Orthorexia?

Water_Gal

My grandmother was orthorexic, for the last thirty years of her life. She thought she could manage her real health issues by managing her diet. She disregarded the advice of doctors and nutritionists and believed she had a magic formula to fix her problems. She only became sicker as her body became more malnourished. Her final primary care phys did identify her behavior as ortho/anorexic. It was too late, she weighed only 72 lbs and it was certainly a contributing factor in her death.

LAHealthAtEverySize

Hi Rosebette,

It is wonderful that you are noticing what is going on with your sister and that you are on the look out for her

I am in an eating disorder support group, and the facilitator talks often about how part of having an eating disorder is not only that a person reduces the amount they eat, but that their food choices tend to get narrower and narrower, until the person is eating a very narrow range. That narrowing of food groups out of a quest for health can end up being unhealthy and dangerous.

Yet restricting this food or that is becoming so much the societal norm, and is regarded as admirable, often times, or demonstrating restraint and will power, and is seen as healthy. When in reality, it can get unhealthy, and kick off restricting more and more types of foods.

So part of our recovery is to not only stop restricting calories, but to expand the range of foods we eat (yes, sitting down with an oreo cookie or an ice cream bar) with the recognition that no one food is going to harm us if eaten in moderation. So we have to work through the fear of trying one new (forbidden) food at a time and expanding our range.

And noticing that the oreo didn't strike us dead

I don't have anything in particular to say about your sister's situation, because only a qualified professional can really evaluate a person's eating attitudes and behaviors.

But I think it's great that you are noticing what is going on with her, and perhaps you can encourage the idea that restricting more and more food types, for some people, can start to snowball, and get kind of addictive, and to try not to restrict any group of foods entirely, because no food is harmful if eaten in moderation, and as the American Dietetic Dietitian puts it, "All foods can fit in a healthy diet."

I think orthorexics may feel that it is easier to cut out an entire group than to try to eat it in moderation. They may be afraid of losing control if they allow themselves to have a little bit of something. But that is the case with restricting in general: restricting calories causes bingeing, and restricting certain foods can cause bingeing on that food. In your sister's case, she might benefit from noticing over time that if she tries to be too pure, she's super hungry and hitting the ice cream (too hard, not that she did, but this might happen if she restricts too much), when she might have been better off allowing herself her usual foods, such as a sandwich and dessert in moderation.

If it does get worse, or if you think she might be getting unhealthy physically or psychologically, please urge her to get evaluated by a qualified professional who specializes in the treatment of eating disorders. There are so many wonderful resources, especially in N. California, including free support groups, etc. and the sooner someone gets diagnosed and treated, the easier it is for them to recover. Also, most eating disorder support groups and professionals gladly welcome people who are subclinical in their behaviors, they don't have to meet all the criteria for an e.d. to be welcomed.

Many of us with e.d.'s don't fit all the criteria as laid out in the DSM, yet receive wonderful support.

She is lucky to have you: a caring sister.

rosebette

Ironically, she is seeing a therapist for other issues, who actually encouraged her to start giving up sugar and carbs (she was already a vegetarian for moral reasons) because doing this would lift her mood and give her more energy. I sometimes wonder if some in the medical community are encouraging orthaxia -- oh, you have this or that -- no carbs, no fat, no this, no that...... for people who don't have serious medical conditions.

Actually, on vacation, she seemed pretty happy -- she wasn't overeating by any means, but there were 3 full-fat ice cream places within walking distance from where we were staying, and she ate there 3 times -- she only had the small each time, not exactly a binge, but I wonder if she was actually unconsciously replacing some of the proteins and fats she was missing in her diet. The vacation was very healthy for her as far as her mood.

SLLRunner

My grandmother was orthorexic, for the last thirty years of her life. She thought she could manage her real health issues by managing her diet. She disregarded the advice of doctors and nutritionists and believed she had a magic formula to fix her problems. She only became sicker as her body became more malnourished. Her final primary care phys did identify her behavior as ortho/anorexic. It was too late, she weighed only 72 lbs and it was certainly a contributing factor in her death.

I am so sorry. .It must have been painful to watch your grandmother go through this.

PapaChanoli

Awesome communication. Thanks for all the input.

SomeNights246

Technically it's not a recognized disorder. Yet. There are many in the field who want it to be recognized, as when someone suffers from it.. it legitimately interferes with their life. As it stands, it is most likely a form of OSFED (formally EDNOS; other forms of this are purging disorder, atypical anorexia, exercise addiction, and thinks of the like). Yes, I do believe it is a legitimate problem. The difference between it and people who are, genuinely, pursuing a healthy lifestyle.. is that the person with orthorexia becomes obsessed with their perceived healthy lifestyle. They, like everyone with an eating disorder, lose sight of the bigger picture. They get pleasure from food only when they perceive it to be healthy. They may exercise only because they believe they should, and not because they actually feel like they want to. They turn away from social events for fear of having to face food or situations that they do not deem healthy or righteous. It is, literally, a disordered thought pattern concerning exercise and food. And as such, it should be classified as a feeding and eating disorder.

My current eating disorder began with orthorexic tendencies. I became obsessed with eating only foods that I thought were healthy. First, I cut out soda. Then, chocolate went. They, I went vegetarian. Then, fat free. Before I knew it, nothing felt safe anymore and I was restricting everything. Eating disorders aren't black and white. They cross lines a lot (at one point, I was actually a binge eater). Orthorexia, just like anorexia, bulimia, and binge eating disorder... can quickly consume the person. And that's the key difference between it and someone making healthy life style changes. That it consumes them. That they are not really happy with the changes. They obsess over them, and panic when they eat or do something that they do not consider healthy. Likewise, they may not even necessarily pursue an actually healthy diet. What they perceive to be healthy could, actually, be unhealthy in the grander scheme (not just psychologically - think strict 'mono diets' here).

I think that orthorexia and anorexia have many... similarities. I have heard from many people who fit the criteria for anorexia or atypical anorexia (restrictive OSFED) that they, also, relate to orthorexia. Or have at one point or another. And vice versa. The key difference, I believe, is that during orthorexia.. one is more fixated on eating 'healthy' than counting calories, the anorexia sufferer is usually more focused on calorie counting. That aside, it is not at all uncommon for anorexia sufferers to pick up gluten free, vegetarian, vegan, or low fat diets... perceiving them to be healthier. In general, any disordered eating behaviors and thought patterns about food could, hypothetically, be an eating disorder. Orthorexia has always existed, and I'm sure many people with OSFED fit the orthorexia definition. Now there is merely a name for it.

Also, it's not surprising that the word is flung around here. This is a calorie counting, weight loss, and exercise tracking website/app. It is going to attract people with eating disorders. Both... those of us who are and aren't in recovery from them.

SomeNights246

How do you get it.....cuz I need it....like now

Sad to joke about actual disorders...

This.
I get that you were trying to be funny - but its like saying I wish I had OCD, my house needs a good clean.
Not funny and insulting to people who have the actual disorder.

OP, yes, I can understand orthorexia as a mental disorder - sort of OCD and ED combination.

Like many other new terms, it does get thrown around indiscriminately so people need to be careful about doing that.

A lot of eating disorders (especially anorexia) are sometimes comorbid with OCD. And large similarities have been drawn between the two. So, that's kind of a given.

And yes, definitely not funny to joke about it. It's just as hurtful as when people tell me they wish they could go on my diet... even knowing about my ED. I get the joke, and I get that some people don't get it, but it can hurt.

Hearts_2015

This article about a vegan blogger suffering and trying to recover from orthorexia was (for me) a good way to understand what orthorexia really is. Not just setting a lot of limits (food wise), but suffering from those limits and not knowing what to do to feel normal about food.

http://www.theblondevegan.com/2014/06/23/why-im-transitioning-away-from-veganism/

Here's a quote from it:

"I started living in a bubble of restriction. Entirely vegan, entirely plant-based, entirely gluten-free, oil-free, refined sugar-free, flour-free, dressing/sauce-free, etc. and lived my life based off of when I could and could not eat and what I could and could not combine. There is nothing wrong with any of those things (many of them are great, actually!!) but my body didn’t feel GOOD & I wasn’t listening to it.

Does that sound crazy to you?

Yeah, it sounds crazy to me too. My wake up call came when one of my best friends was in town and we went to get smoothies at Juice Press before spending the day in Central Park. We went to Juice Press because I was the difficult one– I was very limited when it came to breakfast foods, and my friends suggested Juice Press knowing it would make things easier on everyone.

I knew which juice I wanted long before we headed over… A green juice with a tiny bit of apple but not their green juice with more apple juice because that one was too sugary. (If you’re familiar with JP, I wanted ‘Series B’.) We got there, and they didn’t have it. I stared at the juices and smoothies and raw food for a good 15 minutes, panicking, because I had no idea how I was going to navigate this setback. By this time my two friends already had their smoothies and were nearly done with them. Since they’ve known me forever and they know my issues with decision making… They were patient.

Eventually my roomie Katie suggested we walk to a different Juice Press location, a mile out of our way, to get the juice I wanted. I was so relieved… Or so I convinced myself. My stomach was in knots because I had hardly eaten for days, and my body wasn’t sure it could even walk a mile without any sustenance. And we were at a raw food juice bar! A place where everything on the menu was vegan! I should NOT have been feeling so limited and so helpless."

Daiva,

Thank so much for sharing that.

My severe food restrictions were around foods that were on my "fattening" list: cakes, cookies, candies, ice cream/frozen dairy deserts, anything processed with sugar), red meat, pork, breads, eggs, oils, anything that had more than 10% fat in it. Therefore, what I allowed myself was fruit, vegetables, salads (luckily I don't like dressing at all), I also had convinced myself I was allergic to granulated sugar. If I ate outside of these foods I felt like I was "cheating" on my "diet" and would then go all out and binge.

I don't know what I describe is even related to orthorexia, but for me it was heading down a dangerous road because (1) I could not do proper portion control because I missed the foods I loved, therefore I binged, and (2) I didn't have a whole lot of energy to move as much as I felt I needed to.

It took me years to work on this mindset and to realize that no food in and of itself is good or bad. Food is just food. It's going to take me the same amount of calories to lose, gain, or maintain, no matter what eat. Once I realized this, and I began to understand that I can eat foods I love in moderation, a whole new world opened up to me.

An example is today. My man made some of the most wonderful zucchini bread from scratch. He had all the nutrition information and everything. When I was doing food restriction, I would have steered clear of it because it was fattening and I was not allowed fattening food. Today, I weighed a piece out, logged it, put a measured portion of butter on it, and I enjoyed every single bite.

When he asked me if I wanted to take some with me I said no thank you. His comment was, "well, it's pretty healthy." I said, "I don't doubt that, but I don't want to spend all my calories on any one thing." Also, that wonderful piece I had was enough for me, where it the past it would not have been.

To add to what I said above, there is nothing wrong with restricting trigger foods that you feel you are not ready to have in your diet.

GertrudeHorse

Technically it's not a recognized disorder. Yet. There are many in the field who want it to be recognized, as when someone suffers from it.. it legitimately interferes with their life. As it stands, it is most likely a form of OSFED (formally EDNOS; other forms of this are purging disorder, atypical anorexia, exercise addiction, and thinks of the like). Yes, I do believe it is a legitimate problem. The difference between it and people who are, genuinely, pursuing a healthy lifestyle.. is that the person with orthorexia becomes obsessed with their perceived healthy lifestyle. They, like everyone with an eating disorder, lose sight of the bigger picture. They get pleasure from food only when they perceive it to be healthy. They may exercise only because they believe they should, and not because they actually feel like they want to. They turn away from social events for fear of having to face food or situations that they do not deem healthy or righteous. It is, literally, a disordered thought pattern concerning exercise and food. And as such, it should be classified as a feeding and eating disorder.

My current eating disorder began with orthorexic tendencies. I became obsessed with eating only foods that I thought were healthy. First, I cut out soda. Then, chocolate went. They, I went vegetarian. Then, fat free. Before I knew it, nothing felt safe anymore and I was restricting everything. Eating disorders aren't black and white. They cross lines a lot (at one point, I was actually a binge eater). Orthorexia, just like anorexia, bulimia, and binge eating disorder... can quickly consume the person. And that's the key difference between it and someone making healthy life style changes. That it consumes them. That they are not really happy with the changes. They obsess over them, and panic when they eat or do something that they do not consider healthy. Likewise, they may not even necessarily pursue an actually healthy diet. What they perceive to be healthy could, actually, be unhealthy in the grander scheme (not just psychologically - think strict 'mono diets' here).

I think that orthorexia and anorexia have many... similarities. I have heard from many people who fit the criteria for anorexia or atypical anorexia (restrictive OSFED) that they, also, relate to orthorexia. Or have at one point or another. And vice versa. The key difference, I believe, is that during orthorexia.. one is more fixated on eating 'healthy' than counting calories, the anorexia sufferer is usually more focused on calorie counting. That aside, it is not at all uncommon for anorexia sufferers to pick up gluten free, vegetarian, vegan, or low fat diets... perceiving them to be healthier. In general, any disordered eating behaviors and thought patterns about food could, hypothetically, be an eating disorder. Orthorexia has always existed, and I'm sure many people with OSFED fit the orthorexia definition. Now there is merely a name for it.

Also, it's not surprising that the word is flung around here. This is a calorie counting, weight loss, and exercise tracking website/app. It is going to attract people with eating disorders. Both... those of us who are and aren't in recovery from them.

Agree with all of this. Perfectly said. The only thing I'd add is that orthorexia is when the obsession with being healthy actually becomes unhealthy. That is, it's based on the distorted belief that "X = healthy food = good" therefore "exclusively eating X = super super extremely healthy and perfect".

Athijade

How do you get it.....cuz I need it....like now

Sad to joke about actual disorders...

This.
I get that you were trying to be funny - but its like saying I wish I had OCD, my house needs a good clean.
Not funny and insulting to people who have the actual disorder.

OP, yes, I can understand orthorexia as a mental disorder - sort of OCD and ED combination.

Like many other new terms, it does get thrown around indiscriminately so people need to be careful about doing that.

A lot of eating disorders (especially anorexia) are sometimes comorbid with OCD. And large similarities have been drawn between the two. So, that's kind of a given.

And yes, definitely not funny to joke about it. It's just as hurtful as when people tell me they wish they could go on my diet... even knowing about my ED. I get the joke, and I get that some people don't get it, but it can hurt.

I am actually very concerned about the possibility of ended with taking what I am doing on MFP and going overboard with it. My therapist and my psych are making sure to ask questions about it in order to keep be from going into a disordered thinking when it comes to food. Why? Because I already suffer from OCD, GAD, and Depression.

There are times where I have to force myself to not log for a day or I start down the obsessive road. I can't stop reading every label because I also have medical concerns that can be made worse by specific foods, including many that like to hide in foods (like soy).

The difference with a "normal" person and someone with disordered thinking is that the disordered thinking impacts just about every aspect of ones life. Thanks to medication that no longer happens for me, but I can still remember when it did. It's not fun. It's nothing to joke about (though I do joke about it when it comes to ME because it is one of the ways I deal with it). You don't have OCD just because you like to organize things so stop saying "OMG I am SOOOOOO OCD!" If you had it, you wouldn't be saying that.

Lawngirl296

My daughter struggled with this for 2 years while in college. I can assure you that there is nothing funny or normal about the thought process. To believe that something you eat is so bad for you that it makes you a horrible person to even think about eating it is painful to watch. It is not just restricting what you eat but if you eat it you will die and that is not an exaggeration, she really believed that. Instead of teaching and learning "everything in moderation" we hear that "clean and green" is the only way to go makes it too black and white. It is a good thing to eat healthy, avoid processed food, and chemicals BUT if for some reason you cannot avoid it, it has to be OK and for people suffering with this disorder it is not.
As much as MFP can help someone like me to keep track of the over eating and it does, it also was the thing that keep my daughter obsessed with calories, weight and exercise. Again everything in moderation and some people can't do that no matter how hard they try or how much they want to.