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Orthorexia: When "Healthy" Food Becomes An Addiction

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  • Orthorexia: When "Healthy" Food Becomes An Addiction

    When eating well becomes hell

    Cari Corbet-Owen, Shape magazine
    Mon, 22 Aug 2005

    We all know someone who's doing it (or we're doing it ourselves) — banning bread from the table, ditching dairy, carefully scrutinising product labels for preservatives, colourants and chemicals. Sky-high obesity stats have made us more aware than ever of the need to eat healthily; to cut out fat, cut down on snacks and up our intake of fresh fruit and veg.

    But what happens when awareness turns to obsession? When you can't get through a restaurant meal without grilling the waiter, maître d' and chef about what's in the food; when you isolate yourself socially because you don't eat what friends serve at dinner parties; or when grocery shopping takes longer than an appointment at the hairdresser?

    This disturbing new trend is called orthorexia nervosa — a pathological fixation with eating righteous or healthy food.

    Janet's dance with orthorexia started with cutting out wheat and yeast. Amy can't eat anything with nuts. Susan won't touch anything with fat, and Nadine is into "raw-foodism". Linda is a fruitarian and Joey is a vegan.

    At what point does righteous eating become just plain wrong?

    Allergy or obsession?

    Food health and food allergies are big business. Bookshelves are crammed with food allergy titles; in health shops, gluten-, wheat- and lactose-free products stand cheek by jowl. Soya is in, dairy is apparently out. Tofu is in, potatoes are out.

    With the advent of legislated food labelling, colourants and additives no longer go unnoticed. Food stores claim to stock "only organic". There's a new emphasis on food, nutrition and health. Which is good… until it becomes obsessive.

    The causes

    The roots of orthorexia are varied. Sometimes it's a desire to improve general health; for some it's about attaining holism or spiritual purity (some of the strongest ideals of alternative medicine), and for others it starts simply as an adjunct to getting over illness.

    Jill cut out all dairy products when a friend suggested her post-nasal drip was a symptom of lactose intolerance. But as time went on, she found herself developing increasingly specific food rules. Planning ways to stick to her self-imposed dietary regimen took up more and more of her time. As is common with orthorexia sufferers, what to eat, and the consequences of a dietary indiscretion, began to control her.

    Now Jill cannot go anywhere without carrying her own "pure" food supply. Her eating habits have isolated her. She no longer eats out, not only because she can't, but because her friends are tired of being lectured on the evils of refined, processed and junk food, and the dangers of pesticides and artificial fertilisers.

    From asthma to isolation

    Lynn was a chronic asthmatic. She first cut out milk, then later, wheat and maize. Her asthma improved drastically, thereby also reducing her reliance on medication.

    She was hooked on her new "food therapy". Next to go were other "allergens", like meat and eggs. The demise of several vegetables and fruits followed, as she discovered additional "sensitivities". Even eating a carrot became an issue, until eventually her diet was a complex rotation of only a couple of foods, with days of fasting to "clear" her system.

    Social butterfly Lynn stays at home worrying about what to eat, because while the asthma hasn't come back, headaches, nausea and "strange moods" have taken its place.

    From phobia to self-control

    Janet, 170cm tall and weighing only 49kg, admits that her ability to participate in normal conversation is impeded by intrusive thoughts of food. After two years, she's no longer able to eat what's readily available, as her phobias have extended to include fat, chemicals, colourants and preservatives.

    Sticking to this regimen takes tremendous willpower, which allows Janet to feel self-righteous and superior to those who don't have her kind of self-control. It's here that symptoms common in anorexia emerge: limiting foods, feeling superior and in control, and then crashing into a binge.

    As with anorexics and bulimics, when Janet breaks her health-food vows and gives in to a craving she feels guilty, and punishes herself with even stricter rules and more restrictions.

    The difference, though, is that she's concerned only with the quality of food, rather than the quantity. While anorexics want to lose weight, orthorexics want to feel pure or holy, but their relationship with food is equally neurotic.

    Dr Steve Bratman, who coined the term "orthorexia" in 1997, says: "The act of eating pure food begins to carry pseudospiritual connotations. As orthorexia progresses, a day filled with sprouts, umeboshi plums (Japanese pickles), and amaranth biscuits comes to feel as holy as one spent serving the poor and homeless. When an orthorexic slips up (which may involve anything from devouring a single raisin to consuming a large pizza), (s)he experiences a fall from grace and must perform numerous acts of penitence. These usually involve ever-stricter diets and fasts. This "kitchen spirituality" eventually reaches a point where the sufferer spends most of her/his time planning, purchasing, and eating meals."

    Information overload?

    This is a biology teacher’s story: "I've thought about the orthorexia phenomenon for a long time without knowing it had a name. The people I know who have developed eating disorders have all been like that, overly concerned with eating healthily, but taking food far too seriously. None of them was too concerned with body image in terms of fashion, so I've wondered if subjects like those I teach are partly to blame. When I discuss nutrition in class, for example, I try to make pupils aware of reading labels, so that they're aware of additives, etc.

    "Also, the media is full of research detailing what you should and shouldn't be eating, and I think young people take it all to heart. They can't just relax and enjoy food without analysing it."

    The bottom line

    There's never been a better time to eat healthily. Obesity stats are terrifyingly high (children as young as 11 are being diagnosed with type-2 diabetes, and heart attack rates continue to soar). So it's vital that we, and our children, are taught to distinguish good food from bad, and to understand that eating healthily prevents disease and prolongs life.

    But obsession is never healthy — whatever form it takes. It is equally important to understand that an obsession with good health can be as harmful as not taking care of your health at all.

    Article courtesy of Shape magazine.
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  • #2
    Fussy can be dangerous

    Filed: 01/11/2004

    Orthorexia – an obsessional interest in the quality and purity of food – can lead to severe weight loss and social isolation, writes Raj Persaud

    Never before have we been so obsessed with the quality of our food. We are concerned about whether it contains too much sugar, is too processed, whether it is genetically modified, organic or not.

    Orthorexic sufferers 'devote great mental energy to their strict dietary rules concerning food purity'

    These widespread worries appear to be producing a new eating disorder. Orthorexia is the expression used by eating disorder specialists to describe an unhealthy fixation with the purity and quality of food. This can lead to such an obsession with healthy eating that sufferers avoid most foods and have their lives seriously disrupted.

    Among the many consequences is a severe and dangerous loss of weight, though, more often, an orthorexic's fussy demand for nothing but "perfect" food leads to social isolation, as the sufferer won't indulge in the everyday dishes that friends and colleagues eat.

    You can get a sense of the new epidemic of milder forms of orthorexia when you try to order a meal with a group in a restaurant. More and more of us specify particular ingredients or the strict removal of others, or grill waiters as to exactly how the dishes are prepared and where the ingredients came from.

    But beneath the surface of milder orthorexic thinking lurk cases of more hardline sufferers, who devote great mental energy to their strict dietary rules concerning food purity and spend hours worrying about whether the next meal is going to measure up to their rigid standards.

    Dr Steve Bratman, the Colorado physician who coined the term orthorexia, has now drawn attention to one of the first patients diagnosed with the condition, who recently died of heart failure brought on by orthorexia-induced starvation.

    Kate Finn, who, like many orthorexics, had some connection with the "health industry", worked as a yoga instructor and massage therapist in California, and had been concerned for many years about balancing the correct proportions of carbohydrates, fats and protein in her diet. She seemed to move constantly from one "detox" or healthy eating plan to another.

    Although it seems that she died, eventually, from being too thin, Dr Bratman believes Finn wasn't afraid of being fat, as in classical anorexia nervosa. The tendency of orthorexics to waste away persuades some eating-disorder specialists that this may not be a genuinely new disorder, merely a form of traditional anorexia nervosa – where young women compulsively lose weight because of a pathological fear of fatness.

    Persaud: 'when was the last time you ate something without worrying whether it was good for you?'

    However, the underlying motivation is quite different. While an anorexic wants to lose weight, an orthorexic wants to feel pure, healthy and natural. Failing to understand this distinction may lead to incorrect treatment.

    A study just published by the Institute of Gut Sciences of La Sapienza University in Rome is the first attempt to measure the prevalence of orthorexia in the general population. Researchers found that up to seven per cent of the Italian population suffer from orthorexia nervosa; intriguingly, it was a misunderstanding of nutrition that seemed to be the most commonly found predisposing factor.

    This is a staggeringly high prevalence figure for a brand new disorder that did not appear in the academic medical journals until this year.

    It is possible that orthorexia is being fuelled by the health-food and alternative-medicine industry, whose advertising and "educational" messages stress the vital importance of getting the recommended daily allowance of vitamins and minerals. This, combined with burgeoning government and official medical warnings about the epidemic of obesity, is perhaps producing an unhealthy hysteria over what we eat.

    In the past, orthorexics were probably affectionately referred to as "health-food junkies", but now, doctors are increasingly realising that an obsession with healthy food can progress to the extent where it crowds out other activities and interests, impairs relationships, and even becomes physically dangerous.

    While there might be scepticism among some specialists about whether we need yet another "new" disorder, it is important to remember that the well-established and accepted category of bulimia nervosa - the eating disorder characterised by purging and vomiting to get rid of recently consumed food, in order to avoid weight gain - was first described as recently as 1979.

    It doesn't seem impossible that the current preoccupation with healthy eating could be nudging people towards illness, just as a preoccupation with emulating the looks of a stick-thin model can nudge young women towards bulimia.

    After all, when was the last time you ate something without worrying whether it was good for you?

    Raj Persaud is Gresham Professor for Public Understanding of Psychiatry and presents All in the Mind on BBC Radio 4
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    • #3
      Yellow is not the only colour

      Food faddism in California has reached new heights with reported outbreaks of 'orthorexia' - an enthusiasm for 'pure' eating that ranges from raw vegetable abuse to people who insist on ordering lunch in a particular colour. If this really qualifies as a dangerous eating disorder, how long will it be before we catch it? Self-confessed fussy eater Liz Jones reports

      Sunday September 9, 2001
      The Observer

      I'm sitting across the table from a powerful LA publicist in a s****y hotel on Sunset Boulevard. We're discussing which films will be hot this autumn, while the waiter hovers ready to take our order. 'Hi, Renaldo,' says the publicist, 'I would like the organic greens, torn not chopped, do you know when they were harvested?' He doesn't.

      'Then I would like the steamed vegetables, no peppers or tomatoes, make sure the pot is not aluminium, the whole-grain rice steamed, and a sealed bottle of organic rain water...' The publicist tells me that since she started eating 'live foods' - not, I hasten to add, meaning fish that still thrashes about on your plate, but a diet mainly consisting of raw vegetables, fruit, sprouts, soaked grains, seeds and nuts - she has cleansed her body of toxins and impurities, and now has so much energy she hikes before breakfast. I decline to ask what exactly it was she ate for breakfast, but I'm sure it wasn't a bowl of Coco Pops.

      In America, extreme fussiness about food has suddenly become very fashionable indeed; it now even has a brand new name, is struggling to become recognised as a bona fide eating disorder, and has the medical establishment scrabbling for answers. What can often be a debilitating phobia about food - and carry severe health risks - is having an even bigger problem being taken seriously. This extreme phobia about food isn't about weight loss but about adhering to as pure a diet as possible, and its new name is 'orthorexia nervosa', from the Greek word 'orthos', meaning correct. Being orthorexic isn't about being a gastronome, either - taste, texture and variety don't come into it.

      'The most extreme case I have ever had,' says Steven Bratman MD, a Californian practitioner in alternative medicine who first coined the term in 1997, 'is a patient who would only eat food that was yellow.' He has even written a book on the subject - Health Food Junkies: Overcoming the Obsession with Healthful Eating (Doubleday). Bratman first came across the problem when living in a commune in upstate New York during the Seventies, where he was a cook and organic farmer. All he could think about was food. After two years, he realised it would be healthier to enjoy a pizza with friends (processed cheese, refined flour, tomatoes!) than to eat bean sprouts alone.

      'Orthorexia begins innocently enough,' he says, 'with a desire to lose weight, cure digestive problems, live healthily. But the orthorexic is plunged into gloom if he or she lapses; they spend an inordinate amount of time planning meals and shopping.'

      Dr Bratman believes that people who are obsessed with eating 'healthily' have a real problem, and should be taken as seriously as an anorexic or bulimic. They tend to spend their time alone indoors contemplating their bean sprouts, condemned to a diet of boredom and roughage. Extreme diets that set out to be a way of eating healthily first took off on the West Coast of America in the Sixties: there were vegetarians and vegans, of course, but there were also the non-garlic, non-onion aficionados, who believed that bulbs increase sexual deviancy; there were the raw foodists, who would only eat uncooked vegetables which were preferably torn or snapped, not chopped, as cutting destroys a food's 'etheric field', a new age health concept. Macrobiotics would eat cooked vegetables, but no fruit, and wouldn't touch deadly nightshade plants, such as tomatoes, peppers and aubergines. Some would eat only fruit and vegetables in season. Some only fruit or vegetables 15 minutes after they had been pulled from pristine soil. Some refused to eat food that had been boiled. For some, fasting on oranges was healthy; milk caused mucous and cancer; pasteurised milk was even worse...

      But it seems that extreme diets, especially now they have an all-embracing name, are mushrooming, and not only in the US - Dr Bratman has had desperate e-mails from men and women all around the world. His book, which recommends a more 'normal' and varied approach to eating, is almost alone among the hundreds of others on sale that advocate often dangerously exclusive diets, from Intuitive Eating by Humbart Santillo, to Herbert Shelton's Fasting Can Save Your Life. Take, for example, the pattern of eating described in the book Fit for Life by Harvey and Marilyn Diamond. They advise what they have coined a 'Natural Hygiene' approach of just fruit for breakfast, a light lunch such as salad and then heavier, protein-type foods (grains and pulses) at dinner. There are also numerous websites for the food phobic, such as, where people swap ideas, food diaries, diets and recipes.

      There are many people who genuinely believe they have a problem, and that they are often not getting the help they need. Kate Finn, a 34-year-old massage therapist who lives in Venice, California, has not eaten normally for a decade. 'I am an orthorexic. I had a digestion problem, and tried to control my diet more and more, but I never reached a point where I felt OK. My friends and family all thought I was anorexic - I'm the only woman I know who's trying to put on weight. I was scared of losing control. I felt I needed to seek help, but I didn't know where to go.

      'As a child I ate normal things, I went to McDonald's, but when I was in high school I was semi-vegetarian, and became very interested in looking after my health. I was never really extreme, until I started to get some health problems with my digestion; I would feel bloated and sluggish. I got into the raw foods theory when I was in my late twenties and would only eat raw vegetables and raw fruit, with a small amount of grains and nuts. I felt better at first, then really weak, and my digestion problems came back. I became cut off from other people. Everyone was commenting on the fact I was getting so thin.'

      What advice would Dr Bratman give her? Treatment involves 'loosening the grip. Diet is important, but isn't it also important in life to have some spontaneity, some enjoyment?' For most people, he says, making the change is a big step. 'It has been so long since they've eaten spontaneously. They don't know where to start. It's very tricky.' 'I still think about food a lot,' says Kate. 'The other night I ate some ice cream and the next day I woke up and felt really awful physically. It made me want to swing the other way, it made me want to never eat anything that isn't pure and healthy.'

      But should these restrictive, and very often unhealthy, patterns of eating really be called an eating disorder? Many experts both here and in America think not. Kelly Brownell, PhD, director of the Centre for Eating and Weight Disorders at Yale University, says: 'In a year's worth of work in our clinic, I don't know that we would see a single person that fits Bratman's label. Without research to back his theory, Bratman is simply another guy trying to make a buck off the health-conscious public.

      'Some diets, while sounding healthy, pose real dangers if a balance of nutrients is not consumed. The phenomenon Dr Bratman has observed does occur, but whether enough people are similar in ways that justify a new label is not known. Research is necessary before one begins to label people. This in itself can have damaging consequences. Bratman has not done the necessary work.'

      Dr Brownell believes that obesity, and a disinterested approach to food, is far more damaging - after all, one third of Americans are clinically obese, and less than 5 per cent of Americans exercise regularly. 'Obesity dwarfs eating disorders in public health significance because of the number of people affected, and the damaging medical consequences. Anything that brings about healthier eating in the population is good in my mind.'

      Steve Bloomfield, spokesman for the Eating Disorders Association in the UK, goes even further. 'Orthorexia was made up by a writer to make his book sell,' he says, sounding exasperated. 'It didn't exist before he invented it. Eating disorders are defined by the American Psychiatric Association in a document called DSM4, which is recognised by the World Health Organisation.'

      He says that orthorexia is not an eating disorder because it doesn't start with low self- esteem. 'Orthorexics believe, "My body is a temple, I must eat only high-quality food".' He does concede that orthorexia can lead to an eating disorder, as the diet becomes more refined and compulsive; and from a parent's or partner's point of view, it can appear similar to anorexia.

      'I am not saying food fads or phobias don't exist, just that the name "orthorexia" is not yet recognised. We had phone calls when Bratman's book was published from people who were concerned,' he says. 'The issues he raises are real, and calling it orthorexia nervosa gained him interest, but it is a made-up name.' But wasn't the term anorexia poo-pooed for many years by the medical establishment? In the first part of the twentieth century, young women were said merely to have wasted away. But today, particularly in America, where health care is covered by cautious and powerful insurance companies, it is difficult to get recognition for what could be a real health problem. In 1958, Albert Stunkard published a paper called Night Eating Syndrome, a variant of bulimia. The diagnostic criteria for the syndrome was only published after he presented his evidence at the Eating Disorders Conference in April 1999. It had taken him that long to come up with sufficient evidence. The US Psychiatric Association will test it, and in five or so years' time it might be included in an updated version of DSM4. Only then will sufferers be able to seek treatment. Steve Bloomfield says that the lengthy, painstaking research necessary for an eating disorder to be recognised is vital to ensure that any treatment is appropriate. He also points out that the EDA is a charity, which therefore must first and foremost help those with eating disorders that are already recognised. Last year alone, the number of calls from sufferers of anorexia and bulimia increased by 8-10 per cent. But he stresses that people who are worried about their eating habits are welcome to call the EDA, if only to be reassured. And that not all eating disorders take as long as night eating syndrome to be accepted. Bulimia, first written about in 1978, was acknowledged quickly because of the overwhelming evidence.

      It does seem that the number of people who are seriously worried about the quality of what they put in their mouths is increasing. Sainsbury's, whose own-brand products have been GM-free since 1999, has noted a fourfold increase in sales of organic food since 1996, and across the food industry in Britain organic sales have risen by 55 per cent in the past year alone. There are already plans afoot to set up a British equivalent of the Food and Drug Administration (FDA) in the US.

      But what type of person would turn an understandable concern about eating healthily into an obsession, who could, one day, be called orthorexic? Peter Smith, manager of the Eating Disorders Unit at the Priory Hospital in Roehampton, believes people who are fussy about food are probably overly concerned with their health, and faddy in other areas of their lives. 'Of course people in Britain are more aware of what they put in their body. They read about food scares in the papers every day,' he says. 'But you need an extra factor to trigger a phobia or fear - that could be a genetic predisposition; a personality that is a perfectionist, someone who places unrealistic demands on themselves; add in social pressures, and there could be a biological factor as well.'

      Orthorexia could simply be a fanciful American term for a phobia about food, but Smith agrees that there are comparisons with other eating disorders, including anorexia and bulimia. 'The sufferer is emotionally fixated on food, fixated on controlling what they eat; they also fool themselves into thinking that what they are doing must be good for them,' he says. 'The Priory treats people with a fear of food in the same way as it treats other eating disorders: we ask the patient to hand over control of their diet, while we try to uncover what drove them into a strange eating pattern in the first place. Eventually, we would take them out to Pizza Express, to try to get them to eat in a normal situation.'

      • Eating Disorders Helpline: tel 01603 621414

      Life as an orthorexic
      Liz Jones

      At last, those of us who are pernickety about our food can come out of the closet. But when does a desire to eat well become an unhealthy obsession? I am no stranger to food disorders. I became anorexic at about the age of 11, an illness that continued into my late twenties. Although I now no longer want to lose weight, that obsession with food has never gone away. I do not want to lose control of what I eat - I could never eat a whole bar of chocolate, or a tub of ice cream - and so the need to monitor the purity of what I eat has replaced mere counting of calories.

      I became vegetarian at about the age of 12, mostly because I found the idea of eating animals repulsive, but also to get me out of potentially fattening family and school dinners. I am now vegan, which makes me a very difficult dinner guest indeed. If I was invited for lunch at Nigella Lawson's, I would have to ask her if she had lied about using anchovy in the sauce. Going to restaurants is very difficult indeed; if they have a vegetarian option on the menu, it is often a cheese-endowed cholesterol fix. Even if they do come up with a plate of grilled vegetables (I would leave the onion, aubergine and giant mushroom on my plate), I always leave the table hungry.

      And I worry about the serving area; have they sterilised the knife, or used a separate chopping board, for example? The waiters at most eating establishments roll their eyes towards heaven when I enter; at my local Pret A Manger, staff know to make my coffee with Evian, and not to touch their faces with their hands. As an anorexic, I looked down on people who ate heartily; I think orthorexics like being awkward and see people who eat what I would term 'rubbish' food as weak and unhealthy.

      So how does this obsession manifest itself? Well, being vegan rules out an awful lot of foodstuffs; but I also only buy organic fruit and vegetables, and I would rather die of thirst than drink tap water. I have tried to loosen up and now drink the odd glass of white wine, though I insist that it be certified vegan (I make the young man at the Majestic warehouse look up the bottles in his catalogue). And I'm afraid I inflict my fears on my cats as well - they never eat ordinary cat food, only organic human food with supplements.

      Do I want to seek treatment? No, I eat very well, but recently have been getting worse. When ordering a salad, I suddenly have a thing against spiky leaves. I do not like fennel. Or wild mushrooms. Or big tomatoes (baby plum are fine). Or peppers. Or spring onions, olives and cauliflower. Or biscuits. I love the feeling of being disciplined. As Renée Zellweger said when she had to pile on the pounds to become Bridget Jones, food loses its appeal when you know you can eat what you want. I don't know about orthorexia, but it's great having an excuse for being fussy. I know I should learn to relax. And though I will never eat meat, fish or dairy, I do hope that one day I will be able to eat a Chunky KitKat or an unwashed grape.,00.html
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      • #4

        23 August 2005
        By Helen Carroll

        Endless diet crazes have made us all aware of healthy eating. But these three women became dangerously obsessed with low-fat food - and seriously damaged their health.

        I banned 'bad foods'.. now I'm 5st
        JANET Hackney, 42, is single and lives in Uttoxeter, Staffordshire.

        It's strange but I was only 10 when I became aware of healthy food. While other children were tucking into cakes, biscuits and sweets, I wanted to eat fruit instead.

        I don't know how it all started because both my parents enjoyed their food, ate a rounded diet and were a healthy weight. But by the time I'd reached my teens, my diet had taken over and I'd cut out all high-fat foods, such as butter, cheese and pastry, from my meals.

        As much as I felt good about eating healthily though, my body felt weak. I was constantly picking up bugs and viruses and I had to take so much time off work I eventually quit my job because I wasn't there enough.

        My attitude to only eating healthy food became an obsession. My doctor diagnosed me with the eating disorder anorexia nervosa. Back then nobody had heard of orthorexia nervosa ( see box, top right) but I think that more accurately describes my condition as I was always more interested in eating healthy foods than starving myself.

        My condition has put a big strain on my personal life. Small things like going to restaurants are out of the question as I don't know for sure what's in the food. In fact I find it hard to eat food prepared by anyone but myself, in case it's been fried in fat or there's butter in the vegetables.

        I'm 5ft tall and weigh 5st 5lbs, which I know isn't enough. My periods are very erratic.

        I try to force myself to eat crisps or chocolate buttons but if I do, I suffer terrible self-hatred afterwards because I can't bear the thought of having those 'bad foods' in my body. I've also developed osteoporosis, which means my bones are thinning due to a lack of calcium in my diet.

        I know rationally that eating so little isn't good for me but breaking the habit now seems impossible."

        Low-fat diet has stopped my periods

        STEPHANIE Margaronis, 19, is a student from West London.

        My obsession with healthy eating started when I was 15 and training as a track runner.

        My trainer referred me to a dietitian to help me get in the best shape possible and he drew up a low-fat eating plan of skimmed milk, cereal, chicken, turkey, steamed rice and vegetables.

        At the time my body fat level was already too low at 20 per cent - it should be more like 25 per cent.

        For the first two months on my diet my periods were very light. By the third month they had completely stopped.

        I'm 5ft 7ins tall and although I weighed a good 9st, there wasn't an inch of fat on my body because the training had made me so muscular.

        I was obsessed with only eating food the dietitian deemed healthy and wouldn't allow myself any fat or sugar. I loved chocolate, crisps and puddings but I couldn't bear to eat even tiny amounts.I developed dry flaky skin on my arms and legs. My mum tried to encourage me to have some oil and cheese so that I had more fat in my diet but I refused.My parents wouldn't force me to eat anything I didn't want because neither wanted me to blame them if I gained weight and lost a race.

        After six months on the diet my body fat had gone down to 13 per cent and my absent periods were becoming a worry.

        I went to see a gynaecologist who said my hormone levels were so low I wasn't ovulating. She told me to stop running and change my diet. But I'd just started to do well in my races so I couldn't give up.

        So I started taking the contraceptive pill and even though that meant I still wasn't ovulating naturally, I felt reassured when my period came every month.

        It wasn't until I was 18 and stopped competing that I started to think about my health. I stopped taking the pill but, even though I was no longer training, my periods didn't return.

        My gynaecologist has recommended I start eating more to trigger my body to start ovulating again. But even now I can't bring myself to eat anything that contains more than three per cent fat.

        I survived on just 300 calories a day

        LOTTI Brunsdon, 30, is a TV engineer from Malvern, Worcestershire. She lives with her partner, Lee.

        At 19 I moved away from home and started cooking for myself. But as I planned out my meals, I thought: 'I'm not going to allow myself to be unhealthy.'

        I cut out chocolate, biscuits and cakes from my diet. Knowing my body was free of sugar gave me such a buzz, I started thinking about all the other foods I was eating.

        I'd spend hours in the supermarket, checking the E numbers and fat content of everything and only chose foods with the very lowest fat content.

        Before long I'd cut my diet down to just a few foods - cereal, fruit and pasta with vegetables. Most days I survived on just 300 calories, and on the rare occasions I allowed myself something with any fat in it, I'd run up and down the stairs to burn it off.

        Because I was living alone nobody knew how little I was eating. I quickly lost a stone and went down to just 9st - an unhealthy weight for my 5ft 9in height. My family and friends all remarked on how skinny I looked.

        Being thin wasn't my motivation but it made me feel good because it proved I was healthy. But the truth is my body was deteriorating. My periods became irregular - I only got one every three months. Then I started to black out from lack of food. I would faint at work, on trains, and even in checkout queues.

        The fainting became so regular I had to introduce more food groups into my meals. But my poor diet had already caused serious damage. My lack of nutrition meant I had a low blood sugar level and I was diagnosed with hypoglycaemia.

        Because of this and to avoid fainting I now need regular amounts of slow-release carbohydrates, like bread and bananas, as well as protein. I can't have high-sugar foods, like chocolate, and only small amounts of alcohol.

        My so-called 'healthy' diet means I'll be dealing with my health problems for the rest of my life.


        OBSESSION with healthy eating has a name - orthorexia nervosa.To see if you're a sufferer, answer the following questions set by Dr Steve Bratman.

        1. Do you think about food for more than three hours a day?

        2. Have you planned today the food you will eat tomorrow?

        3. Do you care more about the fat content of what you eat, rather than whether you will enjoy it?

        4. Have you found that although the foods you eat are healthy, you actually feel unhealthy?

        5. Do you get stricter on yourself the more you eat "bad" food?

        6. Do you turn down offers to go out for meals because you're worried you won't know how healthy the food is on the menu?

        7. After a healthy meal do you get a big boost in self-esteem? Do you look down on others who don't eat healthily?

        8. Do you feel racked with guilt when you eat "unhealthy" food?

        9. Does your diet stop you going out with friends?

        10. When you're eating the way you're "supposed" to eat, do you feel a sense of total control?

        If you answer "yes" to more than four, you may have orthorexia nervosa. Contact the Eating Problems Service on 020 7602 0862 or visit
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        • #5
          Orthorexia Nervosa: Does This Disorder Deserve Recognition?

          A name has been given to an alarming new eating trend linked to the health industry's growing emphasis on the importance of getting the daily allowance of vitamins and minerals.

          Orthorexia nervosa, a term coined by American physician Dr Steven Bratman, author of the book Health Food Junkies , refers to an unhealthy fixation with the health value and purity of food. In December 2003, American health fanatic Kate Finn, one of the first people to be diagnosed with orthorexia, died from heart failure brought on by suspected orthorexia-induced starvation.

          While not yet an officially recognized disorder in the psychiatric literature, the disorder is similar to other serious dietary diagnoses such as anorexia nervosa. According to Dr Bratman, obsession with healthy food can progress to the point where it crowds out other interests and even becomes physically dangerous and orthorexia takes on the dimensions of a true eating disorder, like anorexia nervosa or bulimia.

          But the so-called orthorexics are obsessed with food quality rather than with their body image, often avoiding caffeine, preservatives, salt, and sugar in their diet. While it is perfectly normal for people to change what they eat to improve their health or lose weight, orthorexics take the concern too far until it becomes a pathological obsession. Sufferers avoid most foods, can experience severe weight loss, and often become socially isolated as they refuse to eat the same everyday meals as friends and family.

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          • #6

            OBSESSION with healthy eating has a name - orthorexia nervosa.To see if you're a sufferer, answer the following questions set by Dr Steve Bratman.
            Bring it on.

            1. Do you think about food for more than three hours a day?
            Yeah, and mostly during lectures or when at 'work'.

            2. Have you planned today the food you will eat tomorrow?
            Yeah, it's either pizza, doner kebabs, or pizza. Maybe chocolate if I have spare change.

            3. Do you care more about the fat content of what you eat, rather than whether you will enjoy it?

            4. Have you found that although the foods you eat are healthy, you actually feel unhealthy?
            Not applicable, but for the record I'll start feeling unhealthy when I'm dead.

            5. Do you get stricter on yourself the more you eat "bad" food?
            Yep, I make a mental note to never again buy a kebab from that guy.

            6. Do you turn down offers to go out for meals because you're worried you won't know how healthy the food is on the menu?

            (A word of caution: If going out to an Indian Restaurant, stick with tandoori chicken and naan, you'll never go wrong,)

            7. After a healthy meal do you get a big boost in self-esteem? Do you look down on others who don't eat healthily?
            No. My self-esteem is boosted by playing Counterstrike.
            I look down on people who force themselves to eat healthy, somebody forgot to tell them that today's banana isn't gonna save them from somebody else's stupidity (and their ability to harm you).

            8. Do you feel racked with guilt when you eat "unhealthy" food?
            Yep. Especially when nature calls soon after.

            9. Does your diet stop you going out with friends?
            That depends on whether they want a free slice of pizza.

            10. When you're eating the way you're "supposed" to eat, do you feel a sense of total control?
            No. My sense of total control is based on forcing traffic to stop by rearranging road signs :D

            If you answer "yes" to more than four, you may have orthorexia nervosa. Contact the Eating Problems Service on 020 7602 0862 or visit


            Oooh, 5 and a half Yes's. I better get in touch with these people...Wish me luck!
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