NUTRITION TIP OF THE WEEK: Can healthy eating really go too far?

People with orthorexia are preoccupied with finding and eating the “perfect” diet. The National Eating Disorders Association explains that people with orthorexia will fixate on eating foods that give a feeling of being pure and healthy. Many people with orthorexia are of normal weight, so the eating disorder can be hard to recognize.

It’s good to eat a healthy diet, but for some people, a fixation on healthy eating becomes an unhealthy obsession. Strict food rules of any kind can develop into an eating disorder in some people. The term “orthorexia” was coined in the late 1990s to describe an obsession with eating only healthy or “pure” foods. This disordered eating behavior has become more prevalent, likely fueled by conflicting dietary advice, confusing food marketing and social media.

People with orthorexia are preoccupied with finding and eating the “perfect” diet. The National Eating Disorders Association explains that people with orthorexia will fixate on eating foods that give a feeling of being pure and healthy. Many people with orthorexia are of normal weight, so the eating disorder can be hard to recognize. Common behavior changes that may be warning signs of orthorexia include:

Obsessive concern about the relationship between food choices and health concerns, such as digestive problems, mood, anxiety or allergies

Avoiding foods with artificial colors, flavors or preservatives, as well as anything that is genetically modified or has possibly had pesticides or other chemicals used in its production

Noticeable increase in the use of supplements, herbal remedies or probiotics

Irrational concern about food preparation techniques; perhaps refusing to eat out due to lack of control

Classifying foods as “good” or “bad,” with “good” foods providing a feeling of virtue and self-esteem and “bad” foods associated with being inferior or unclean

Spending an excessive amount of time planning meals; prepping food; or reading books or social media sites about diet

Undergoing cleanses or detoxes

Refusing to treat oneself to a favorite food, even for a special occasion

Feeling guilty after deviating from self-imposed diet restrictions

A drastic reduction in acceptable food choices, often due to “allergies” that are not diagnosed; this can lead to the elimination of entire food groups, such as animal or dairy products, and a list of “acceptable” foods that is quite small

Distancing from friends or family who do not share similar views about food

Avoiding eating foods bought or prepared by others

Rigid eating patterns

Compulsive checking of ingredient lists and nutrition labels

Orthorexia symptoms are serious and go beyond a simple lifestyle choice. Obsession with healthy food can crowd out other activities and interests and impair relationships. It can also become physically dangerous when the list of acceptable foods dwindles, resulting in calorie restriction and severe weight loss. Malnutrition is also a real possibility due to limited diet variety. Cardiac problems also can arise.

Treatment for orthorexia usually involves psychotherapy, much like the treatment of other eating disorders, including anorexia and bulimia. The variety of food is gradually increased as the person learns to accept foods that had been shunned. Balance and moderation to life and diet is restored, using coping mechanisms to reduce the power of food.

Orthorexia often starts as a positive way for someone to improve their health, but for those who have the biological, social and psychological precursors for developing an eating disorder, these lifestyle changes can become an obsession. Common disorders that co-occur with orthorexia include depression, obsessive-compulsive disorder, bipolar disorder, panic or anxiety disorders, substance abuse disorder, and post-traumatic stress disorder.

Anita Marlay, R.D., L.D., is a dietitian in the Cardiopulmonary Rehab department at Lake Regional Health System in Osage Beach, Mo.

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