There are two answers to this question: yes and no. Yes, because there is a simple 10-item questionnaire that can indicate whether your healthy eating has turned into an unhealthy obsession. No, because Orthorexia Nervosa is not a clinically recognised eating disorder and there are no accepted diagnostic criteria.
The questionnaire is called The Bratman Test and was created by Dr Steven Bratman as a first attempt to assess whether someone’s attachment to “healthy eating” is in fact, unhealthy.
Dr Bratman created the term Orthorexia Nervosa in 1996, after his personal experience of “a phase of extreme dietary purity”, where he experienced intrusive thoughts of kale that prevented him from having good conversations with others.
The “ortho” part refers to the idea that a sufferer of this proposed eating disorder eats and drinks in a self-defined “correct” manner. This “correctness” can be seen to an extent in some modern diet trends, including the paleo, clean eating and raw movements. However, the level to which someone achieves correctness by restricting “unhealthy” grains / gluten / dairy / food or nutrient X in their diet can range from half-hearted attempts at healthy eating to something that is more sinister.
When trying to differentiate between “healthy eating” (which in many people is unnecessarily strict), and Orthorexia Nervosa, asking the following question is important: “Are my eating habits causing significant distress or impairment of my everyday functioning, e.g. socialising?”. The terminology “significant distress or impairment of functioning” is what is currently used for the clinical diagnosis of other eating disorders, such as Unspecified Feeding and Eating Disorder (UFED). Additionally, you can take The Bratman Test below.
The Bratman Test for Orthorexia
- Do you spend more than 3 hours a day thinking about your diet?
- Do you plan your meals several days ahead?
- Is the nutritional value of your meal more important than the pleasure of eating it?
- Has the quality of your life decreased as the quality of your diet has increased?
- Have you become stricter with yourself lately?
- Does your self-esteem get a boost from eating healthily?
- Have you given up foods you used to enjoy in order to eat the ‘right’ foods
- Does your diet make it difficult for you to eat out, distancing you from family and friends?
- Do you feel guilty when you stray from your diet?
- Do you feel at peace with yourself and in total control when you eat healthily?
- Yes to 4 or 5 of the above questions means it is time to relax more about food*.
- Yes to all of them means a full-blown obsession with eating healthy food*.
*The Bratman Test is not a robust, universally-accepted test. Completing it will only give you an indication of whether you are too focused on healthy food, it will not mean that you have Orthorexia Nervosa. It cannot diagnose Orthorexia Nervosa, partly because it is a proposed eating disorder that is not clinically recognised and there are no robust, accepted diagnostic criteria for it.
There is research currently underway to test more robust questionnaires and to find out whether Orthorexia Nervosa should become clinically recognised, or if it is an emerging part of currently defined eating or obsessive disorders (like Anorexia Nervosa, UFED and Obsessive Complusive Disorder). Time will tell.
If you think that you have a problem with your eating habits, please visit www.b-eat.co.uk and see a mental health professional, your GP or a dietitian. Life is too precious to not have a croissant now and then.
Rebecca Reynolds, MSc PhD RNutr, Lecturer and nutritionist, School of Public Health and Community Medicine, The University of New South Wales, Australia www.therealbokchoy.com
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