Orthorexia Nervosa - healthy eating obsession

[Broxy]

Orthorexia nervosa is defined as an obsession with eating to improve health. Those who suffer from orthorexia have an unhealthy obsession with healthy eating. The condition orthorexia comes from the Greek word “ortho”, meaning straight/correct and “orexia”, meaning appetite. Dr.Steven Bratman, an MD who specializes in treating eating disorders, has seen many people in his practice with strict food habits, such as vegans (vegetarians who eat no eggs, dairy or animal products), raw food followers, and people who follow the strict food rules of macrobiotics [Dietitians of Canada; Addiction, Mental Health, and Eating Disorder Network, 2009].

The term “orthorexia nervosa” is a label given to those who push interest in normally healthy foods to extreme levels. Experts believe that the condition can begin with a desire to overcome illness or to simply improve general health, but over time, what they eat, how much, and the consequences of dietary restrictions come to occupy a greater and greater proportion of a person’s day. It becomes a way of life filled with concern for the quality of food being consumed. When a person suffering with orthorexia nervosa slips up from the “perfect” diet, they may resort to extreme acts of self-discipline including further restriction.

Orthorexia shows close links to anorexia nervosa (AN) or an eating disorder not otherwise specified (EDNOS). There is an obsession about food and restricting what they eat, for example, cutting out fat, or whole food groups, often seen in those suffering from AN [Dietitians of Canada; Addiction, Mental Health, and Eating Disorder Network, 2009].

By no means is this post suggesting that I think anyone in the gym has this condition. However, with a background in Foods & Nutrition and Life Sciences (two B.Sc.’s) I often listen intently when people discuss their views on healthy eating and various diets (i.e. The Zone, Paleo, etc.) that seem to be popular with CrossFitters. Sometimes I leave the gym wondering, “Can someone really eat the same 10-15 items every single day, seven days a week, and NOT get bored of the routine?” or “I wonder how weighing exact portions of foods works when visiting friends, family, or out to dinner at a restaurant… or is that a part of their social life they can no longer fully partake in due to their food restrictions?”

To quote Ellyn Satter, a Registered Dietitian and Social Worker who has been writing on this topic for a decade or more, “Normal eating is being able to eat when you are hungry and continue to eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it – not just stop eating because you think you should. Normal eating is being able to use some moderate constraint in your food selection to get the right food, but not being so restrictive that you miss out on pleasurable foods. Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good…Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but KEEPS ITS PLACE AS ONLY ONE AREA OF YOUR LIFE. In short, normal eating is flexible. It varies in response to your emotions, your schedule, your hunger, and your proximity to food”. [From Ellyn Satter’s book “How to Get Your Kid to Eat But Not Too Much”]

So here is my two cents on “healthy eating”:
Healthy eating is eating a variety of foods, from all of the four food groups, in moderation. Enjoying delicious and healthy food is one of life's pleasures. Today's dietitians have an approach to healthy eating called, the total diet approach. This means that no food should be labelled as good or bad. In fact, all foods can be part of healthy eating patterns. A healthy diet is one that is based on moderation, and variety, not restriction, and combined with regular physical exercise, can help individuals achieve an appropriate, maintainable bodyweight for life.

[dccollie]

I think it's important to give some quantifiable measure to what constitutes extreme behaviour. I weigh and measure most of my food. To most people this is an extreme behaviour. However, I don't think about food any more than I used to before I started zoning and I haven't noticed any increase in my time preparing food.

Would a fair definition of extreme behaviour be that which causes harm to one self or drastically restricts ones lifestyle?

To answer some of your other questions. I've been following the zone diet for the past 4-5 months. Which means I weigh and measure my food... most of the time. I've also logged everything I've eaten for a couple of weeks at various intervals. I found this process very helpful in determining appropriate portion sizes. I am fairly consistent with weighing and measuring but there are times when I just estimate how much I need. Previous experience with weighing and measuring has helped me be more accurate in my estimates.

In terms of food variety I try to try something new every week and change up what I buy when I get groceries. I know that I can eat the same thing everyday for weeks. But for me that leads to binging when I finally can't take it anymore. I think that variety, like you said, is key in any diet in order to be sustainable.

Socially, I don't feel as if I've had to give anything up. I try to control my portions when eating out and not feel like I have to finish everything put in front of me. At the same time I don't regularly eat out or drink a lot. So when I do either I don't feel too bad because I know that my diet is good.

I spent the last six days in airports, hotels, and crashing on a friend's couch. I tried to make healthy choice when picking food but at many times my options were limited. So I didn't worry too much about it and did the best I could. This has probably been the first time since Christmas that I was not following the zone diet for a period of more than a day or two. Trying to pick food that I felt was healthy was always at the back of my mind at every meal but it wasn't my primary concern.

So for me my diet gives me a reliable metric for controlling my portions and relating food intake to performance. While still providing variety and flexibility to occasionally venture outside of the "recommended" foods.

[Merritt]

A agree with both posts. I'm not zoning, but have been pretty stict paleo eating for a few weeks now. While initially the foods you can't eat seem daunting, I've found the transition far easier than I had anticipated. I had always eaten healthy, but having a farily firm set of rules to follow make it easy to kick it up a notch. The zone would never have worked for me like is has for many, only because the weighing and measuring would have failed after a while and therefore so would have been the diet. Paleo for me however doesn't really limit quantity, only what you should be eating. i decided to give this 30 days as strict as I can to see how my body reacts and if my performance goes up or down. I can honestly say that the changes have already been positive. I'm not going to lie and say I'll never cheat, but eating an almost all natural and veggie heavy diet isn't one that I have found to be bad. In general I just needed to find a way to overhaul my eating with a strategy that has proven successful and that works for my lifestyle. Zone, Paleo, everything in moderation etc... any eating habits that work for active people can work. Just listen to your body

[Freeman]

This is a very interesting post. 2 Comments: 1) Healthy eating and 2) obsessive behaviour

1) Healthy Eating: I find that a main benefit of the Zone diet is that it gives me a framework to follow. Without this framework I would have very little knowledge of appropriate portion size. Within the Zone framework and after weighing and measuring for a short time, portion size becomes obvious. Look around you, most people in this world have no clue about proper portion size. The "eat until you are full, listen to your body" philosophy does not work when you are eating too much calorie dense foods. Zone provides the framework that tells me what and how much I should be eating. The goal is to gradually improve within the Zone framework. Without a framework either Zone, Paleo or whatever, you don't have a chance.

2) Obsessive Behaviour: There seems to be a lot of obsessive behaviours within society "these days". Each classroom of children now has a least one kid with terets, compulsions, childhood ticks, (and another compulsive disorder with a funny name that I can't remember right now) etc. Adult compulsions are even more numerous such as eating disorders mentioned above, drug abuse, sexual compulsions such as pedophilia, porn or cross dressing, shopping addicts and all other manner of uncontrollable destructive behaiour. Makes you wonder about the source of these behaiours. Are they learned behaviors, a response to an enviromental stimulous or a genetic defect. Certainly putting on frilly underwear and high heels is not coded in ones DNA. Are these North American diseases of afluence causing us to be feable minded and not responsible for our behaviour? Perhaps these behaviours are part of our DNA makeup and science is just better at diagnosing, labeling and informing us that such things exist.

[Broxy]

Very interesting discussion we have going on here! All three of you make excellent comments that I agree with. The reason why "diets" like the Zone or Paleo work for people is because they teach the general public who have varying levels of knowledge in nutrition the principles of healthy eating ("eat LOTS of veggies" - Paleo) and appropriate portion sizes ("weigh and measure your food"... until you have an intuitive understanding - Zone).

That being said, I think being focused on what you eat using a tool such as Zone or Paleo isn't a bad thing, and can be great at helping make good nutrition a permanent and easy lifestyle change. The topic I posted on Orthorexia Nervosa relates to the EXTREME of a behaviour, which like John touched upon, can manifest itself in many forms today (food, sex, alcohol, drugs, personality, etc). It's a topic that was meant to spark interest and create conversation, because hopefully readers take a moment for some introspection to see how much their eating habits play a role in their day-to-day thinking, activities, and social lives. If you can happily and healthily say that you eat well without it controlling your life, AMAZING, you are ahead of 36% of our population that is overweight (BMI > 25.0 kg/m2) and the 24% that is obese (BMI > 30 kg/m2) [Statistics Canada, 2005]!