Causes of dietary fanaticism

31 October 2002

Published in The Age

Results from a radical new diet can, at first, be breath-taking. Juice fasters, fruitarians, vegetarians, vegans and others frequently experience an initial, pronounced change for the better. More energy, better mood and weight-loss are common.

Indeed the results are often so good that dieters can’t envision abandoning the diet which “saved” them. Self-imposed regulations are tightened. Dedication and certainty deepen. Dietary deviations are reduced - eventually toward vanishing point.

Given a few months, where can all of this end up?

“Many of the most unbalanced people I have ever met are those who have devoted themselves to healthy eating,” writes Dr Steven Bratman, an author and dietary medicine practitioner in Colorado, USA. “In fact, I believe some of them have actually contracted a novel eating disorder for which I have coined the name orthorexia nervosa. The term uses ortho means straight, correct. Orthorexia nervosa refers to a pathological fixation on eating proper food.

“Where the bulimic and anorexic focus on the quantity of food, the orthorexic fixates on its quality. All three give food an excessive place in the scheme of life. The transference of all of life's value into the act of eating makes orthorexia a true disorder.”

One with more experience than most in combatting dietary extremism is Australian nutritionist Dr Rosemary Stanton. What did she think might be the syndrome’s underlying psychology?

“There are those with obsessive personality traits,” Stanton says, “and they turn these to food - rather than food being the primary causative factor. A lack of self-esteem seems to be behind many people's need to follow some strange diet fad. They are easily convinced by someone selling something. A lack of knowledge about health in general, and food in particular, makes them easy prey.”

Like religious and political extremism, “orthorexic” dietary obsession often involves camouflaging psychological problems with an outward “purity”. It’s a problem mirrored in more mainstream weightloss diets too. A 1998 study by Professor Sue Popkess-Vawter at the University of Kansas, in the US, revealed that 90-95% of all such diets fail. This was because the diets addressed merely the physical aspect of over-eating - rather than the psychological and social dimensions, where the problem had its roots.

Where weightloss diets fail banally (most dieters simply remain overweight), “orthorexic” diets can fail spectacularly: as with the Australian fruitarians whose teeth fell out, the vegan toddler who developed rickets, and the American “instincto” (raw flesh eater) who nearly died from the parasites in the squirrels he hunted.

A person highly familiar with such disaster stories is US author Ward Nicholson, who has written extensively about dietary extremism. Nicholson is a former leader of the US “Natural Hygiene” movement, and an ex-vegan-raw foodist. He agrees that religious and dietary zealots have much in common:

“Everything you can get out of a theological religion, it seems you can get out of a dietary religion. Guilt, redemption, salvation, heroes and heroines to emulate, a supreme end-state perfection to strive for, being one of the ‘chosen’, a behavioural morality to judge oneself and others by, a worldview that explains evil - why people become sick and die - and how to conquer that evil. You can even be a guru and save your friends.”

From Nicholson’s observations, the most damaging diets over time are fruitarianism, strict macrobiotics and raw-food veganism. Initially, he believes, the mental narrowing caused by fanaticism is the biggest problem: but medical complications take over in time.

“Fortunately, most people quit these diets before they get in a bad way. In the beginning you have all these newbies who after six months are ‘experts’, and full of arrogance that puts both themselves and others on the road to trouble.”

Until 1997 Nicholson co-ordinated America’s M2M newsletter, where fruitarians, raw-fooders, vegans and others shared their experiences. A few thrived long-term on these diets, he says. But after two years “they often start suffering from one or more of the following symptoms: They may lack energy, or their stools will become chronically diarrhoea-like, they feel hungry all the time, they may not be able to maintain their weight without struggle, or they develop B12 deficiency, lose sex drive, fatigue easily, and/or develop insomnia or a hyper-reactive nervous system”.

The illnesses are often rationalised away, Nicholson says - most commonly as “detoxification” brought on by the diet. The ubiquitous idea of “detox”, he says, “is a way of reducing most dietary questions to a single criterion by which diets and symptoms can be judged”.

Such rationalising can be dangerous, because it helps dieters not to look at the possibility of deficiency, and of metabolic imbalances: “hyperinsulinism, omega-6/omega-3 imbalances, mineral imbalances, and so forth”.

“The worst medical effects I've seen,” says Dr Steven Bratman, “end up being very similar to anorexia.”

Once you’re in that spiral, what’s the way out?

“That’s a hard question!” Dr Bratman says. “There's no easy way out. Increasing honest awareness of the situation is the first step. I use the analogy to workaholism. Once you begin to be aware that perhaps it's not a virtue to work ninety hours a week, you have a chance to change.”

Ward Nicholson feels that “the majority of people eventually burn out from the exhaustive focus it takes to be an extremist, although it takes longer for some than others”.

“In addition to psychological burnout, many people approaching the age of forty begin to find their body doesn't tolerate a strict or deficient regime as well anymore - so their well-being starts to suffer. It's at that point reality often begins
to set in.”

Since defecting from it, Nicholson has taken on America’s longest-established “reformist” health regime, Natural Hygiene - a diet of mostly raw-food vegetarianism. NH, he believes, often flies in the face of evolutionary good sense. (NH has influenced the Australian naturopathic approach to diet.)

What brought an end to his faith?

“After less than a year on a raw-food diet, I could see my health was going downhill. I then moderated to conventional veganism, which was better, but after a year or two of that, and continued stagnation, I abandoned it as well.”

“One of the cardinal signs of extremism is that it distorts your relationships with the people in your life. You become more isolated, smug or argumentative, concerned with being right, milking your feelings of superiority. Perfectionism is a great burden. It means if you slip up, you can't let other people know. Or if you do let them know, you feel you have screwed up or failed somehow.

“I’m glad those days are behind me. Being an extremist is being ‘stuck’. It feels a lot better to keep moving, growing, learning, going beyond where you were before. Having plenty of questions to ask that are still unanswered touches you into a dimension that is rewarding in a different way from certainty. Certainty gets boring, stale and claustrophobic.”

Today, Nicholson’s advice to those slipping into dietary fanaticism is simple: “Put results before theory.”


Dr Bratman’s book on orthorexia nervosa: stevenbratman@orthorexia.com

Ward Nicholson’s website: www.beyondveg.com