a foodie
culture equates wholesome eating with a happy life and
disparages ingredients that are not organic, natural or
of my colleagues call it the ĎWhole Foods syndrome,í"
says Katie Bell, medical director and a psychiatric nurse
practitioner at the Healthy Teen Project in Los Gatos, Calif.
She added that an initial choice to cut out sugar, processed
foods or other oft-labeled "bad" foods wins
orthorexics praise from others who admire their
self-discipline and slimming figures.
became a hot social media topic this spring when Jordan
Younger, the Blonde Vegan blogger, startled her 70,000
Instagram followers with news that she had the eating
disorder. She said she cut out options that even fell under
the vegan umbrella because they were "not 100 percent
clean or 100 percent raw," she told People magazine.
"I was following thousands of rules in my head that were
making me sick."
unlike the more well-studied disorders of anorexia and
bulimia, has not made its way into the Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition, the
universal authority for psychiatric diagnoses.
working definition comes from San Francisco physician Steven
Bratman. In a 1997 Yoga Journal essay and subsequent book,
"Health Food Junkies," he recounted his "health
food addiction," which he called orthorexia, using the
Greek work "ortho" meaning "straight, correct
who declined to be interviewed for this story because the
disorder is no longer part of his practice, wrote that his
orthorexia began in the 1970s when he was a
"dedicated" vegetarian living and cooking at an
organic food commune. Self-denial and "pure" choices
made him feel "clear-headed, strong and
self-righteous." Like Righini, he developed an aversion
to produce that hadnít just been picked and lectured friends
and family about the evils of refined, processed food and the
dangers of pesticides and artificial fertilizers. "My
ability to carry on normal conversations was hindered by
intrusive thoughts of food," he wrote. "The need to
obtain meals free of meat, fat, and artificial chemicals had
put nearly all social forms of eating beyond my reach. I was
lonely and obsessed."
say orthorexia becomes life-threatening when peopleís food
restrictions make it impossible for them to take in enough
calories and nutrients to maintain good health. Bell recently
treated a 14-year-old girl who ate only raw fruits and
vegetables. She dropped to 80 pounds and had to be
hospitalized for an irregular heartbeat.
describes his anguish as more mental, though his restricted
eating made it difficult for him to regain the weight he lost
through anorexia, which at one point took him down to 61
pounds on a 5-foot-7-inch frame.
effect of malnutrition is a "starved brain," which
further distorts thinking and self-awareness, Bell said. It
doesnít help matters that orthorexics grasp at any piece of
news from a new study or social media post, even from
acclaimed physicians and best-selling authors, telling them
whatís "good food, whatís bad food, whatís safe and
not safe," said Dr. Christine Pappas of the Eating
Recovery Centerís clinic in Corte Madera, Calif.
if there is truth to these scientific observations, an
orthorexic will selectively choose data that justify decisions
about what not to eat, she said.
influence notwithstanding, orthorexiaís underlying cause is
complicated and elusive, just as it for other eating
disorders. Bell cites research showing that 75 percent of
people with eating disorders have an underlying anxiety
disorder, and 75 percent of those show features of
obsessive-compulsive disorder, whose sufferers sometimes are
known for their concerns about hygiene and germs. Similarly,
orthorexics are "driven to malnourishment by a focus on
keeping toxins out of their bodies," Bell said.
disagree on whether orthorexics are likely to suffer from
other eating disorders. Pappas has seen patients, like Righini,
who had anorexia or bulimia, then transition to orthorexia,
which is also distinguished by a need to assume tight control
over food intake.
say orthorexia usually marks a patientís first time with an
eating disorder. "More often, they have a health issue,
and they decide they want to Ďeat healthy,í "
Lombardi said. "The challenge is that it spirals out of
can include inpatient care to correct life-threatening
conditions, a program of "re-feeding" and intensive
one-on-one and group therapy. Patients may also receive
prescriptions for antidepressants or anti-anxiety medications.
who had previously been hospitalized for anorexia, isnít
currently in any formal program, but attends support groups
for people with eating disorders. He still adheres to a vegan
and raw foods diet out of belief that itís the best way to
nourish his body.
aware that some people think heís still being too
restrictive, but for Righini the orthorexia was never about a
particular diet, but about his "mind set" toward
food. He said heís no longer the "drill sergeant"
justifying every bite, and is slowly becoming more flexible,
eating cooked foods now and then. He has increased his daily
intake to 3,000 to 4,000 calories and is gaining weight to
reach his 115-pound goal.
now put love and positive energy into the food I grow or buy,
prepare and consume," he said. "My diet and health
are more stable because my mind is more stable."