Ongoing coverage of orthorexia — an obsession with eating only healthy or "pure" foods — illustrates how much we still suck at talking about eating disorders.
As with pretty much every eating disorder trend piece ever, Time's "Orthorexia: Can Healthy Eating Be a Disorder?" starts by profiling a young woman and how little she eats. Writer Bonnie Rochman details orthorexic Kristie Rutzel's "strict raw-foods diet" and — as is de rigueur — gives us the chillingly low weight she hit before seeking help. Rutzel's suffering was real, but Rochman's treatment of it is a little tired, not to mention triggering. She approaches her subject seriously, but coverage of "new" eating disorders (pregorexia, drunkorexia) can make them sound sort of like fads. As Jezebel's Jennifer once wrote, "Anorexia is out and orthorexia is in."
Of course, that was back in 2008, and clinicians and patient advocates still can't agree on whether orthorexia is a distinct disorder. Rutzel, for her part, appears to have lost enough weight that she would have qualified for a diagnosis of anorexia, but the restrictive behaviors associated with orthorexia can cause isolation and anxiety even if they don't result in severe weight loss. We should probably know by now that you don't have to be underweight to suffer from eating disorders, but as Rochman's article shows, even doctors are still in the dark about how the disorders work and how to treat them. Of orthorexia treatment, Kathleen MacDonald of the Eating Disorders Coalition says, "It's hit-or-miss."
It's no wonder that articles about orthorexia sometimes feel sensationalistic — as yet, there's little of substance to say. Despite the efforts of the Coalition, the disorder probably won't be listed in the DSM-5, because it simply hasn't been researched enough. As Abby Ellin's recent piece on the classification of Eating Disorder Not Otherwise Specified makes clear, those whose eating issues don't fit the relatively rigid criteria set forth in the DSM-IV often find themselves misunderstood by doctors and peers alike. It's easy to say the solution is more research, and that's certainly part of it. But I'd argue that we also need a more holistic understanding of what constitutes healthy eating, one that incorporates not just weight but also all the social and psychological implications of food. Perhaps if we had a better idea of what "ordered" eating was, then we wouldn't have to keep talking about "new" eating disorders like they were the season's latest shoes.
Related: Healthy Food Obsession Sparks Rise In New Eating Disorder [Guardian]