Too much of a good thing

by Nicky Pellegrino / 08 January, 2015
Careful eating is healthy but obsessing about it isn’t.

Juice fasts, raw and paleo diets – they are the stuff New Year’s resolutions are made of as we attempt to become healthier versions of ourselves. Before you start whizzing up your first green smoothie of the day, though, it may be worth pausing: there are concerns that the trend for clean eating may be making some of us unhealthier, and that it has the potential to develop into a more serious issue.

It’s called orthorexia. An American physician of alternative medicine, Steven Bratman, coined the term in 1997 to define an unbalanced obsession with healthy eating, and although it’s not officially recognised as a disorder, there is anecdotal evidence that it’s on the rise.

Auckland nutritionist Claire Turnbull, author of Feel Good For Life, has come across it in her practice. “Absolutely we are seeing it,” she says. “Every day we are seeing people who have excluded too many food groups from their diets.”

Turnbull says from detoxing teens to mothers bringing up their children on grain and dairy-free paleo diets, people are willingly adopting rigid rules and becoming fixated on the purity of what they are eating. She suspects this is more common in the bigger cities where cafes and shops cater to clean eating. But what’s really feeding the problem, she believes, are confusing nutritional messages and the power of social media. It’s become the norm, for instance, for people to post pictures and details of their latest health kicks.

“When people are posting these things, it’s a Photoshopped version of what their life is really like,” she says. “They’re showing their best food and not mentioning that they had pizza and a glass of wine last night. It’s setting up unrealistic expectations.”

US blogger Jordan Younger, known as the Blonde Vegan, has gained tens of thousands of followers with photos of her meals and inspirational posts. In reality, Younger was eating such a restricted diet that she was malnourished and ill. When she told her followers she was giving up veganism for the sake of her health, she got hate messages and death threats from people furious with her for abandoning her path of righteous eating.

Turnbull has had similar experiences. “I get hate mail if I post something on Facebook showing myself enjoying a chocolate brownie. People will say they can’t believe I’m promoting sugar. The demonisation of food is out of control.”

Nutrition is complicated, she points out, and cherry-picking dietary advice from different sources, even with the best intentions, can result in an unbalanced and inadequate diet. The greatest concern is for those who are genetically predisposed to developing an eating disorder, since a focus on extreme healthy eating can be a pathway to anorexia nervosa or bulimia.

So where is the line and how can you tell if someone has crossed it? Auckland psychotherapist Kellie Lavender of the Regional Eating Disorders Service says it comes down to the degree of obsession and anxiety people experience in relation to their eating regime. For instance, is the diet so strict essential nutrients are being missed? Is the diet taking precedence over a normal social life, leading to avoidance of opportunities to eat out or share meals with family? Are these people punishing themselves when self-imposed rules are broken?

“They may become righteous about what others around them are eating, which can also lead to social isolation,” says Lavender. “If a diet regime is impacting to the degree that quality of life is significantly reduced, this can lead to other disorders such as anxiety, depression, OCD, bulimia and, more dangerously, anorexia nervosa, which has the highest mortality rate of all psychiatric disorders.”

Of particular concern is exposure of children to these types of obsessions. “Especially young children, who need a wide variety of food for healthy growth and development. They may learn that food is to be feared and that certain foods are ‘good’ or ‘bad’, perhaps leaving them vulnerable to eating disorders and their associated conditions.”

Orthorexia tends to be a problem among highly educated, middle-class people. “They’re not the ones struggling with obesity and type 2 diabetes,” says Turnbull. “And although there may be some who are doing it to live longer, for most it’s about controlling the way they look and feel.”

Turnbull focuses on helping people regain balance. “Eating better makes a significant difference to the way people look and feel but this extremeness is not necessary to live a long and healthy life.”

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