- The Washington Times - Tuesday, June 25, 2002

DENVER — Dr. Steven Bratman has seen the quest for healthy eating take a sour turn, from dietary vigilance to dangerous obsession.Dr. Bratman's extremes in dietary purity peaked in the 1970s, when he was living on an organic farm in New York. He disdained to eat any vegetable that had been plucked from the ground more than 15 minutes earlier and chewed each mouthful at least 50 times. He lectured friends on the evils of processed food and once feared a piece of pasteurized cheese would give him pneumonia.

"To be that obsessed with eating healthy food is to be really out of balance," he said in an interview from his home in Fort Collins.

Dr. Bratman coined a term to define his illness, orthorexia nervosa. He described it as an eating disorder whose sufferers fixate on eating proper food. The term uses "ortho," which means straight, correct and true, and "nervosa" to indicate obsession.

Dr. Bratman, an authority on alternative medicine, has written several articles and a book on his theory. The term is not recognized as a clinical diagnosis and Dr. Bratman hasn't lobbied for such recognition but some in the field say he may have identified a dietary trend.

"He's on to something quite interesting," said Adam Drewnowski, director of the nutritional-sciences program at the University of Washington School of Public Health. He is also a member of the task force that established official criteria for eating disorders for the American Psychiatric Association.

"I think there are consequences to being on a virtually fat-free vegetarian diet or a very restrictive diet," Mr. Drewnowski said. But "there's a distinction between a trend and a definable eating disorder."

Last year, Dr. Bratman detailed orthorexia nervosa in a book called "Health Food Junkies: Overcoming the Obsession with Healthful Eating," published by Broadway Books.

Like anorexia nervosa and bulimia, the behavior of orthorexics is marked by obsession, he said.

"Eventually, orthorexia reaches a point at which the orthorexic devotes most of her life to planning, purchasing, preparing and eating meals," he wrote.

"If you had a window into her inner life, you'd see little else but self-condemnation for lapses, self-praise for success, strict self-control to resist temptation and conceited superiority over anyone who indulges in impure dietary habits."

Transferring all value onto eating makes it a true disorder, he said, one that is broken only when the sufferer breaks free of obsession.

Tom Billings, a 48-year-old San Francisco computer consultant and co-founder of the alternative-diet Web site Beyondveg.com, believes he was orthorexic 30 years ago, when he followed a diet of mostly raw fruits and vegetables.

"I had this idea that if I ate something that wasn't on this approved list that I would be impure," he said.

Mr. Billings said he thought about food all the time and was so hung up on his diet that he couldn't go out to dinner with friends. At the same time, he had anorexic tendencies: His 6-foot-1 frame plummeted to 88 pounds.

Eventually, he got frustrated with thinking about food all the time and returned to a more diverse diet. He now eats raw and cooked foods, and will even eat chocolate occasionally.

"I've worked through those issues, and I don't see it being a risk for myself. But I do see other people getting on restrictive diets," said Mr. Billings, who now weighs 170 pounds.

"I've seen this obsession with food purity. It's not as dangerous as anorexia, and it's not as messy as bulimia because you can hide behind this screen of saying, 'I'm trying to eat right.'"

Critics question whether orthorexia is a true disorder.

"If these people are obsessed with eating healthy food because they want to be healthy as opposed to wanting to lose weight that can be an abnormality, but it still would deviate from eating disorders as a major theme. Unless their objective is to dramatically change their weight or shape, then I would be reluctant to call it an eating disorder. It might be obsessive-compulsive; it might be some form of a psychosomatic problem," said Michael Lowe, a professor of clinical and health psychology at MCT Hahnemann University in Philadelphia.

Since "Health Food Junkies," Dr. Bratman has written other books about alternative medicine and has worked as a consultant. But he doesn't fancy himself an eating-disorder specialist. "I would just like somebody to read the book and take a look at themselves," he said.

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