 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 1s and 2s, or even occasional 3 in your answers, would mean you may have it, so lower scores are worse. Okay, 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, like 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, only may end up having to drug you. Question number three. In the last three 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 you were eating choices where 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 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%. But no wonder the DSM, the Psychiatry Professions 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 ortho-15 they use and come up with their own cut-off scores for diagnosis, resulting in an alarmingly erratic use of the ortho-15 tool that was designed to measure orthorexia. The bottom line is that the ortho-15 test is likely unable to distinguish between healthy eating and pathologically healthy eating, whatever that is. And more recently, new criteria have been introduced, given the impossibly high prevalence rates. New emphasis is placed on health problems because of diets, such as malnutrition or medical complications that would, by definition, make 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 bedridden. If that's what you want to call orthorexia, fine. And one wonders if there 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 donut rather than the lentil soup.