Source: Nadine Primeau/Unsplash, Creative Commons
Co-authored by Fatmah Jahim and Robert T. Muller, Ph.D.
With diabetes, cancer and high blood pressure on the rise in North America, it’s not surprising that doctors and nutritionists are encouraging dietary changes, including eliminating processed foods, reducing fat and sugar, and eating more vegetables. There’s even a recent trend for social media influencers to share theirs clean Diets with the hashtag #CleanEating.
On the surface, there doesn’t seem to be anything wrong with having a strong desire to eat healthily. But desires can lead to obsessions, and obsessions can be unhealthy, sometimes even deadly.
Orthorexia nervosa is an eating disorder defined by a maladaptive obsession with healthy eating. People with this disorder fixate on that purity of their food and obsessed with ingredients. They can limit the types of foods they eat by eliminating food groups, such as: B. the strict adherence to a vegan, gluten-free, dairy-free or purely organic diet. These pursuits can be extreme, as some people with orthorexia spend hours preparing, categorizing, weighing, and thinking about food.
What sets this apart from other eating disorders is an intense focus on the quality of the food consumed rather than the quantity. However, as with other eating disorders, these behaviors can lead to malnutrition, mental impairment, and social isolation.
Because orthorexia has not yet been included in the DSM-5, the dominant American psychiatric diagnostic system, there is an ongoing debate about diagnostic criteria. The most frequently asked question is: where is the hard line separating healthy from unhealthy eating? Jessica Setnick is a registered dietitian, author and member of the task force of experts working towards a unified definition of the diagnosis. Setnick says it’s the same hard line that separates use out abuse with any substance or behavior that focuses on whether it is causing problems in your life. A person may enjoy going to five farmers’ markets, spending their disposable income on gourmet groceries, or spending hours each day preparing new recipes. If they are healthy and have happy lives that support these behaviors, who are we to judge?
But a person who does the exact same thing and is depressed when they don’t, or cannot eat a meal prepared by a loved one because they are afraid of the food or because of the time they no longer have for work forced to prepare food, these are problems. Not the food itself, but the way the food obsession affects their lives.
Social reinforcement and idealization of healthy eating make orthorexia harder to detect. Jennifer Mills, a professor of clinical psychology and an expert on eating disorders, explains that people with orthorexia are much less likely to seek treatment because eating healthy is societally acknowledged as a virtue. “They might get all sorts of positive social reinforcement for that, so they might not see it as a problem.”
The disorder can also be difficult to detect medically. A clinical problem is that general practitioners do not know enough about orthorexia to ask patients about their eating habits. Someone might be struggling quite badly, but not medically underweight, and loved ones might not notice or say anything about the person’s weight. Even a family doctor or general practitioner may not address this at an annual check-up since the person presents as if they are in a healthy weight range. Mills adds: “The only way to know would be to do a blood test. That’s the worrying part of it. It can go undetected.”
In recent years, the wellness culture on social media platforms has created a toxic environment for those most vulnerable to eating disorders. A recent study found a link between orthorexia and Instagram use. One possible reason for this association is that Instagram celebrities give the impression that you have to eat a certain way in order to be successful.
Instagram blogger Jordan Younger, 23, was known for her “gluten-free, sugar-free, oil-free, legume-free, plant-based and raw vegan diets.” They sold over 40,000 copies of her to clean Program. A lot of fans didn’t see their fights behind the screen. She stopped menstruating. Her hair fell out. Her skin had turned orange from eating too many sweet potatoes. After seeking help and recovering from orthorexia, she announced that she was going off her clean diet and consuming foods she had previously restricted.
As she began her recovery, she lost thousands of followers. People insulted her, accused her of lacking self-discipline and even demanded her money back. Society seems to reward clean eating and shame those who stray.
However, social media platforms are not solely to blame. Mills claims that the diet and exercise industry bears much of the blame. It promotes the idea that if you eat a certain way, you will not only look better, but be happier. This idea is internalized by young people, men and women, from an early age, that what you eat somehow reflects your worth as a person.
What can we do to prevent eating disorders from being promoted and contributing to the glamorization of clean eating and thin idealization? Setnick says the main thing is to stop judging and commenting on other people’s bodies. Accept that everyone will look different even though we all ate the same. In addition, we need to change the belief that weight change is the solution to problems. Instead, we can focus our efforts on helping people with the real issues they are struggling with, not just recommending a change in weight to make them feel better.
Whether it’s weight or food, obsession is unhealthy. Many people seek control through the magic of clean eating. Unfortunately, their diet can soon control them.
Copyright Robert T. Muller, Ph.D.