What do I mean by "orthorexia"
Yes, I know that orthorexia is not an established diagnosis. I'm using it here in a broader sense as a shorthand for a cultural phenomenon, a set of ingrained beliefs about food.
In that sense, I'd say that an "orthorexic" is somebody who is righteous and even self-righteous about eating the one "correct" food (which is then labeled healthy food). Their beliefs then include some misconceptions like:
- a certain food (or food combination) is always either healthy or unhealthy. These are seen as absolute categories regardless of the body's current needs, or the amount of food consumed.
- a healthy food is 100% healthy (cannot do a single bad thing to you), an unhealthy food is 100% unhealthy (cannot do you a good thing under any circumstances)
- some foods are side-effect-free medicine. If you have an ailment, you have to find the one right food to eat and you will get to health baseline again, without any other changes to lifestyle or need for other treatment.
- some foods are like Mario mushrooms. If you eat them, you get a superpower (have great memory, become immune to cancer, whatever).
- if you want to achieve a nutrition related benefit, you have to execute [whatever rules the orthorexic believes in] absolutely faithfully. It is impossible that there is more than one way to get to the goal of being properly nourished.
I am saying "food" above, but it frequently extends to nutritional supplements such as vitamins, amino acids, fibre and others.
The idea that such cults exist in our culture is not new. They have been around since Hippocrates, have created multinational industries, and are slowly becoming salient in the media.
What are we seeing of it
The sad thing is: while I know very few hard-core orthorexics who really hold onto these beliefs (and even they will object to the snarky formulations above), the press and the popular dieting literature is full of information which implicitly makes these assumptions. This can reach from superficially good looking science reporting like this report of a valid study which upon deeper reading turns out to blow a simple correlation out of all proportions 1, to downright ridiculous claims where the reporter states that cannibalism will protect us from Alzheimer 2.
A large crowd of normal people without a neurotic relationship to food gets immersed in these messages, and starts to unnoticeably internalize their distorted representation of nutrition. One day they read that nuts will slash their cancer risk in half, the other day that it's the cruciferous vegetables which will do so. In the end, they are confused whether they should eat peanuts or kale, but think that there is a food which will prevent cancer all by itself.
We already have a handful of questions which are based on these assumptions. Here a short list of examples which cover the orthorexic beliefs:
- Is drinking papaya juice daily healthy? I'd say it shows signs of the first and second belief listed above, a black-white split of foods into heroes and villains.
- What is rock salt? Is it helpful for diabetics? Tentatively, I'd classify this one as an example for the third belief, a food can heal (or at least substantially help) a certain disease.
- What food should I eat before going to bed at night so that I wake up full of energy in the morning? The question got downvotes and was later self-deleted. I see it as an illustration of the "superpowers" assumption.
- https://health.stackexchange.com/questions/1122/optimal-macronutrient-split-for-cheat-meals An example of the last point, that there is one single way to do things right.
I don't want to pick on the authors of these questions here. They are probably normal people trying to make sense of confusing information. But I'm somewhat worried about the questions and their possible effect on the site. Also I'm noticing that the community handles these questions in different ways, from upvoting through indifference to downvoting.
Potential problems
On many SE sites, questions based on false assumptions are not much of a problem, because they are a good occasion to debunk a myth or misunderstanding. But in this case, we are up against a "cult" with its own inertia. I can imagine several negative effects facing us.
- True orthorexics are incorrigible Only a fraction of the people asking these questions will be self-righteous. But when they appear, there will be Big Drama, draining for anybody trying to participate.
- Lots of unanswered/unanswerable questions. From my point of view, questions like "is it healthy to drink papaya juice" are completely unanswerable. I could write an answer explaining why it's unanswerable. But just the thought of writing that up every time such a question appears makes me exhausted. If others react the same way, these questions are likely to stay unanswered, frustrating the asker and lowering our statistics.
- Breeding ground for quacks There is an industry catering to the orthorexics. The presence of these questions invites them to come and give answers, which will be supported by their own references. Especially if the previous point leaves us with an answer vacuum.
- Weakening of the "votes mean quality" connection In truth, votes on SE are related to popularity, not quality. And the whole reason why orthorexic ideas are so widespread is that they are popular. People crave simple explanations and hate being told "there is no answer to your question". Once we get large enough, we might see the pleasant answers upvoted more than the true answers (if they are given at all).
If we leave these questions go their natural course, we might end up frustrating the large demographic of new askers, the small but important demographic of core answerers, and fill up with bad content.
What can we do?
Years ago, Cooking decided to skirt the problem by completely making nutrition off topic. As a moderator there, I am very happy about it, as it has spared us much grief. But I don't think that this is the way a health-centered site should go. Instead, I hope we can collect ideas how to act on these questions so we become a source of information, not desinformation. For example:
- Find out why if these questions can be reformulated in a way which invites good answers and discourages bad ones. Have the community enforce such edits diligently.
- Find out if there are criteria for acceptable and unacceptable orthorexic questions. Create a culture for closing the bad ones. It can be supported by custom close reasons, or by the recognition that a certain type of question always hurts a standard SE rule (e.g. "Is eating X healthy" can always be closed as "too broad" for any X).
- Create canonical questions (or other canonical sources, maybe as blog posts) which explain some of the basic misconceptions in orthorexia. Close cookie-cutter misguided questions with a reference to these questions which give the OP the chance to understand why their question was unanswerable.
- Whatever rules we use, we should somehow make sure that they don't prevent us for having quality discussion on very simple cause-and-effect cases in nutrition. If somebody asks a question about the relationship between eating fresh fruit and scurvy, we shouldn't have a draconian system which forces us to close it.
- ??? I think the three ideas I had are only a first step in solving the problem, and might be not as effective as I'd like them to be. I'd be very happy to hear more of them!
1 The study found that people who eat a bit of nuts daily have lower chance of certain diseases. For some reason, people love to operationalize such statements to "I have to start eating a handful of nuts daily, so I won't get sick" even though basic logic and decades of evidence show that such leaps of logic are fully unjustified.
2 I did not read the original study, but even the article text only explains that one previously cannibal population has developed kuru resistance, without stating anywhere that Alzheimer was mentioned in the study at all.
