"The Orthorexia Nervosa Test"
Orthorexia is defined as an unhealthy obsession with eating healthy food.
Want to know if you're orthorexic?
"The ORTO-15 is the most widely accepted assessment tool
to screen for orthorexic tendencies."
A score of 40 or lower was considered the best threshold
for an orthorexia diagnosis.
There are 15 questions, each scored from 1 to 4, so you can end up with a score
of 15 to 60, with a score under 40 denoting orthorexia.
So getting 1's and 2's or even an occasional 3 on your answers
would mean you may have it, so lower scores are worse.
OK, let's check it out.
The first question: "When eating, do you pay attention
to the calories of the food?" Always, Often, Sometimes or Never.
According to the test, the healthiest answer is Often,
with the orthorexic answers being Always or Never.
I can see how always obsessively worrying about calories could hint at a problem,
but if you're eating healthy enough, a diet centered around whole plant foods,
you don't need to worry about calorie counts or portion control.
And the healthiest foods— fruits and vegetables—
don't even have a nutrition label.
But apparently, if you're never googling the calories of every apple you eat,
you may have a problem.
When you go to the grocery store do you feel confused?
Supposedly, the healthiest answer is Always.
You should always be confused, and if you're not at least often confused,
we may end up having to drug you.
Question 3: In the last 3 months, did the thought of food worry you?
The supposed healthiest answer? Never.
The thought of what you're putting into your body didn't worry you once.
According to the test, it would be healthier if your eating choices
were "conditioned" worries about your health, and of course taste should
"always" be more important than the quality of your food.
I mean if you think the quality of food is even "sometimes" more important,
you may have a mental illness.
And if you're often willing to spend more money to have healthier food?
Crazy! Are you so delusional that you think consuming healthy food
might improve your appearance?
My favorite, though, has to be question 14: Do you think that supermarkets
also sell unhealthy food? You've got to be kidding, right?
And then, they like penalize people who live alone.
If you scored under 40, you are not alone.
Using this test, about 50% of registered dietitians
in the United States are supposedly suffering from a mental illness.
The prevalence of orthorexia nervosa presents as being impossibly high.
I mean anorexia and bulimia are estimated to be no higher than about 2%,
and so it's kind of counterintuitive to believe that
there's some eating disorder out there that has rates as high as nearly 90%.
No wonder the DSM, the psychiatry profession's official diagnostic manual,
does not include orthorexia as a psychiatric diagnosis—
and, look, they love turning things into mental illnesses.
The latest edition can turn kindergarten temper tantrums into a disorder,
too much coffee or even bad PMS into a mental illness,
but they're still not going to go there with orthorexia.
For example, researchers have a tendency to pick and choose
which questions of the ORTO-15 they use and come up with their own cut-off scores
for diagnosis, resulting in an alarmingly erratic use of the ORTO-15 tool
that was designed to measure orthorexia.
The bottom line is that the ORTO-15 test is likely unable to distinguish
between healthy eating and pathologically healthy eating, whatever that is.
Now more recently, new criteria have been introduced.
Given the impossibly high prevalence rates, new emphasis is placed
on health problems because of diet, such as malnutrition or medical complications
that would by definition make it an unhealthy diet.
Like this tragic case in which someone had tried to live off a few spoonfuls
of rice and vegetables and ended up bed-ridden. If that is what
you want to call orthorexia, fine, but one wonders if it might have been
clouded by some actual psychiatric diagnosis like OCD,
obsessive-compulsive disorder.
And if you add in those adverse health criteria, then the prevalence drops
to less than one half of 1%, which seems a little more reasonable.
Interestingly, those eating vegan diets had the least pathological scores
in the sample, though this may reflect them just being less serious
about healthy eating,
reaching for the vegan doughnut rather than the lentil soup.