So what’s the cure for orthorexia?
Wait, what IS orthorexia?
Orthorexia is a term that’s been running around food and diet circles in recent years. It refers to the extreme health-food types who have tied themselves so completely to their food consumption habits that they’ve gotten a bit nuts about what they eat.
On my recent post Why You Should Say Goodbye to Immortal Food, my friend Steven Edholm made an excellent comment. In part, he wrote:
“I’m still always surprised when I realize people eat junk food. It seems so obvious that we shouldn’t eat food that contains non-food ingredients. I mean the occasional indulgence when doing as the Romans do is one thing, but to buy the stuff and keep it in your house is entirely different. I think of it as creating a food environment. It’s often difficult to get good food on the fly in town, but the stuff we buy and keep on hand or grow or process ourselves is a real choice. I eat more or less instinctively. If I build a food environment consisting of quality food, then that is what I’ll eat. If there is junk available I’ll end up eating junk. So that is the base to me. I basically don’t buy anything with any preservatives, artificial dyes or anything that is obviously not food. I also very rarely buy anything with corn syrup, though I’m not absolutely strict if there is a tiny bit as a minor ingredient or something.
People should be aware though that there is another unhealthy, very real and growing extreme, orthorexia. I’ve been there and it’s a very un-fun place to be. Orthorexia is the unhealthy fear of food that is perceived to be unhealthy. Like a lot of neuroses and behavioral conditions, it’s basically judged to be pathological when it affects your life negatively. If someone is starving for “health” reasons, they are often applauded, while if it’s to lose weight we call it anorexia, but there is little difference if the result is the same. Usually it’s from consuming a ton of diet related information, adopting a diet ideology and then overthinking food choices to the point of developing anxieties about food and eating more cerebrally than by instinct. We are not smart enough to outguess our bodies and what they need. We are made to run without huge amounts of information about what to eat. To make almost all of our food choices based on information is dangerous. Besides, no one agrees anyway.”
I greatly appreciate Steven’s input. He’s one of the brightest people I know and helped me lose my irrational fear of grafting (Graftorexia nervosa?) a while back.
So – What is “Orthorexia?”
According to eatingdisordershelpguide.com:
“‘Orthorexia’ is defined as an obsession with “healthy or righteous eating”. The phrase was first created in 1997 by California doctor Steven Bratman, and refers to people who create severely limited diets in the name of healthy eating. It often begins with someone’s simple and genuine desire to live a healthy lifestyle. The person may choose to stop eating red meat, but eventually cuts out all meat; then all processed foods, and will eventually eat only specific foods that are prepared in very specific ways.
Some psychologists have noticed a change in attitude towards people who have “quirky” eating habits, which may contribute to the rising trend of orthorexic-type diets. Systems like the Atkins Diet – which limits the intake of carbohydrates – have made out-of-the-ordinary dietary restrictions seem normal. And many bookstore shelves are replete with this type of material.
“Where ‘that quirkiness used to reduce your status’, says Deanne Jade, a psychologist and founder of the National Centre for Eating Disorders in Britain, ‘the attachment to strange eating systems and theories is now supported by a thriving industry and gives people a sense of status.'”1
For nearly a decade, orthorexia wasn’t recognized as an eating disorder, and there’s still some confusion as to whether or not it should be. Some medical experts believe it’s actually another form of obsessive-compulsive disorder, citing the fact that “less intense” forms of orthorexic behavior aren’t dangerous. Where orthorexia is similar is in its obsessive nature. It is based on an obsessive fixation on food, just as with anorexia or bulimia.”
Yeah, that’s obviously not good. It does seem to be a type of obsessive-compulsive issue. I once knew a person who was an extreme Vegan. She’d only eat one raw vegetable or fruit at a time for an entire meal and had some health issues I’m convinced were linked to that pattern.
That said, I was really impressed with her self-control.
One argument you’ll often hear from people who complain about “fat-shaming” is that those who don’t embrace the idea that all body types (including obese out of shape bodies) are equally beautiful and/or healthy will push people towards anorexia.
Let’s look at the leading causes of death according to the CDC:
- Heart disease: 611,105
- Cancer: 584,881
- Chronic lower respiratory diseases: 149,205
- Accidents (unintentional injuries): 130,557
- Stroke (cerebrovascular diseases): 128,978
- Alzheimer’s disease: 84,767
- Diabetes: 75,578
- Influenza and Pneumonia: 56,979
- Nephritis, nephrotic syndrome, and nephrosis: 47,112
- Intentional self-harm (suicide): 41,149
More than one of those mortality statistics can be linked with obesity, in particular heart disease and diabetes.
The deaths per year from Anorexia in particular were reported in one study as follows:
“Overall, the weighted annual mortality for AN was 5.10 deaths (95% CI, 3.99-6.14) per 1000 person-years (Figure 2), of which 1.3 deaths resulted from suicide.”
Very sad, but nowhere near the deaths caused by obesity-related illnesses.
Claiming that mentioning the ill effects of poor eating habits or encouraging someone to fight their slide into obesity is likely to doom them to death by self-starvation is similar to claiming that telling your children not to play in the street is likely to cause them acute depression and future suicide because their life choices were not affirmed.
The worst case I remember hearing on this front was when I was listening to a pop psychologist type on Christian radio one day and he stated something along the lines of “Dads… never, ever mention your daughter’s weight, no matter what. You could drive her into a tailspin.”
Wait a minute. Aren’t we supposed to “talk to our children about drugs?” And help keep them from making dangerous life choices? And make sure they get a good solid education?
I understand the thought, of course. You really could be a jerk and hurt your kids feelings. Lots of moms and dads have screwed up their offspring with harsh words, cutting comments and bad choices. Yet if you really love someone, and they know you love them, would you let them drift into unhealthy patterns that might shorten their lives and cause them ongoing problems and self-esteem issues?
It would be a hard talk, I’m sure, but I think you’d probably just have to bite the bullet and do it. Before someone else does on the internet… in a much meaner way.
And of course, if you’ve modeled moderation and healthy eating at home already, you’ll probably never have to have that conversation to begin with. Many of us are prone to giving our kids “treats” because we want them to be happy… and those treats can turn into lifestyles and habits that are hard to break later on, if they’re not given in moderation.
It’s taken me years to break some of my bad habits. I still fight with some of them, such as tortilla chips and cheese dip.
Cheese dip is my Vietnam.
Discipline, Obsession and Quackery
This isn’t really about the outside pressures such as the abundance of bad foods, or our culture, or our parents.
Eating issues come from problems inside of us. Orthorexia may become a problem because we focus on food. Obesity may happen because we lack discipline. Anorexia could happen because we hate ourselves or have focused outwardly and think others hate us.
Most of the time, though, I think it’s more of a lack of discipline combined with information overload.
You try a diet for a while, lose some weight, then drift back into old eating habits. Then another diet comes along and you starve yourself for a while and go jogging, then eventually (as P. D. Mangan says in his book Top Ten Reasons We’re Fat) the hunger wins, we binge, and we gain back what we’ve lost.
It’s easy to get caught up looking for the magic bullet for our health (or magic bullets). Maybe we’re high in heavy metals? Maybe we’re dealing with low-level allergies? Maybe a zinc supplement, or eating raw, or getting more Vitamin D or fixing our gut with expensive probiotics?
Sure, try some of those things and see… but you may end up spending all of your life’s savings buying supplements.
I’ve made sauerkraut and kimchi and kombucha and kefir at various points over the years. When a doctor told me a week ago that I may need more probiotics in my gut, I looked at supplements and had this one recommended to me as being really good.
But it’s expensive, so I thought: hey, why not just eat dirt instead?
I then proceeded to pack some compost-rich food forest soil into capsules. As I wrote in my recent newsletter (you can sign up here), there’s some good science behind ingesting soil organisms.
Heck, I think I’ll market mine. How’s this?
I’ve already had one reader write and say they’d buy them.
Chasing down health via the diet and supplement route can get expensive quickly and there’s a lot of quackery out there.
Listen to your body first. If you feel lousy when you drink, don’t. If you’re sluggish after eating a sub sandwich for lunch, ask why. If you can’t chew a can of Skoal a day, well… shame on you.
You get the idea.
Some of us have to say “I will never again eat this particular food,” and then stick to it, AA style. Others may find a good balance over time because they’re not driven to extremes. Personality type makes a big difference. There are people like my dad who can simply make a choice and stick to it forever. Then there are people like me who have to fight to stay focused because there’s always something else out there to tempt or distract us from our resolutions.
The many crazy diets and alternatives may make us eventually throw up our hands and give up. Far from worrying about a cure for othorexia, we don’t even get to the point where we follow anything at all.
“What is truth,” we say, washing our hands of responsibility like the villainous Pilate as we pull in to the Golden Corral.
You know as well as I that you’re going to feel lousy after making those choices, so don’t make them. Listen to your bubbling stomach, then do some reading, which leads me to my final point.
The Cure for Orthorexia?
I think Steven nailed it in the quote from the beginning: “We are not smart enough to outguess our bodies and what they need. We are made to run without huge amounts of information about what to eat.”
I went through a period of time where I tried vegetarianism. I gained weight, felt poorly and had multiple issues crop up. I also tried eating more whole grains and healthy carbs… and gained weight. I dealt with joint pain, heartburn, minor heart issues, high blood pressure and too much weight around my middle. You wouldn’t know it from seeing me now, but there was a time when I was a good 25lbs overweight. That’s not a lot compared to what many face – but I was eating healthy (or so I thought).
I had quit soda long before, I rarely ate any fast food, we were eating homemade bread, Rachel cooked most meals from scratch… and there I was, feeling lousy.
It wasn’t until I tried fixing my heartburn by systematically quitting various foods that I discovered my main enemy.
I stopped eating spicy foods: no effect.
I stopped drinking alcohol: no effect
I quit coffee: no effect (except for a day-long headache)
And then one morning as I sat at breakfast, I ate a piece of toast and started to feel my heartburn cropping up. Incredulously, I looked at the toast. “You? You did this to me? A piece of TOAST?”
Googling heartburn and bread led me down the rabbit hole and to the writing of Mark Sisson and his book The Primal Blueprint.
Yep. I went “paleo” with a vengeance. I utterly quit all grains, potatoes and processed stuff and ate meat, fat, and vegetables. Within 2 months I dropped from 185 or so lbs down to 153lbs… which was actually rather low, considering my height (6′ 1″). But I felt great and started to gain weight back as I exercised and balanced out.
My heartburn disappeared the first day. My joint pain disappeared after about a month and a half. My heart issues quit being a problem. And my gut was gone.
It happened because I figured out bread made me feel lousy… and that got me chasing the reason why. I seem to have some issues with wheat and I now know it’s one of the most inflammatory foods we eat. It’s also been called a “supercarbohydrate” and is known to cause many of us to pack on the pounds.
After a few months, I let some carbs back into my diet but I stay mostly away from the ones that make me feel lousy. If I go to someone’s house for dinner, I’ll eat what they serve (though I usually skip dessert) and not turn the dinner table into a debate over diet – that’s just rude, though sometimes it’s hard to resist when you think you have some Great Information They Totally Need To Hear.
Paleo is what worked for me. There may be another solution for you.
But first you need to listen to what your body tells you, then act on it in a disciplined way without turning into a food Nazi (unless that’s the only way you can make yourself get fit… in that case, I understand).
Being obsessed with what we eat isn’t healthy, so orthorexia isn’t a good place to hang out… though, weighing it all in the scale, it’s much more likely that the alternative – eating all the junk you want – is much more of a risk for us in the grand scheme of things.
I know far fewer disciplined individuals than I do undisciplined ones. I generally fall into the latter category and must stay on track by keeping trashy food out of the house or I will eat it. I also find that I need to eat good food when I’m hungry or I’ll pig out on trash food when I feel like I’m starving.
I posit that the cure for orthorexia, as it seems to be for many other disorders, is to fix what’s wrong inside of ourselves first and know our limitations. Know what makes you feel lousy and avoid it – but also know, that if you’re prone to compulsive behaviors, that you need to moderate that as well.
What do you think? Let me know in the comments.
*(Lead image at top credit Samantha Forsberg)