Eating Only What's Good for You Might Not Be

Katherine Seligman
c.2002 San Francisco Chronicle

      At the height of his dietary vigilance, Steven Bratman would eat only vegetables plucked from the ground 15 minutes earlier and chewed every mouthful 50 times. He agonized over whether to eat a piece of Kraft Swiss cheese, certain it would give him pneumonia.

      ``I was seriously orthorexic,'' said Bratman, who should know, because he invented the term for people whose obsessive quest for healthy food overtakes their lives. The former Bay Area health food junkie eventually went to medical school and later began noticing patients whose fanaticism mirrored his own.

      Five years ago he wrote a simple, semiserious article for Yoga Journal. The reaction astounded him. The piece drew responses from around the world, eventually being reprinted in Lithuanian, Portuguese and Spanish and prompting him to write a book.

      ``I'd try to tease my patients out of being so serious about their food,'' said Bratman. ``It was funny, really. Patients would come in and say, `I feel so terrible. I ate a piece of bread.' I'd say, `That's not your problem. You're an orthorexic.' I'd say it with a smile.''

      Orthorexia nervosa, the technical name, is not recognized in the treatment books of mental illness, but it is now mentioned in the online Oxford English Dictionary.

      Bratman said though serious cases are rare, he estimated close to half of his patients in the early 1990s had ``orthorexic tendencies.'' And there is certainly no shortage of people who encounter or experience it, particularly in the food-conscious Bay Area, home to myriad diet trends and movements and ``a hotbed'' of orthorexia, Bratman said.

      Even within some of those movements, there is a growing belief that adhering obsessively to any health food diet can have distinctly unhealthful ramifications. The head of San Francisco's raw food society admits her initial strictness almost made her ``an uptight little hermit,'' and a raw foodist in Alameda says her beginning zeal alienated friends.

      Tom Billings, a Berkeley computer consultant, admits to orthorexia along his own raw food odyssey, which included the all- fruit diet, the living foods diet and the natural hygiene-style diet. Though he is more than 6 feet tall, there were times he weighed less than 100 pounds.

      These days, at age 48, Billings has another diet. Or rather a nondiet. After decades of extreme food regimens, he now dines in a way that once would have seemed unthinkable - he eats what appeals to him when he's hungry.

      ``I'm a vegetarian, but I don't obsess about it a whole lot,'' said Billings, a co-founder of the Web site Beyondveg.com, which posts information on alternative diets. ``I eat raw foods and cooked foods. I'm not preoccupied with it like I used to be.''

      But plenty of people still are. Americans spend more than $30billion a year on diet products. Diet and nutrition books routinely land on best-seller lists.

      ``Many of the most unbalanced people I have ever met are those who have devoted themselves to healthy eating,'' said Bratman, 45, who lives in Fort Collins, Colo.

      Orthorexia is a catchy phrase for what many nutritionists already believe - that people who consume too much of anything, even if that thing is a carrot or wheat berry, might get bad results if they exclude other food.

      ``They end up on jags on these diets. It becomes almost a religion,'' said Carol Porter, director of nutrition services at the University of California at San Francisco Medical Center.

      Bratman, a graduate of the University of California at Davis medical school and medical director of the Web site Natural Pharmacist, said most orthorexics embarked on diets with the desire to improve health and lose weight.

      They kept to The Zone, Eat Right for Your Type, macrobiotics, raw cuisine. But they began spending excessive time planning, thinking about, buying and preparing their food. They felt morally superior when they were strict and guilt-ridden when they cheated with forbidden items. They evangelized and ultimately alienated friends and family.

      Though Bratman has seen cases of severe malnutrition, he does not consider orthorexia as dangerous as anorexia or bulimia. But he believes it is no less real.

      His own fixation began in the early 1970s, when he lived in Santa Cruz and began to meet people who took healthy eating seriously.

      ``I was having friends over to my house one night and someone looked in my cupboards and shrieked, `Look what he has!''' recalled Bratman. ``It was a can of Nally's Beef Stew.''

      So began his education about the world of natural foods. It led him to a diet of vegetables, then raw food. Eventually he moved to a commune in New York, a magnet for food idealists, he said.

      As a staff cook there, he had to prepare separate meals for the raw food eaters, vegetarians who wanted cooked food, the no-animal-product vegans and the crowd that eschewed garlic and onions. He remembers how a visitor insisted that slicing vegetables destroyed their ``energy field.''

      That kind of detail resonated later, when he was a doctor and began to see what he would later call orthorexia.

      His 2000 book, ``Health Food Junkies/Orthorexia Nervosa: Overcoming the Obsession With Healthful Eating,'' published by Broadway Books in New York, led to television appearances, magazine articles and a review in the Journal of the American Medical Association. He got letters and phone calls from people who said he saved their lives or thought he was an extremist or ``an infidel.''

      ``The book turned me around,'' said Troy Gilchrist, co-author of a book called ``NeanderThin: A Caveman's Guide to Nutrition,'' which touted a meat-heavy diet. Gilchrist ate slabs of meat, up to three pounds daily, for 10 years. Then he began developing gout- like symptoms and skin problems.

      ``I figured part of it was such a rigid and unvaried diet, so I decided to try and not be so rigid,'' said the Kansas resident. ``I'm a recovering orthorexic. I need to watch everything I'm eating, down to a gram of carbohydrate and fat. Those feelings are still with me, but they are no longer the first thing I think about.''

      Bratman says his criticism is aimed at such fanaticism, not at any specific diet.

      ``I'm not saying you shouldn't eat health food,'' he said. ``I'm just saying it's not as clear as you think what health food is. I think it's a waste of one's time to think about food that much.''

      Elizabeth Bechtold, who retired from her food label consulting business and turned her Alameda home into a health food retreat where she hosts food demonstrations and veggie potlucks, agrees such diets can draw extremists. One guest criticized her soap for containing animal products, and another pitched a pie in the trash because it contained a little honey.

      Five years ago, Bechtold's boyfriend told her to ``back off'' when she preached to friends and family about her raw food diet. She did. Now she feels her regimen, including a half-gallon of kale juice daily, is her path to health. But she is comfortable with meat eaters and likes to dine out - usually handing the chef a bright green card with instructions on what she can eat.

      ``There was a time when I was only thinking of my eating,'' said Bechtold, who at 63 says she feels better than she did 20 years ago.

      Dorleen Tong, head of SF- LiFE, San Francisco's raw food society, and an instructor at City College of San Francisco, said she has relaxed since downing her first glass of wheatgrass juice 12 years ago. She used to bring her own food to social events, but now eats from what is served.

      ``It occurred to me that more harm was done emotionally and psychologically than to just relax about it,'' she said.

      Bratman said he let go of his obsession after a series of revelations. The first was when his own food guru, a vegan about to start on all fruit, suddenly gave up his diet, telling Bratman he realized that ``rather than eat my sprouts alone, it would be better for me to share a pizza with some friends.''

      It was shocking news to a man who planned every sprout and avocado he ingested. A Benedictine monk subsequently encouraged him to eat Chinese food, with an ice cream chaser. That led to liberating junk food binges and a painful path to what he calls a ``middle way'' of eating.

      Billings said his departure from extremism was undramatic. After so many years, he got burned out.

      ``I liked chocolate too much to remain extreme,'' he said. It was the pseudo-science, ``flat-out strange stuff and weirdness'' that convinced him to help found the Web site.

      His stance - he doesn't denounce specific diets, but says many advocates are cultish and extreme - has provoked passionate response.

      In a section of Beyondveg.com titled ``the darker side of rawism,'' Billings describes how a raw/fruitarian group threatened physical violence if he attended the 1998 Raw Expo in San Francisco. He stayed home.

      ``Many advocates have extreme hostility,'' he said. ``Some people are like religious fanatics whose religion is eating raw food. You could call them the vegan Taliban if you want.''

     

      -----

      (The San Francisco Chronicle Web site is at http://www.sfgate.com/chronicle)

     

-- Anonymous, January 07, 2002