orthorexia: a real eating disorder with real mental + physical health risks

You’ve met them at various points in your life:

  • The friend who brings her own food everywhere she goes (or skips out on eating at social gatherings altogether)
  • The co-worker who never partakes in the office birthday cake
  • The family member who gets anxious at the thought of travel outside of large food-conscious cities
  • The health food store evangelist who wouldn’t dream of ingesting anything with high-fructose corn syrup on the label

Diagnosed food allergies aside, the above examples all describe people who may have orthorexic eating patterns. What is orthorexia?

In 1997, Dr. Steven Bratman coined the term “orthorexia” to describe a rigid devotion to healthy eating that becomes obsessive to the point of actually creating health risks and interfering with a person’s quality of life.

Orthorexia starts out with a true intention of wanting to be healthier, but it’s taken to an extreme,” says eating disorder specialist and Academy of Nutrition and Dietetics Spokesperson Marjorie Nolan, MS, RDN. “If someone is orthorexic, they typically avoid anything processed, like white flour or sugar. A food is virtually untouchable unless it’s certified organic or a whole food. Even something like whole-grain bread – which is a very healthy, high-fiber food – is off limits because it’s been processed in some way.

Though still sorely misunderstood, anorexia nervosa and bulimia nervosa are well-known disorders, and binge eating disorder has now finally made it into the DSM-V, the diagnostic manual for mental disorders. Orthorexia, on the other hand, is newer to the scene, not included in the DSM-V, and less behaviorally clear-cut than the aforementioned eating disorders.

So, is orthorexia a real eating disorder?

The answer will certainly depend on whom you ask, but for many in the mental health field including myself, an eating disorder therapist, it’s a definite “yes.” While anorexia involves restricting the amount of food, orthorexia similarly involves restriction of the type of food or ingredient. Often, the restriction can start off more or less benign, such as simply adopting a vegetarian, vegan, gluten-free or dairy-free diet, but can develop into orthorexia when someone continues to restrict and their list of “allowed” foods gets smaller and smaller.

Read the full post at Adios Barbie. 

reflections on the wellness-sphere {food rigidity, 'good' vs. 'bad' food}

As I've more fully dedicated myself to this blog over the past several months, I have soaked up tons of content from dozens of folks in the wellness blogosphere via following their blogs, newsletters, social media streams, and podcasts. If I followed all the people who were making waves in the online wellness world, I wouldn't have time to do anything else -- but I've tried to immerse myself enough in the culture that I know who some of the key players are and the messages and tone that are out there right now. Naturally, I jive with some more than others.

Many of these people (most I'm following are women) are very savvy and successful, so there's a lot I can learn from following what they're doing. But as I dive into this world, I've found that I have to be really intentional about keeping my Critical Awareness sunglasses on to filter things through my own philosophy and beliefs (while being open to new ideas) in order to stay authentic to who I really am.

It can be very tempting to put some of these successful people on a pedestal, or get trapped in the "I'm just researching!" game and fall down the comparison rabbit hole. In the blogging e-course that I'm taking, the lovely course creator Rachel MacDonald has continuously reminded us about the dangers of getting stuck in comparison when there are so many inspirational women out there already, and it's easy to say, "there's no room for me at the success {read: cool kid} table." It can also be tempting to think, "well if 80% of these really successful people are saying XYZ, then clearly I should be on board with XYZ and be talking about it, too."

I haven't written much about nutrition or food on the blog yet because I've been exploring this area of my own life and waiting for the right time to say something about this. While I'm not a Registered Dietitian or official Certified Health Coach, I am a clinician working every day with women and their food at the therapeutic level, and my own life was transformed when I changed my relationship with food and my body. So I definitely have opinions about this stuff. Also, thankfully, I'm far from the only one in the overall "wellness" world who feels this way about these issues. Hilarious coach Isabel Foxen Duke has a coaching program to help women "stop feeling crazy around food", and she *gets* the restrict (diet)/binge cycle because, like me, she's lived it and broken free of it. 

I plan to write a lot more on food in the future, but in this post I wanted to set the scene of where I'm coming from, and establish some key points about my philosophy and concerns I have about some of the popular messages out there. And if you don't agree with me, that's okay, too.

  1. Food rigidity is harmful.I can absolutely agree that, as a culture, we have gotten waaaaay off-track with where we need to be with food. No question there. We are a society that, on the whole, needs more education and guidance about food, and better ways to access and prepare nutritious food without breaking the bank. Some folks in the wellness world are really helping with this. But I also see a lot of rigidity. Whether it's Paleo, Whole 30, veganism, Bulletproof Coffee, whatever -- there are messages out there that if you don't adhere to something in a very specific, regimented way, that you're not doing it right, and that's "not healthy."Ultimately, for many people, food rigidity leads to feeling restricted (and in some cases, actually restricting), which results in feelings of deprivation and scarcity. Feeling deprived in one area of life can also lead to depriving yourself in other areas, until eventually you break and the pendulum swings to bingeing side -- whether you're bingeing with food, shopping, sex, you name it. The messages of rigidity that I hear are concerning to me, and often it's done in this contradictory way, like, "Everything is great in moderation, yay! You can have chocolate (if it's organic 90% cacao raw vegan dark chocolate)!" It's a bit confusing -- a message of not being rigid/restrictive, but it certainly still feels that way to me. Shrug.
  2. There are no bad foods.This is sort of a continuation of #1, but worth elaborating on specifically. Of course, we absolutely should limit our intake of chemicals and non-naturally occurring ingredients. Some things don't really fall into the category of "food." (Cheez Whiz, anyone?)  If I have a choice between a Whole Foods bakery cookie and a box of Oreos, I'll take the Whole Foods cookie every time. It tastes better to me, on top of being much more natural. But if I'm at a birthday party and the only choice is Oreos? I'm going to have a damn Oreo. (Hell, I might have 3 or 4! CRAZY TALK.) And am I going to dip my cookies in unsweetened vanilla almond milk (even though my body has no problem digesting dairy) just because "dairy isn't healthy and you should only have milk if it's raw and fresh from the cow's udder at the farm next door"? No, give me the real milk! Now, I do prefer organic milk (because I prefer the taste and there's a strong possibility it's more ethically produced, depending on the brand), but I'm not going to refuse to drink milk if it's not organic. This is a tough one, I know, because the ethics of production DO come into play, especially regarding animal products. And obviously, some people have health issues that require them to stay away from certain foods.But again, just like in #1 -- if I had a dollar for every time I heard a bulimic or binge-eating client say, "my parents didn't let me have any 'bad food' and we only had 'healthy food' in the house," I'd be investing in stocks right now.  (Even the most health-food-conscious clients often binge on fast food -- and "getting rid of it" does much more damage to the body than just allowing yourself a Frosty and some french fries now and then. The diet/restrictive/rigid mentality fails.)I noticed that as I followed more wellness folks online, I started feeling a little guilty if I had "regular" whole wheat bread instead of sprouted grain bread, pineapple in my smoothie instead of blueberries, corn tortilla chips instead of Beanitos, or regular Greek yogurt instead of organic. WTF? I'm still trying to be more judicious with refined starches and processed foods, but now also with the intention of being flexible and forgiving of myself when I have those things. Sure, plant-based foods = best. But that doesn't mean that you shouldn't ever have the other stuff, or that you should feel guilty for it.
  3. For many people, less-than-optimal eating patterns are not for lack of knowledge or access to good quality, nourishing food.As much as I sometimes wish I could get a dual certification as an RD, this is ultimately the reason that I went the therapy route instead: because I was once crazy with food, and it was only the heart-healing and finding a connection to spirituality that helped me pull out of it. (Had I been connected with a skilled RD, it probably would have been a much more integral component for me... but living in small(ish)-town Texas, the resources weren't great and I only remember meeting with an RD a few times, who totally didn't "get it.") Once that healing happened and I experienced that it was possible to *not* be crazy with food even with a long history to the contrary, I knew I had to try to help other women find that freedom, too. I think most people know that "it's not really about the food,", but there can still be this judge-y sort of attitude like "you know better and you're still gonna eat that?" The truth is that you never know what someone has been through and where they are on their journey. So how about we support each other in the ways that matter most, yeah?

That's all for now, folks. I'd love to hear your thoughts on these topics -- leave your 2 cents in the comments!