An excerpt from the foreword of Breaking Vegan:
"The Origin of 'Orthorexia'
When I invented the term 'orthorexia nervosa' 20 years ago, I didn’t realise I was naming an eating disorder. I was practicing a form of 'tease therapy'.
I practiced alternative medicine at the time and although I was a proponent of healthy diet I thought a few of my patients took it too far. I remember one in particular who began every visit by asking, “Doctor, what food should I cut out of my diet?” I came to feel that she did not need to cut anything out; rather, she needed to relax the grip of her mind and live a little.
However, because I had once been a raw food vegan myself (and, at other times, a follower of macrobiotics) I understood how difficult it would be for her to hear this. To ask her to lighten up on her diet was tantamount to asking her to embark on a life of crime. “Go and commit some larceny. It will be good for you.” She saw healthy diet as pure virtue. How can one lighten up on a virtue?
As a devious therapeutic technique, I decided to stand her virtue on its head by calling it a disease. I consulted a Greek scholar, and coined the term orthorexia nervosa. It is formed in analogy to anorexia nervosa, but using ortho, meaning 'right', to indicate an obsession with eating the right foods.
From then on, whenever this patient would ask me what food she should cut out, I would say, half tongue-in-cheek, “We need to work on your orthorexia.” This It made her laugh, and ultimately it helped her loosen the lifestyle corset. She moved from extremism to moderation.
Later, I published a funny article on the subject, and then a humorous book with a bad cover color scheme. I didn’t take my own idea too seriously. I just trying to get a few overly obsessed health foodists to take a look at themselves.
It was only after the publication of the book that I began to realize I had tapped into something bigger than tease therapy: I learned that there are people who die of orthorexia.
That was a shock. I understood that people can make themselves crazy with healthy diet, but not that the problem can lead to death. However, orthorexia truly can kill, via malnutrition. People with this kind of severe orthorexia don’t think they’re too fat; they think they’re impure. They want to cleanse, not to lose weight. The conscious motivation is quite different.
Because the concept of orthorexia was still little known, eating disorder specialists didn’t ask the right questions. They would say to such people, “You think you are too fat.” But that is not what it feels like to be orthorexic. This misunderstanding led to treatment failure, with occasionally tragic results.
Even when orthorexia is not fatal, it can commandeer a person’s life. Eating disorders have that power."
— Steven Bratman, MD, MPH