Talk:Orthorexia nervosa/Archive 1

Title
Since the full term for the condition is orthorexia nervosa, should it be moved to an article with that title? Anyone? --Frecklefoot 18:07 21 May 2003 (UTC)
 * Done. Kent Wang 22:27, 9 Mar 2004 (UTC)

Untitled

 * This article was nominated for deletion on June 9, 2005; the consensus was to keep. For discussion, please see Votes for deletion/Orthorexia nervosa.

I

 * I removed the following; it didn't seem directly relevant to orthorexia as a medical condition, only indirectly relevant. Maybe it could be moved to another page:

Others say that many scientists are divorced from ethics... and that one cannot be too rich or too thin. They cite statistics that nonagenarians and centenarians are usually thinner than average, placing less stress on organs.

7000 vegan MD's have numerous articles on overweight in relation to animal products. http://www.pcrm.org


 * I also removed the following line, because thinnes isn't the major problem with orthorexia, there are other concerns:

As a result, the sufferer may become as hazardously thin as those suffering from anorexia.

This
This article and this whole concept is so biased and not based on scientific evidence. Perhaps eating the flesh of once-living animals, when there are healthy alternatives, is an eating disorder? This is junk psuedo-science and I am one of many who do not believe it belongs on wikipedia. —Preceding unsigned comment added by 71.192.26.252 (talk) 04:58, 30 December 2007 (UTC)

Totally disputed
One MD decides to name a "condition" based on "excessively healthy eating = mental disease" unsupported by any studies or medical consensus, and this is the apparent basis of the article. To the extent I might be inclined to include this material it should be merged into eating disorders and even so it seems rather marginal at best. Whig 16:49, 9 Jun 2005 (UTC)
 * The NPOV tag in this instance is innappropriate as at no point in it's current incarnation does the article accuse or imply through language or tone that "excessively healthy eating = mental disease" (your quotes). It simply reports on the ongoing scientific study of the phenomena without judging anyone or anything.  As time progresses and more evidence is published for or against, then such information can obviously be added.  Disaggreeing with the existance of the subject of an article does not make it POV, and as, so far, there has been one objection to it, it is not "Totally disputed."  --Jeffrey O. Gustafson 17:56, 9 Jun 2005 (UTC)
 * There's a great risk of trying so hard to provide a neutral description of a topic, that you lend credence to a fraud, and perform a great disservice to people looking for information. The article mentions that a study has been performed, in 2004, but doesn't tell us what the results were.  That's a little fishy, no?  And the man who invented this eating disorder is selling a book to combat it ... alterior motive?  FireWeed 23:01, 23 January 2007 (UTC)
 * It's a bit of a stretch to call this an "ongoing scientific study." Scientific figures try to introduce pet theories all the time.  FireWeed 19:35, 11 January 2007 (UTC)

'Unhealthy obsession with eating healthy'?

Since food is by far the primary determinant of good health, can there even be such a thing as an unhealthy obsession with health?


 * Allow me to introduce you to Andrew Lin. - Jersyko   talk  19:04, August 16, 2005 (UTC)


 * There can be an unhealthy obsession with anything, and generally this is obsessive-compulsive disorder. The MD who invented this prank tells us "orthorexics" have starved themselves to death, which is as dubious as you can get.  If a person refuses to eat bacon, then they'll eat bread and broccoli to avoid death from starvation.  Anybody who feels so compelled to "be pure" that they would risk a very slow, painful death, has more serious issues to deal with than their choice of diet.  FireWeed 23:01, 23 January 2007 (UTC)

What the article needs
Conspicuously missing is the reason why Bratman claims this condition is a disease. The article is otherwise unintelligible and gathers the above type of comments from those who think it is simply calling people who eat healthily crazy. Could whoever wrote this to start with please add the key info? Thanks alteripse 23:04, 27 November 2005 (UTC)


 * Actually, I don't claim it's a disease. I invented the word as a kind of "tease therapy" for my macrobiotic and rawfoodist patients who took their diet too seriously. My book -- which mostly no one reads -- is rather funny and light and amusing.  However, several years after the book went essentially out of print I began to hear about people who were dying from a more extreme form of health food obsession than I even knew existed.  This is rare, but awful for the person who's wasting away and can't stop it, and who doesn't have anorexia but rather something related to it. Whether that's a form of obsessive compulsive disease or a variant of exercise-addiction, I don't know.  I'm not an eating disorders specialist. Sbratman (talk) 23:17, 9 April 2008 (UTC)


 * My guess is there should be a distinction between people who eat healthily, and people who are obsessed with healthy eating, to the point that such fixation affects their life negatively. ( Say by causing undue stress. )  However, as obvious as this seems to me, I'm not going to edit a "scientific" encyclopedia article to clarify it based on my guess.  That would be very unscientific of me.  ;-P  FireWeed 19:37, 11 January 2007 (UTC)


 * The term "nervosa" means fixation. So people, like me, who just enjoy eating healthy food, are not orthorexic. It has to cross some line into obsession.  Where to draw that line?  Like all such divisions, there's no clear answer. Sbratman (talk) 23:17, 9 April 2008 (UTC)

Why the concept is not accepted
Bratman did not back up his concept with any research. His concept is not neutral. Some of his statements indicate that he wanted to write a parody!


 * Please cite an instance of Bratman stating that his intention was to write a parody. Skinwalker 16:32, 28 April 2006 (UTC)


 * Not a parody, exactly. But I wasn't trying to invent a disease, either.  I was trying to tease overly serious health food maniacs into relaxing a little.  Sbratman (talk) 23:24, 9 April 2008 (UTC)

... Bratman hasn't done clinical tests or studies, but insists he isn't trying to create a medical disorder that would belittle the serious problems involved with other eating disorders. "I invented the word orthorexia as a tease. I don't really believe it's as bad as anorexia, but the word has shock value to get people to reexamine their values," Bratman says during a telephone interview from his home office in Fort Collins, Colo. "It's like workaholism. Nobody thinks it's as bad as alcoholism. But like workaholism, people mistake it as a virtue." http://www.metroactive.com/papers/metro/08.02.01/eating1-0131.html

Thus the term is not accepted neither by the research community nor by the medical community. It is worhless for diagnostic and therapeutic purposes and it is dangerous to label people. The concept is not critized by experts, because they feel eating healthy would be fine in all cases. The concept is not accepted because it is not funded on sound research like for example the concept of bulimie or anorexia nervosa!


 * It's being investigated now, and at some point it might or might not become an accepted diagnosis. For reasons entirely unclear to me, most of the scientific interest has occurred in Italy and Turkey. In Turkey, they've adjusted the meaning a bit: "orthorexia," to them, means just "interest in health food, whereas "orthorexia nervosa" means a fixation on it.Sbratman (talk) 23:24, 9 April 2008 (UTC)


 * The study cited in the article found a 6.9% prevalance of orthorexia, as they defined it. Please explain why a peer reviewed paper does not constitute "sound research".
 * unfortunately there is one study - but wait until the research community has discussed the paper! It very much depends on how you define "orthorexia". I do not believe that they think that it might be possible that 6,9% of the population counts calories and vitamins 3 hours a day. One study is weak evidence nevertheless, it does not prove anything. Compare to anorexia or bulimie, there are hundreds of studies.


 * Night eating syndrome, a fairly recently recognized eating disorder ( 7 years ), affects between 1 and 2 % of the population. And as a disorder would seem to include some amount of "orthorexia nervosa" - in fact, without this component, people suffering from NES would not be suffering.  The idea that 7 % of the population suffers from orthorexia is absurd.  FireWeed 19:43, 11 January 2007 (UTC)


 * I agree. It sounds absurd to me too.  The scale they used seems to be very, very overbroad.Sbratman (talk) 23:24, 9 April 2008 (UTC)

Are you aware of any expert dieticians or other physical/mental health professionals who have criticized this study, or Bratman's hypothesis? If so, please cite them, so we can include it in the article for balance. We cannot include editorial commentary in encyclopedic articles. WP:NPOV states:


 * Lots of dieticians, eating disorder specialists, etc., seem to take it seriously. But that doesn't mean it's a real disease.  It seems to be pretty much trendy at the moment.  Before I closed my website to email, I was inundated with emails from journalists wanting to know about it.  Many countries too: Germany, Brazil, Chile, Sweden, UK ...  But the fact is, orthorexia is NOT a scientific diagnosis.  It's just a popular culture term at the moment.  I think there's about a 50/50 chance that it will some day be a DSM term.  Someone else besides me will have to do that.  I'm not an eating disorder specialist, and I really don't have an investment in what happens with it.Sbratman (talk) 23:24, 9 April 2008 (UTC)


 * "A good way to help building a neutral point of view is to find a reputable source for the piece of information you want to add to wikipedia, and then cite that source. This is an easy way to characterize a side of a debate without excluding that the debate has other sides."


 * I have no problem with including anti-orthorexia information, but we must find reliable sources to back it up.  Skinwalker 16:32, 28 April 2006 (UTC)


 * the concept is not discussed in the scientific community. Go and ask a psychiatrist.

There are many reasons why people can get too fussy about food. This is well known in psychology and psychatry. But Bratman does not have any expertise on these fields. He simply ignores all differential diagnosis. He just describes things that he observes in himself and other people.Thus merges together very different things:


 * some observations he presents as symptoms are no sypmtoms at all, like buying too much healthy food or eating organic.
 * some symptoms might be first signs of psychose or borderline syndrome.
 * only few of his observation could indicate eating disorders - perhaps the classical anorexia.
 * wrong self-therapy of people that are seriously ill

I suggest to give much more stress to the fact that the term is not accepted by the scientific community! There are very good reasons to reject it. Scientific ressources must be named!


 * It's not really _not_ accepted. It's just not a DSM diagnosis at this time. Mostly what I've run into is "oh, that's interesting."  Many disease names exist on a provisional basis long before they become official.  Not that I'm really certain that it _will_ become official.  I'm agnostic on it.Sbratman (talk) 23:53, 9 April 2008 (UTC)


 * I agree that scientific sources should be used, ideally on an exclusive basis. Skinwalker 16:32, 28 April 2006 (UTC)

Newspapers and online portals that copy from each other do not count for resources.

It is absolutely NOT acceptable that term is presented in a way that people believe it is a medical condition like bulimie or anorexia!


 * Why not? Please review WP:NPOV and WP:NOR. Thanks! Skinwalker 16:32, 28 April 2006 (UTC)

Dear Skinwalker: the concept is not accepted by academics like other disorders. Thus it cannot be presented in that way! Please stop deleating my contributions! I always try to consider your objections.


 * I agree with Anonymous; this article is presented as if Orthorexia nervosa were an actual medical term for an actual condition, which it's not.  There are serious, irredemable flaws here:


 * 1) This "disorder" was "discovered" without help from the scientific method.  It's pseudoscience pure and simple.


 * I agree that this concept is NOT in the category of anorexia and bulimia. First and most important, it is not an official diagnosis. Second, it is clearly far, far less dangerous than those.Sbratman (talk) 23:53, 9 April 2008 (UTC)


 * That is entirely your opinion. Find a credible outside source that defines it as pseudoscience, and we can discuss it as pseudoscientific.  Skinwalker 23:08, 18 January 2007 (UTC)


 * Pseudoscience has a strict definition, that Orthorexia fits. The reference you're demanding is difficult to find because orthorexia is not notable enough for any credible doctor to debunk it.  FireWeed 23:15, 18 January 2007 (UTC)


 * Would you be kind enough to link to a few credible articles listing the Theory of Deadly Initials as pseudoscience? FireWeed 23:54, 18 January 2007 (UTC)


 * I don't think it's pseudoscience; I never claimed that it was an established diagnosis. It's a descriptive expression, like "workaholism." The analogy is close, in that use of a disease name is employed for expressive purposes.  Sbratman (talk) 23:53, 9 April 2008 (UTC)
 * It sounds as if the inverter of this term himself is telling us that this is a coined term, not a medical condition. Yet we've written a medical article about it.  —Preceding unsigned comment added by 70.91.201.209 (talk) 18:54, 16 July 2010 (UTC)


 * 1) Lack of any peer review of Orthorexia.  No psychologist or doctor takes the idea seriously.  The fact that no scientist has spent (wasted) any time on a supposed disorder that was invented almost a decade ago tells us something important.  Just as no scientist has spent any time proving the moon exists.  Others, like night eating syndrome have been given attention, because those concepts warrent it.


 * I think this is just wrong. A number of scientists have taken the concept seriously. Whether they've gotten anywhere with it is another story.Sbratman (talk) 23:53, 9 April 2008 (UTC)


 * As of today, there are several peer reviewed articles listed at Pubmed that discuss orthorexia. The rest of this comment is strikingly similar to the No True Scotsman argument.  Skinwalker 23:08, 18 January 2007 (UTC)


 * 1) Orthorexia nervosa is not listed in the DSM-IV, which is the current version.


 * The DSM is not the final authority in psychological disorders. For example, the DSM specifically excludes men from being diagnosed with anorexia nervosa, since a criterion for diagnosis is the cessation of menstruation.  This omission has been criticized, since there are men that objectively suffer from anorexia, and there are quite a few other obscure disorders that the DSM ignores.  If you look at the Veganism talk archives, I argued against discussing orthorexia on that article since it is not in the DSM, but we can and should neutrally discuss it on its own page.  Skinwalker 23:08, 18 January 2007 (UTC)


 * 1) The concept is absurd on its face.  If there's a shred of truth here, it could be described as people with obsessive compulsive disorder turning their attention to their diet.  If so, that's already covered by OCD.


 * I agree that it might turn out to be best described as a form of OCD.Sbratman (talk) 23:53, 9 April 2008 (UTC)


 * I still think you're taking out your displeasure with the term on this article, which neutrally reports on the controversy surrounding the term. Skinwalker 23:08, 18 January 2007 (UTC)


 * In short, orthorexia should not be presented as a medical condition, because that's not what it is.


 * Are you a doctor, perchance? Just curious... Cheers, Skinwalker 23:08, 18 January 2007 (UTC)


 * My wife is. FireWeed 23:17, 18 January 2007 (UTC)


 * Being one myself, and the inventor of the term, I agree: it's not a medical condition. It might or might not be one in the future.  Right now, it's only a descriptive term. However, it's increasingly widely used, and it is a subject of study.  So it's in an intermediate stage from pure hot air (my original use of the term) and something more substantial.  Sbratman (talk)


 * FireWeed 19:09, 18 January 2007 (UTC)

Vegetarians are (all) mentally ill?
"The subject may avoid certain foods, such as those containing fats, preservatives, or animal products." Hopefully I can voice my objection without sparking a debate on the merits of vegetarianism. What matters are that these people represent a sizable group. According to time Magazine 10 million Americans are practicing vegetarians and 20 million have flirted with the idea in the past. As a percent, England is more "veggy" than the United States. Then we have Krishnas, immensely popular in India, who avoid meat.

Are we really to believe that tens of millions of people world-wide suffer a psychological eating disorder, one that doesn't exist according to the scientific community? Without even looking into whether avoiding animal products is healthy or unhealthy, the numbers are far too many to call this a pathology.

Now, still quoting the Time article, The American Dietetic Association, a pretty centrist group, has proclaimed that "appropriately planned vegetarian diets are healthful, are nutritionally adequate and provide health benefits in the prevention and treatment of certain diseases." George Bernard Shaw complained in his 90s that the one problem he suffered from vegetarianism was longevity - not being able to die. On the whole, it seems that well-planned vegetarianism is healthy, which, again, seems to make it impossible to call an "eating disorder."

FireWeed 20:04, 11 January 2007 (UTC)


 * Perhaps you should meditate on the meaning of "well-planned". Cheers, Skinwalker 23:58, 11 January 2007 (UTC)


 * Perhaps you could stop talking in riddles? You've been an outspoken critic of veganism on wikipedia and have reverted constructive edits of mine with no explanation - please, don't just be bold, but be clear, too.  Thanks.  FireWeed 05:43, 12 January 2007 (UTC)
 * Let me be clear, then. There is little doubt that a well-planned vegetarian diet results in the health benefits described in the Time magazine article you cited.  You are, however, conflating the concept of orthorexia with vegetarianism as a whole.  As I'm sure you know, there is a wide spectrum of vegan/vegetarian dietary notions, ranging from the scientifically based to those that are not very well-planned at all.  I am not so much a critic of veganism as I am a skeptic of sweeping, uncritical claims of health benefits that are not supported by evidence-based medicine.
 * The concept of orthorexia is certainly controversial, and the article notes it. I don't believe that controversy, however, amounts to pseudoscience, particularly since there are peer-reviewed articles that discuss the concept.  There is also a fair amount of anecdotal evidence that supports the concept, although I don't trust anecdotal claims very much in any field.  I suspect you are taking out your displeasure with the concept on this article, which reports in a neutral manner on orthorexia and cites skepticism of the term among dieticians.  The simple fact that you don't like the term doesn't mean that the wikipedia article about it is biased.
 * While it may not be germane to this discussion, you may want to take a look here. This article is written by a long-term vegetarian who describes the use of pseudoscience in the vegan/raw community.  I apologize for being elliptical in my earlier post.  I have grown tired of arguing with True Believers, but I have written this reply in order to give you the benefit of the doubt.  Cheers, Skinwalker 23:34, 12 January 2007 (UTC)


 * I see. When you asked me to "meditate" on the meaning of well-planned, it was an opportunity to change the subject.  True believers is a red herring.


 * I'm confused. An opportunity to change the subject to what?  Skinwalker 22:55, 13 January 2007 (UTC)


 * The trouble has little to do with whether a vegetarian diet is actually more ( or less ) healthy; there are at least a hundred million of them world wide, and probably vastly more.  Vegetarianism is a practice that has survived thousands of years, at least in India.  By definition this is not a random pathology - it's an enduring part of the human condition.


 * Again, well planned vegetarian and even vegan diets are not pathological, and are not considered pathological by the dietetic community. The concept of orthorexia points out that a small subset of "healthy eaters", be they vegetarian or otherwise, display obsessive symptoms that impact their quality of life through factors like stress (as you note above) and malnutrition.  Skinwalker 22:55, 13 January 2007 (UTC)


 * Further, if you look at real eating disorders, the people who suffer them generally describe the overwhelming compulsion to eat a certain type of food in a certain situation - as difficult to resist as heroin or crack cocaine. Avoiding foods which are unhealthy most certainly does not fit the pattern.  And is quite distinct from anorexia - the near inability to eat anything, regardless of its nutrition value.

Way to generalize. Anorexics clearly eat food - or there would be way higher death rates. And on a more direct note, Orthorexia SHOULD be an eating disorder - when someone would rather not eat for three days than eat non-organic, or non-raw, there's an issue. When it becomes harmful to the individual - when it hampers a life, rather than helps - when it is addictive. When there is no choice. Everyone talking eating disorders is ignoring EDNOS (eating disorder otherwise non specified) - that there are individuals that are clearly disordered but do not fit into either the strict criteria of anorexia or bulimia - ie an overweight individual who loses a large percentage of body weight through starvation, but doesn't meet the under bmi 19 criteria. I agree, Wikipedia should not be arguing that something is a medical diagnosis if it isn't, but an awful lot of people here are offering their somehow expert opinions on things they are not qualified to diagnose. —Preceding unsigned comment added by 205.250.115.206 (talk) 07:19, 8 December 2008 (UTC)


 * There was a lot of debate on the veganism page some time ago about the inclusion of a section on eating disorders. The main gist - which a lot of pro-vegan editors had trouble understanding - is that veganism or vegetarianism does not cause eating disorders, but these diets can be selected by people with existing eating disorders to camoflauge their pathology.  Personally, I am not convinced that orthorexia qualifies as an eating disorder like bulimia or anorexia, but our job as encyclopedists is to neutrally report on sometimes controversial topics, and I believe that this article as it stands accomplishes that. Skinwalker 22:55, 13 January 2007 (UTC)


 * Woody Harrleson, from Cheers and from the marijuanna movement, made a documentary about organic products and their incorporation into modern life. There's a scene where somebody asks one of his co-travellers and co-stars ( who observes a raw-only diet ) if she misses cooked bread.  The woman replies that she does miss it when she walks by a bakery, but doesn't want to get cancer of the intestines.  There's no evidence whatsoever to suggest that cooked food is carcenogenic, and a great deal to the contrary.  This woman's zealousness embarasses her entire community.  I won't for a second argue that pseudoscience doesn't exist in vegans ... in fact, from the ones I've met, I have reason to be sad.  One claims evolution as her religion, but doesn't understand the mechanics of evoltution.  I'm not trying to argue that vegetarianism is an inherently better diet - only that I don't believe it could be reasonably considered an eating disorder.  You're right that it's our job as editors to present a neutral and complete view on controversial subjects, and let the reader make an informed descision.  I just don't believe the article as it stands does that.  FireWeed 23:19, 13 January 2007 (UTC)


 * You are of course correct that there exists plenty of pseudo-science in the vegan community, and far more in the raw foods only community. And I'm correct to point out that it's currently snowing in Seattle.  Both have the same value in terms of the objection I'm trying to raise here.  FireWeed 22:23, 13 January 2007 (UTC)


 * I included the link not because it had anything to do with our current discussion, but because of your demonstrated interests in pseudoscience and vegetarianism. I thought you would find it interesting.  Cheers, Skinwalker 22:55, 13 January 2007 (UTC)


 * Oh, I found it very interesting, I just seem to have read it out of context. It seemed as if you were calling me a True Believer as a way to dismiss my criticism here.  Apologies.  FireWeed 23:19, 13 January 2007 (UTC)

Does this page belong on Wikipedia at all?
A comment left on my talk page:

Hello Fireweed. If you don't think this article is encyclopedic, you could always take it to AfD! The long and twisted history of the article does not (in fact) seem to reflect much progress. And even hoaxes require notability to deserve an article. (They have to fool a lot of people, see WP:HOAX). I don't agree that Orthorexia nervosa should be a 'See also' on Junk science. Perhaps it should simply be deleted. EdJohnston 06:09, 12 January 2007 (UTC)


 * You are of course welcome to nominate this article for AFD, but it has already survived a previous AFD (see link at the top of the talk page) with an overwhelming consensus to keep. Cheers, Skinwalker 22:55, 13 January 2007 (UTC)


 * Yes, I saw that, which is the main reason I'm not going to AFD this article. ( That, and in general I don't believe it's helpful to remove information from an encyclopedia, except in the most extreme cases.  While I don't believe in what's presented here, others, like you, seem to believe that what's reported is valid.  I think you're generally wrong, but my own believe isn't enough to try and remove your and others' good faith work. )  However, I put a link to this article on the pseudoscience page, under the "in health care" section, as I believe this is a concept that claims to be scientific yet doesn't follow the scientific method, and wanted to share the reaction I got privately, to provide context.


 * For the record, I think that anything can be carried too far, to an obsession that hurts the individual. This seems to be where the age-old saying "Everything in moderation" comes from.  But I also believe in the scientific method, and that eating disorder has a clear scientific and medical defintion that hasn't been demonstratably met here.  FireWeed 23:24, 13 January 2007 (UTC)


 * I agree with you this hasn't reached the scientific level of one of the major psychiatric conditions (not that those are terribly scientific, but we're talking relative status). On the other hand, it's somewhat more than nothing, and it's not identical to ordinary OCD.  Keep in mind I'm primarily talking about a type of obsession with health food that is unpleasant to the person his- or herself (eg, ego dystonic), and that feels both detrimental and impossible to stop. Sbratman (talk) 23:53, 10 April 2008 (UTC)

"A first scientific study on the subject was published in 2004..."
It would be incredibly helpful if somebody could summarize the results of this study? Thanks. FireWeed 23:45, 18 January 2007 (UTC)


 * One of the criteria for Junk science is "Recommendations based on studies published without peer review. " Google turns up two results when searching for this study.  One is obvious spam, the other is in a foreign language and requires membership.  Clearly, this purported "scientific study" has had no peer review.  Claiming that a study has been done, without telling us what that study found, is dishonest.  The writer was trying to validate the concept as actual science, by "name dropping" of the word science - a lot like "weasel words."  If the study isn't available to satisfy WP:Verifiability AND is only mentioned to lend credibility to a subject that obviously needs some, it must go.  SeattleChronic 20:08, 26 January 2007 (UTC)


 * Your statements are demonstrably untrue. The journal "Eating and Weight Disorders" is peer-reviewed, is published in english, and makes its article abstracts available online free of charge.  Please review the instructions for authors, which state that all manuscripts are sent out to two referees and are reviewed by the editorial board as well.  I have as yet been unable to access the full articles, but here are the abstracts:

Orthorexia nervosa: validation of a diagnosis questionnaire.

* Donini LM, * Marsili D,   * Graziani MP, * Imbriale M,   * Cannella C.

Istituto di Scienza dell'Alimentazione, Universita degli Studi di Roma La Sapienza, Rome, Italy. lorenzomaria.donini@uniroma1.it

AIM: To validate a questionnaire for the diagnosis of orhorexia oervosa, an eating disorder defined as "maniacal obsession for healthy food". MATERIALS AND METHODS: 525 subjects were enrolled. Then they were randomized into two samples (sample of 404 subjects for the construction of the test for the diagnosis of orthorexia ORTO-15; sample of 121 subjects for the validation of the test). The ORTO-15 questionnaire, validated for the diagnosis of orthorexia, is made-up of 15 multiple-choice items. RESULTS AND CONCLUSION: The test we proposed for the diagnosis of orthorexia (ORTO 15) showed a good predictive capability at a threshold value of 40 (efficacy 73.8%, sensitivity 55.6% and specificity 75.8%) also on verification with a control sample. However, it has a limit in identifying the obsessive disorder. For this reason we maintain that further investigation is necessary and that new questions useful for the evaluation of the obsessive-compulsive behavior should be added to the ORTO-15 questionnaire.

Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon.

* Donini LM, * Marsili D,   * Graziani MP, * Imbriale M,   * Cannella C.

Istituto di Scienza dell'Alimentazione, Universita degli Studi di Roma La Sapienza, Italy. lorenzomaria.donini@uniroma1.it

AIM: To propose a diagnostic proceeding and to try to verify the prevalence of orthorexia nervosa (ON), an eating disorder defined as "a maniacal obsession for healthy foods". MATERIALS AND METHODS: 404 subjects were enrolled. Diagnosis of ON was based on both the presence of a disorder with obsessive-compulsive personality features and an exaggerated healthy eating behaviour pattern. RESULTS: Of the 404 subjects examined, 28 were found to suffer from ON (prevalence of 6.9%). The analysis of the physiological characteristics, the social-cultural and the psychological behaviour that characterises subjects suffering from ON shows a higher prevalence in men and in those with a lower level of education. The orthorexic subjects attribute characteristics that show their specific "feelings" towards food ("dangerous" to describe a conserved product, "artificial" for industrially produced products, "healthy" for biological produce) and demonstrate a strong or uncontrollable desire to eat when feeling nervous, excited, happy or guilty.


 * Can you please explain, now that it is established that these articles are peer-reviewed and constitute proper scientific citations, why they do not belong in this article? I will try and find the full text of the articles in the coming days (may have to pay a visit to the local state med school library) and better summarize the conclusions of these studies.  Cheers, Skinwalker 23:32, 26 January 2007 (UTC)


 * Now that it is established that these articles are peer-reviewed and constitute proper scientific citations, they belong here. However, the simple mention that a "scientific study" has been performed, with no mention of its outcome, methodology, or anything else about it, as the article stood for weeks or months, was clearly inappropriate for an encyclopedia.  FireWeed 23:45, 26 January 2007 (UTC)


 * Good. Since you agree that these articles are relevant, I have incorporated summaries of their conclusions into the page.  I would still like to find the full articles, since abstracts typically do not tell the full story.  My university proxy server, unfortunately, does not allow me access to this specific journal.
 * Since we now have discussion independent of Dr. Bratman on the disorder, I have tweaked the article somewhat to remove some of the "Dr. Bratman says", "Dr. B asserts" phrases, and I have based the symptoms and diagnostic sections on the studies rather than Dr. Bratman. Cheers, Skinwalker 18:43, 27 January 2007 (UTC)

A view based on psychology and science
Anorexia nervosa is an ANXIETY disorder. So bulimia, pica, and so on. Note that the anorexic doesn't avoid food based on its health value; she avoids all food whenever possible. This isn't a bad decision, it's an example of a person who can't control anxiety, despair, and guilt related to her body image. The bulimic doesn't vomit only unhealthy food - again, we have an example of a person whose anxiety pushes them to the brink of starvation.

What's described in this article is clearly not an anxiety disorder. We're reading about people who make a logical choice, perhaps based on faulty logic or bad information, but clearly choose their diet based on their faculties, on logical analysis, rather than on anxiety. Therefore, "orthorexia" cannot be an eating disorder.

Further, what's described here is a healthy behavior that more people should adopt. It's possible for an individual to take any behavior too far, but such cases would be examples of obsessive compulsive disorder, much like the person who locks his door, walks halfway to his car, and then returns to check the door and ensure that it's really locked. This is why you'll find little to no scientific peer review. We don't waste our time on nonsense, as it would encourage the impression that science as a whole takes this type of snake oil seriously. —The preceding unsigned comment was added by 71.216.188.164 (talk) 19:30, 22 January 2007 (UTC).

A suggestion
Since the article gives the appearance that a medical condition is being discussed, i think the article would do well to clearly note how the AMA weighs in on the issue (or has/does not weigh in). Don't get me wrong, I would not trust the AMA (a self-serving trade union to be sure) with my own life/health, but how they view this "concept should be mentioned. Of course once the AMA gets an idea for how much more money they can make off of it no doubt they will state it's a disease for which they hold the cure!  Oh well...Mr Christopher 00:10, 27 January 2007 (UTC)


 * Actually, the AMA wouldn't be the governing body in this case -- it would be the American Psychiatric Association, through their influence on the DSM IV. But the APA doesn't randomly go around issuing opinions of this kind. There are numerous psychiatric concepts floating around that haven't made it into the DSM IV.  Some never will; others will in time.  It's rather less precise, and less unanimous, a field than, say, heart disease. Sbratman (talk) 23:47, 10 April 2008 (UTC)

Wikipedia page ownership
I thought everyone owned Wikipedia knowledge at once, and no one in particular? That's obviously not the case, as one user has done 60 % of the editing to this page based on the edit history, and will not tolerate anything being listed here that doesn't conform to the Skinwalker point of view. This is why Wikipedia is so worthless; when one person is allowed to take ownership of an article purporting to share knowledge, and is allowed to push a certain point of view and censor any facts disputing this the article suddenly becomes worthless, and all of Wikipedia is cast in doubt.

I want the $50 back I donated to the wiki foundation during their pledge drive. —The preceding unsigned comment was added by 24.22.219.128 (talk) 17:19, 6 May 2007 (UTC).


 * There is no evidence of ownership behavior on this article. The most recent page of the history shows at least 13 or 14 people editing the article, and not all in agreement with each other in their approaches.  I see a dynamically evolving article that has improved over time.  --Parzival418 Hello 18:34, 6 May 2007 (UTC)

What's "healthy food"?
I think that an interesting point of discussion for this article would be what the patient diagnosed with orthorexia nervosa would consider to be "healthy food". Are they mostly vegetarians? Or even vegans? Does a significant amount of them eat only raw food? —msikma (user, talk) 19:43, 27 March 2008 (UTC)


 * When I first invented the term, I mostly had people following macrobiotics in mind, along with, to a lesser extent, rawfoodists, fruitarians (and breatharians), and people overly obsessed with food allergies. These days, macrobiotics has declined a lot.  Raw foodism, conversely is bigger.  Also, there are people who follow a lot of rather random healthy diets (or so it seems to me).Sbratman (talk) 23:55, 9 April 2008 (UTC)

I would assume that the foods they eat are verry healthy. They probably do not exercise diversity: they might exclude physical exercise from their schedules, or they may be so well acquainted with the health benefits of one food substance that they rely on only that one substance to provide for all of their health needs. Don't quote me on this though. Caffeine927 (talk) 19:02, 10 June 2008 (UTC)

Evolutionary history
Wikipedia is telling the world that people who refuse to eat foods with preservatives are more likely to die of starvation than people who don't restrict their diet in this way. Wikipedia is also announcing that this is inherent in the human condition - that's what psychological pathology is. Like near sightedness, depression isn't something that nobody experienced until western medicine had names for these conditions. If what's claimed here is true, this would also be the case for orthorexia. One would expect that, until preservatives were invented, humans have been dying of starvation since the dawn of our species. —Preceding unsigned comment added by 207.138.32.33 (talk) 21:51, 19 June 2008 (UTC)

A mix of OCD and Eating Disorder- Balance Please

After years in the health food industry, I can definitely say I have seen versions of OCD that manifest as ON. It is unfair to ask, "Does your diet socially isolate you?" especially in an era where the majority of Americans are overweight and eat unhealthy diets. Amyone who avoids excessive meat, dairy, and processed foods consumption can be easily isolated, and certainly, a raw or vegetarian diet can be extremely healthy. In and of themselves, these things deserve no defamation. However, some people take it too far. I have known at least two individuals who clearly have replaced other OCD fixations with extreme health food obsessions that, even to a healthy eater, can seem neurotic. One of them was even aware of the situation, remarking that it was a healthier alternative to severe bulimia. I could easily see it progressing to a stage needing medical intervention if something were to offset the balance as it currently exists. Wikipedia isn't defaming healthy eating. It is merely pointing out that extremes exist, that even when centered on "health," can become unhealthy, just like exercise bulemia, where people become addicted to excercise to exert some "control" over their lives. Here, the excessive "control" is in purification via food, pushed to an unhealthy extreme. Redhat77 (talk) 17:38, 22 October 2008 (UTC)redhat77

POV
"The subject may avoid certain unhealthy foods, such as those containing fats, preservatives, man-made food-additives, animal products, or other ingredients considered by the subject to be unhealthy"

This must be balanced, there are fats, preservatives and man-made additives that ARE unhealthy. The way this article is weasel worded it makes it seem as if the 'subject' is by in error by default.

"Products that are preserved with additives can be considered dangerous. Industrial products can be seen as artificial, whereas fruits and vegetables can be seen as healthy."

Fruits and vegetables "can" be seen as healthy? Really? Perhaps because they are?

Seriously is this a joke? —Preceding unsigned comment added by Orasis (talk • contribs) 19:50, 4 May 2011 (UTC)
 * We have to stick to what our sources say. In this case, because it's not an officially accepted diagnostic condition, there are not many sources to pick from.  Ideally it would be better to reword it to emphasize that Bratman and others are speaking of people who take it to extremes, and illustrate it with stories of people who spend all their free time growing organic vegetables, etc. because they don't trust store-bought produce, and in the long run end up more unhealthy than they would have been otherwise because they never get enough to eat.  Seriously, if you watch the Stossel video that will get you a picture perfect idea of the kind of mindset that orthorexia is meant to be about.  If you want something shorter (I think it's about 20 minutes long) you can read stories about self-identified orthorexics on beyondveg.com (the owner of the site is a vegetarian who used to be a rawfoodist but quit because he couldn't stop losing weight).  I'm not saying these people are 100% correct in everything they say, just that they are some examples of people who have contributed to the popular definition of orthorexia.  —  Soap  —  23:29, 4 May 2011 (UTC)

Article of humor?
Really? Should this facetious 'condition' even have it's own page on Wikipedia? According to this every bodybuilder in the world has an extreme mental disorder, in fact if we go further every non-human animal is also mentally sick. I suppose we should tell the wolves and lions to stop focusing so much upon meats and you know what they consider to be 'healthy' foods. Poor dears, they are obsessing too much. —Preceding unsigned comment added by Orasis (talk • contribs) 19:28, 4 May 2011 (UTC)
 * If you want to see the page deleted feel free to take it to Articles for deletion. I would recommend reading some of the links above even if you don't agree with them, though.  —  Soap  —  23:21, 4 May 2011 (UTC)

This
This article classify people who avoid preservatives as mentally ill. I avoid one particular type of preservative because if I eat it, I get a migraine every time (a lot of people do). Also, I have to avoid anything with chocolate/cocoa, else I get a migraine, too. In many cases, my diet socially isolates me. Does that make me mentally ill? No, there is something wrong with this article and maybe the diagnose. --80.203.118.137 (talk) 15:15, 4 May 2009 (UTC)
 * The key distinction — or a key distinction — is whether your quality of life is lessened by your avoidance of things that give you a migraine. Look at ON as a compulsion that interferes with normal life in a negative way. A dietary restriction to prevent severely painful migraines, deadly allergic reactions, major GI disturbances ("major" as in the difference between eating a cup of Olestra smothered mashed potatoes which could cause liquid projecting from an exit orifice accompanied by severe cramps versus a cup of gas-inducing beans), feeling sick to your stomach, etc, obviously would not qualify. — al-Shimoni  (talk) 15:00, 3 June 2014 (UTC)

The discussion going on here is worrying and counterproductive
As a psych graduate student, and a person who has worked in a health-food store - I definitely know what orthorexia looks like, and that it exists. It is certainly a separate disease from anorexia, and should be diagnosed and treated as such. The associated behaviors and cognitive hang-ups are entirely different.

Furthermore: simply because there is little research done does not denote that this isn't worth researching further. It is a new phenomenon in a recently aware culture. Health food disorder has been around for a very long time, but has only risen to the prevalence it has recently. I don't understand why there are such a huge number of people questioning the reality of the disease. I imagine that they might be self-protective of their own habits, which they feel the symptoms listed might capture.

If that's the case - that is really worrying, that mild to severe sufferers might be actively trying to crush the development of information about this. I think this article deserves protection and more oversight. 69.121.5.18 (talk) 21:04, 12 May 2009 (UTC)
 * Here's your chance then. Write a paper on the subject. Get it published. Get a reviewer to publish an assessment. Then we can cite what the reviewer has to say. LeadSongDog come howl 19:25, 30 June 2009 (UTC)

Is it a "disease" or is it not a "disease"? That isn't the point, and I venture to guess it wasn't Bratman's point either (from his own comments). The question should not be whether this is a "diagnosable mental illness," but whether or not, using latinized terminology or not, it is a valuable observation. I think it is a valuable observation. I agree with the person who identified him- or herself as a psych graduate student: There are people who have this problem. I know because I, myself, had this problem years ago, and I fell into a crowd of "raw foods" eaters who also had the problem. Some had the problem to a much greater degree than I did. For some, this problem was based on the desire to be healthy which became an obsession; for others it was based on a desire to be "pure," either physically, or, as they saw it, spiritually. In many cases, I think it had to do with an underlying desire to feel in control of one's life. "If I can control my food, which is so central to my existence, then my existence in under control." I will add, however, that the self-diagnosis questions listed in the article are very problematic. To want to eat at home because you have more control over the food you consume, for example, is not *necessarily* a sign of obsessiveness or compulsion - after all, in my view there is no question that food in many countries is polluted with toxins from pesticides; some restaurants' hygiene is atrocious, and so forth. This is one of those fascinating areas where a social problem (a hazardous system of food production) and individual psychological problems may overlap in some people. —Preceding unsigned comment added by 99.253.243.96 (talk) 06:28, 3 March 2010 (UTC)

--Nonsense. Of course a person who has a goal whether it be to be fit, live longer or be an athlete or bodybuilder is going to obsess over their diet and consume healthy foods. Could the same be achieved on a diet of big macs? In fact, is it now normal to consume big macs? Wow, Mcdonald's is going to love to fund this research, eh? One fatty big mac plus sodium bombed fries and a sugary coke per week means you are not insane my friend! —Preceding unsigned comment added by Orasis (talk • contribs) 19:42, 4 May 2011 (UTC)

"As Bratman freely admits..."
I removed this part of the sentence from the article, because
 * it would be silly to deny anything as obvious and controllable as whether or not a disorder is part of DSM or ICD;


 * this is an article on orthorexia, not on Bratman. It is not relevant what Bratman freely admits or not. Lova Falk   talk  13:57, 24 June 2010 (UTC)

I know this is a joke article, but...
... even for Wikipedia's "The Onion" section, couldn't some parts of the article be re-written? For example, the sentence:


 * Orthorexic sufferers have specific feelings about the foods they are avoiding.

Is about as vapid as any sentence can possibly be. Some people have feelings about things they don't eat. Really? I don't eat snails (as the French) or termites (as many hunter-gatherers), I find both ideas a little revolting, and I'm slightly overweight, meaning I couldn't possibly have orthorexia nervosa. In fact, this sentence describes every human that's ever lived, as food choice is a powerful sign humans have always used to distinguish "us" civilized people from "them" barbarian wretches.

I've picked on this one example in detail, but much of the article is like this. The very next sentence is full of weasel words. Whomever wrote this obviously loved composing sentences that seem to contain an empirical statement, but actually say nothing at all: Orthorexic subjects typically have specific feelings towards different types of food.  Really? The Onion doesn't have to repeat themselves like this, which is why they're more entertaining than our joke articles. The only pieces of this article that seem to have any information content are the giveaways where it says, basically, this isn't really serious: There has been no investigation into whether there may be a biological cause specific to orthorexia nervosa. and Although it is not an official medical diagnosis, and it is not listed in the DSM-IV[11]  or planned to be included in the DSM-V...

I'm sure the trolls and humorists can do a better job of this than what's on display until now. —Preceding unsigned comment added by 70.91.201.209 (talk) 21:12, 29 June 2010 (UTC)

Point of View = Steven Bratman, MD, Quackbuster Crusader
I just heard the words Orthorexia Nervosa on Coast to Coast radio. The host mentioned an article in The Guardian, and although the 2009 and 2006 articles have no current corollary, this page is bound to get a little more traffic as a result of national radio.

Dr. Bratman may not want this Wikipedia article to be about him, but he has claimed to have coined this phrase, and I have no reason to doubt that. Further, there do appear to be a large number of OCD behaviours constellated around food, and in the absence of a DSM category this descriptive may help a person frame a particular narrative around eating disorders.

What presents as a red flag for me is that Dr. Bratman has a long history of framing issues that he doesn't agree with in a sort of 'post hoc, ergo propter hoc' reasoning. When I first started seeing his Quackbuster site in the mid-90's he presented some of the most vitriolic and contemptuous derision of therapies or points of view for which he finds no value. This may or may have changed in 15 years, yes there are plenty of charlatans, yes there are people with eating disorders, but either way it remains nearly impossible to separate his Quixotic history and point of view from his current shaping of the content of this article. It may not be hagiography but the article still reads like content on the inside of a book flap. He has significant interest in seeing that this article and links to him are shaped in a manner that benefit him and his point of view.

With no DSM category the article clearly needs to be identified as a theory by an MD author with a history of crusading against alternative therapies he finds disdainful, and it should link to a more extensive exploration of that history. I don't intend to make this ad hominem but there is a very large elephant in the room here with a very large point of view behind it. —Preceding unsigned comment added by Cyclopedic (talk • contribs) 06:31, 30 June 2010 (UTC)

Article contains mass WP:POV errors
This article contains point of view errors, it implies that somebody who focuses on eating healthily is socially unacceptable. This is hardly neutral. Phrases such as "if the sufferer does not eat healthily enough, malnutrition can result" are unacceptable. Another example in the Symptoms section "symptoms of orthorexia nervosa may include obsession with healthy eating" this should be removed or rephrased.

As a side note, I would hardly consider this article subject of any noteworthiness, "orthorexic sufferers have specific preferences about the foods they are eating and avoiding" is akin to myself and individuals I know who avoid McDonalds and other fast food stores because the food tastes as though it is shortening my life. 130.56.82.30 (talk) 19:24, 2 July 2010 (UTC)
 * Thank you for your suggestion. When you believe an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the  link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills.  New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to).  WhatamIdoing (talk) 18:21, 28 September 2010 (UTC)

A category for these idiosyncratic "illnesses"
As with True-believer syndrome this term has been proposed as a diagnose or illness, however it has not been embraced by the mainstream therapeutic community as such. I'm sure there are other, comparable terms for which we have articles, so I'm proposing the creation of a category for these non-approved disease labels. __meco (talk) 08:24, 17 July 2010 (UTC)


 * This assumes that there's some single entity in charge of "approving" diseases, or even their names. It is not unusual for rare diseases and diseases for which the pathophysiology is unknown (or poorly understood) to have a half-dozen separate and sometimes conflicting names, descriptions, and diagnostic criteria for decades.  Everyone will agree that "person may die because she is afraid of eating something 'unhealthy'" is a medical problem; not everyone will agree on its name or where to draw the line between 'healthy' and 'diseased'.  One of the milestones in understanding a disease is the conference at which all of the diverse viewpoints get together and hash out a consensus definition.   The fact that this hasn't yet happened doesn't make any disease or its various names any less valid.  WhatamIdoing (talk) 18:29, 28 September 2010 (UTC)

The reality is that psychiatry does have regulatory bodies and professional associations and not a single one of them recognizes this alleged disease. Moreover it seems to have been given minimal to zero attention by the top psychiatric and medical journals despite being an almost decade old concept. Finally, the fact that its "symptoms" (obsession with healthy eating) seem to be identical to the *definition* and concept of the "disorder" (obsession with healthy eating) suggests that there is little reason to think that this concept is anything more than a label someone assigned to frankly fairly common behavior and preoccupations - absent any external confirmation that this is a coherent syndrome. Since there seems to be none, and Wikipedia is an encyclopedia not a meta-advertisement to lend credibility to someone's book, this article's tone should reflect the skepticism of the medical community as a whole and not the certainty of a handful of people within it. N0thingbetter (talk) 06:02, 13 November 2010 (UTC)

Article needs a massive clean.
As an example:

"people who develop an obsession with avoiding foods perceived to be unhealthy.[1]" (The source cited: http://www.orthorexia.com/)

- This is not correct. The source does not say anything like this at all. - Perception is not mentioned at all. - The source says that it is an "unhealthy obsession" as opposed to an "obsession".

"Orthorexia nervosa is believed to be a mental disorder.[3]" (The source cited: http://www.guardian.co.uk/society/2009/aug/16/orthorexia-mental-health-eating-disorder)

- Believed by some.

"is a non-medically recognized term[a]" (The source cited: The DSM)

- The DSM has nothing to do with something being "medically recognized". I'm laughing so hard right now...

124.191.139.167 (talk) 16:14, 13 June 2012 (UTC)