Orthorexia Nervosa: the Medicalization of Extreme Healthy Eating Practices

This chapter employs a critical sociological lens to examine the social construction of a new eating disorder, orthorexia nervosa (ON) -extreme fixation with healthy eating- the politics around its inclusion in the DSM and interests underpinning its medicalization. To do so we explore three different perspectives on extreme healthy eating; those who self-identify as highly preoccupied with healthy eating, professionals with expertise in eating disorders, and posters on an eating disorder social media site. By focusing on and comparing the narratives of individuals who differentially position themselves around debates concerning health and eating, we can begin to understand the social and psycho-political tensions around labelling healthy eaters as “troubled persons” (Gusfield, 1989). We argue that in neoliberal society the categorization of extreme forms of eating has rendered their “deviance” of high market value. As clinically defined conditions they acquire circumscribed identity, their exploitability in the real and virtual marketplace increases, and in order to receive or give support, people and practitioners feel impelled to adopt the language and labels of the disorder. Their association with other DSM-classified conditions, such as anorexia nervosa, bulimia nervosa and obsessive-compulsive disorder (OCD) further increases their potential for stigmatization. As discourses on ON become common parlance in professional and commercial settings (Horwitz, 2012), so there is a real danger of social institutions “feeding” the eating problems they seek to address. Rather than framing it as a personal dyscrasia, ON should be viewed it as a product of the “troubled” times in which it has emerged and a society in which the act of eating itself has become medicalized and subject to moral censorship