Who is Dr. Steven Bratman?
Dr. Steven Bratman is an American physician and author who has been a central figure in defining and raising awareness about orthorexia nervosa. Practicing holistic medicine, he began to notice a pattern among some of his patients: an excessive preoccupation with the healthiness of the foods they consumed. Unlike traditional eating disorders that often focus on weight or body image, these individuals were primarily concerned with the quality, purity, and nutritional content of their food. He found that this obsession, initially rooted in a desire for optimal health, could spiral into a pathological condition with severe physical and psychological consequences. His personal experiences with restrictive dieting in the 1970s also informed his understanding of the phenomenon.
The Coining of Orthorexia Nervosa
Bratman officially introduced the term "orthorexia nervosa" in his 1997 article for Yoga Journal. The name itself is derived from Greek roots: "ortho," meaning "right" or "correct," and "orexis," meaning "appetite". The term literally translates to "correct appetite," but the "nervosa" suffix, borrowed from "anorexia nervosa," indicates an unhealthy, compulsive psychological state. His work shed new light on how an seemingly virtuous pursuit of healthy eating could become a life-consuming obsession. Following the article, he co-authored the book Health Food Junkies: Orthorexia Nervosa–Overcoming the Obsession with Healthful Eating in 2000, which further explored the condition and its impact.
The Impact of Social Media
While Bratman first defined orthorexia before the rise of social media, the internet has significantly amplified the issue. Wellness blogs, "clean eating" trends, and fitness influencers frequently promote extreme dietary practices that can contribute to the development of orthorexic behaviors. The constant stream of unscientific health claims and idealized lifestyles can make it difficult to distinguish between genuine health consciousness and the beginnings of a disordered eating pattern. For susceptible individuals, this online culture can reinforce rigid dietary rules and perfectionist tendencies, exacerbating their obsession.
Orthorexia Nervosa vs. Other Eating Disorders
It is crucial to understand the distinction between orthorexia nervosa and other, more widely known eating disorders, such as anorexia and bulimia nervosa. The key difference lies in the underlying motivation driving the disordered behaviors. While there can be significant overlap, the focus of the obsession is fundamentally different.
| Characteristic | Orthorexia Nervosa | Anorexia Nervosa | Bulimia Nervosa |
|---|---|---|---|
| Primary Motivation | Fear of poor health from 'impure' foods; pursuit of 'perfect' health | Intense fear of gaining weight; drive for thinness | Binge eating followed by compensatory behaviors like purging |
| Focus | Quality, purity, and healthiness of food | Quantity of food and calories consumed | Quantity of food (binging) and body weight |
| Body Image | May or may not be a significant factor; obsession is not about body shape or size | Central preoccupation with body shape and weight; distorted body image | Central preoccupation with body shape and weight |
| Feelings | Guilt, shame, anxiety over eating 'unhealthy' foods | Intense fear and anxiety around food and weight | Guilt and shame following binging episodes |
The Journey to Clinical Recognition
Despite the significant clinical interest and growing public awareness since Bratman's introduction of the term, orthorexia nervosa is not yet an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is often classified as "Other Specified Feeding or Eating Disorder" (OSFED) or is viewed as a form of obsessive-compulsive disorder. Researchers continue to debate and refine the diagnostic criteria, but its clinical relevance is widely accepted among eating disorder specialists. The ongoing research aims to better understand the condition and ensure appropriate treatment can be provided.
Common Symptoms of Orthorexia Nervosa
Recognizing the signs of orthorexia is the first step toward seeking help. Unlike a healthy interest in nutrition, orthorexia involves an obsessive, restrictive pattern of behavior that negatively impacts one's life.
- Compulsive checking of ingredient lists and nutritional labels.
- An increasing number of eliminated foods or food groups (e.g., all sugar, dairy, meat, gluten).
- Intense anxiety or emotional distress if strict dietary rules are broken.
- Avoidance of social situations involving food that doesn't meet personal standards.
- An exaggerated sense of superiority over those who eat "unhealthy" foods.
- Severe physical health consequences, including malnutrition, caused by excessive restriction.
Conclusion
Dr. Steven Bratman's introduction of the term orthorexia nervosa in 1997 was a landmark moment in the recognition of this serious eating disorder. By identifying the distinction between a healthy interest in nutrition and a pathological obsession with food quality, he paved the way for a deeper understanding of disordered eating. While not yet an official diagnosis, the concept of orthorexia nervosa has gained wide acceptance in the medical and psychiatric communities, highlighting the importance of treating the motivation behind restrictive eating behaviors rather than simply the physical symptoms. The growing influence of social media and "clean eating" culture underscores the continued relevance of Bratman's work in understanding how the pursuit of health can paradoxically become a source of harm. For more information, the National Eating Disorders Association (NEDA) is an excellent resource on orthorexia and other eating disorders.
