American Kate Finn wanted to eat only healthy foods. She fasted and ate whole vegetables and fruits to "cleanse" her body and continually lost weight. Friends and relatives were shocked as they all believed she was anorexic.
"In December 2003, I received the sad news that Kate Finn died," US doctor Steven Bratman wrote. According to his diagnosis, Finn suffered not from anorexia nervosa or bulimia, but from a new eating disorder called orthorexia nervosa, an unhealthy compulsion to eat nutritious foods.
The name is derived from Greek: ortho meaning "correct" and orexis meaning "appetite."
"She was not afraid of getting fat. She didn't want to be thin. She simply wanted to eat only nutritious foods," said Bratman, who coined the term orthorexia nervosa at the end of the 1990s. "It's excellent to eat healthy, and most of us would do it if we would pay just a little more attention to what we eat."
"Some people have the opposite problem -- their perception of healthy food is so extreme that it turns into an obsession," he said.
Bratman says signs that someone is suffering from the illness include spending three hours or more thinking about food, planning meals more than three days in advance and placing the nutritional value of food over the joy of eating.
Experts say the depth of the phenomenon is unknown because the people who have it do not feel sick, said Andreas Schnebel, a psychologist and chairman of Germany's eating disorder association.
Schnebel, who is also director of the Munich-based consultancy ANAD-pathways, said people with the disorder have extremely specific needs when it comes to what they ingest.
"They eat whole foods, very, very defined organic foods, very specific salt and vegetables that were picked during a full moon," Schnebel said. "They also do not drink normal mineral water, rather a special water, and it must have been open for perhaps days," he said.
Some sufferers are so wrapped up in their nutrition, they gradually become isolated from their surroundings.
"They take emergency rations along to social events or avoid people who in their opinion eat unhealthily," the medical Web site www.medizin.de says. Their willpower makes them feel superior to other people. "They are like missionaries."
Psychologist Christoph Usbeck of the University of Duesseldorf said it becomes an illness as soon as a person's quality of life is clearly affected. Treatment should be sought in cases involving social isolation, depressive moods and dramatic weight loss.
"The illness has been qualified, but because of the low number of occurrences and the lack of research, it has not yet been recorded in the catalogue of psychological illnesses," Usbeck said.
Germans and other Europeans could be less affected by the illness thanks to their sense of sociability.
A French study showed that Americans eat far fewer relaxing meals than Europeans, and place a higher-than-average value on having a proper portion size, said the researchers working with sociologist Claude Fischler.
By comparison, people in southern Europe and France associate eating with family togetherness and social gatherings. For them, it's more important to have a relaxing comfortable meal than to count calories.
While some people fall victim to the orthorexia nervosa eating disorder, others are going headlong into organic foods. Sellers of such wares are registering double-digit growth rates, and the new disciples of organic food include 20-somethings as well as retired people.