Crossing the Healthy Line
Written by Corinne Dobbas, MS, RD // December 15, 2009 // Body Image, Health, Nutrition // 23 Comments
GGB is all about healthifying–becoming even more of a lean, mean, green, disease-fighting machine–and MOST importantly, just feeling better! Yet, there is a line that can be crossed in people’s healthifying efforts.
That line is crossed once eating healthfully—or purely—becomes an obsession. Once one enters this realm of healthy eating obsession, orthorexia nervosa may be the culprit (“ortho” means straight and “orexia” refers to appetite).
Yes—orthorexia nervosa– not anorexia nervosa. They are both psychological disorders, yet they differ in that those with anorexia nervosa, as well as bulimia nervosa, obsess about calories, weight, and the quantity of food consumed, whereas those with orthorexia nervosa obsess, on a long-term basis, about “healthy” eating and the quality of foods consumed. Simply put, orthorexics strive for personal purity in their eating habits—think lots of “raw foods” straight from Mother Earth. Here, weight and calories are not the main focus—“pure” foods are.
Ellen Astrachan-Fletcher, a clinical psychologist and director of the eating disorders clinic at the University of Illinois at Chicago, stated in The Downside of Eating Too Healthy:
While orthorexia begins with a desire to achieve better health, it’s very connected to an underlying fear of food. If I believe the food will make me sick, I become afraid of it, and I avoid it and, bit by bit, continue to avoid more and more food types.
Orthorexia is not an officially recognized disorder. According to Psychology Today, the term was coined in 1997 by Alternative Medicine Specialist and author of the book Health Food Junkies, Steven Bratman, who suffered from the disorder himself. In the article Orthorexia: Good Diets Gone Bad, Bratman states, “”This is about the obsession with eating to improve your health.”
In Orthorexia: Good Diets Gone Bad, Bratman says:
The obsession doesn’t necessarily lie just between the mouth and the other end. An out-of-control healthy eater feels a sense of spirituality…You’re doing a good, virtuous thing. You also feel that because it’s difficult to do, it must be virtuous. The more extreme you are, the more virtuous you feel
P.S. there is NOTHING wrong with root veggies, tropical fruits, grains, or beans! In fact, these things are packed with phytochemicals, minerals, vitamins, and fiber! EAT. THEM. UP.
What are signs of Orthorexia?
According to the Palo Alto Medical Foundation, people suffering from this obsession may exhibit the following characteristics:
- Spending more than three hours a day thinking about healthy food
- Planning tomorrow’s menu today
- Feeling virtuous about what they eat, but not enjoying it much
- Continually limiting the number of foods they eat
- Experiencing a reduced quality of life or social isolation (because their diet makes it difficult for them to eat anywhere but at home)
- Feeling critical of others who do not eat as well they do
- Skipping foods they once enjoyed in order to eat the “right” foods
- Feeling guilt or self-loathing when they stray from their diet
- Feeling in “total” control when they eat the correct diet
Treatment Info
According to Astrachan-Fletcher,
Orthorexia should be treated as anorexia. According to the National Institutes of Health (NIH), the treatment for anorexia is three-pronged: “restoring the person to a healthy weight, treating the psychological issues related to the eating disorder, [and] reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing a relapse.
In treatment, Medical Doctors, Registered Dietitians, and psychotherapists specializing in eating disorders, each play an integral role in getting the patient back up to a healthified stance.
Too Much of a Good Thing
Multiple articles on this topic have appeared over the last few weeks, and I have received questions on the topic. Hence, I was prompted to share my findings with you. But, even more so—I wanted to show how a good thing—eating “healthfully”—can be taken way too far!
Yes, stacking your plate high with veggies and fruits, getting in lean sources of protein, amping
up the fiber, downing low-fat or non-fat dairy, wheeling and dealing heart healthy beans, and crushin’ on whole grains, are uber important for health and wellness! But, what I also think is HIGHLY important is enjoying your life and your food!
My rule of thumb is eat 90% healthy and allow for a daily 10% indulgence. So go ahead–have that slice of cake, scoop of ice cream, or few Hershey’s kisses—just make sure it’s not half a cake, 5 scoops of ice cream, or 20 kisses—see the difference?
You should truly enjoy the food you eat and allow for a daily treat! After all, who wants to eat boring “health” food all their life? If you don’t like your “healthy” chow, try new healthy recipes! Go snag a healthy cookbook you like—buy one used if you’re short on cash. Or, spend a couple hours browsing online—with the gazillion foodie sites now awaiting for that click of your mouse, I’m sure you’ll find some recipes you adore!
Lastly, DON’T feel restricted because if you do—I bet that cabinet with the “forbidden” foods will soon not be so forbidden. Make that food “unforbidden,” have a serving, and then put it back. The problem will be if you can’t put it back, then and only then, you may want to consider temporarily evicting that item from your place.
The Bottom Line:
If you or someone you know has an eating disorder, get in touch with a medical professional—they are treatable disorders. Visit the National Eating Disorders Association for further information and helpful resources.
Eat healthy fare you enjoy and indulge in a sweet treat now and then! After all, you follow a healthy lifestyle NOT a diet. AND, if you ask me, a lifestyle just isn’t healthy if you aren’t happy!
Happy Healthifying!
What are your thoughts?
I say goodbye to fad diets, bogus "fat-burning" pills, and processed, non-food food. And, I smile hello to a healthifying lifestyle full of fruits, veggies, and whole grains, sweaty workouts, the occasional "chocolate fix," sleep, family and friend time, and quality "me time" with a focus on health. I look forward to your comments and thoughts as the posts healthify on by!
23 Comments on " Crossing the Healthy Line "
Fantastic post. I did a post on this same issue about a month ago, maybe longer, and people seemed to really appreciate it. Just like them, this concept was fairly new to me, but in the blog world it seems to be something that is more prevelant than ever. It could just seem like many people have this problem, and they may not really, but still it’s too serious to ignore. Thanks for all of your great information. I didn’t even know there was an American Eating Disorder Association!! Yikes Gina, wake up!
VERY interesting! I think it’s important as RDs to keep this in mind for ourselves!! Even the best intentioned RD can overdo it. As long as we’re able to keep a positive mindset and recognize that we LOVE food and are not obsessed with it, we can have that healthy relationship.
Thanks for this informative post!
Great post! This is an important topic and often easily dismissed. I think people start out on a diet or change in lifestyle with good intentions that sometimes turn into an obsession. I’ve noticed it a lot in the blog world lately and it worries me. How do you approach the subject with a fellow blogger without offending them? I sent an email to one blogger a long time ago and she replied back swearing at me. I wasn’t rude to her at all, but now I don’t even bother saying anything. Unfortunately, it’s only gotten worse in her case. What do you do though?
I agree and that’s what I found in my research. People often start out on a “healthy” kick and then it just spirals out of control! And, I hear you on the blog front–it worries me as well. Hopefully, friends and family are there for them and help them help themselves. It is a very tricky situation.
Thanks for your thoughts Melissa!
What an enlightening post! I have never heard of orthorexia nervosa. People’s issues with food come in all forms which I think we have a hard time realizing. It may seem as if someone is just “health conscious” when in fact their eating may be an extreme.
Thank you for this educational post – definitely makes me think about things!
Great post! A friend of mine had this and her thoughts about eating healthy really consumed her. She’d often cancel plans because she had to make dinner. She also suffered a bit from exercise addiction. I wonder how often those two go hand in hand.
GREAT post girl- this is so crazy and its so common too, people dont even realize it
Great post! I think I’ve previously suffered from a mild case of being too much of a health junkie, but then I looked at my diet at realized “too much” healthiness isn’t necessarily a good thing, or a fun thing. Now I have treats all the time, and love them! The key is trying to stick to small portions, like just one square of dark chocolate a day (something I struggle with). But life is all about having fun, and eating fun food is a part of this!
I *think* I’ve heard of orthorexia before, but THANK YOU for this information. This is so valuable and really makes me understand how disordered so many people’s eating is — orthorexic or not. Thanks, Corrine!
I am so HAPPY you posted this!! This is something that is becoming so predominant in society and I especially find it to be (scarily) dominant in the Blogging world…you have to be guilty because honestly I feel guilty for coming home from work and eating a few mini-Twix or cake every night…or something! I think some people can develop into food ‘snobs’…not that there’s anything wrong with choosing to do what you want and being healthy – but too much of anything is not good for you!! I find too that things change so much – it will backfire on you…and what you ate a few years ago isn’t what you will in a few more years. I personally like blogs like EatLiveRun that show a variety of foods . Jenna said she used to be vegetarian for a few years but then decided to just go with how she feels. I think the minute we start obsessing over everything is the minute we’ve ‘lost’ our own ability to live and handed it off to food. I mean…if your skydiving or spending time with a loved one or at a live concert…are you really worried about whether or not you should eat those oatmeal raisin cookies or what they’re made of??!!!
Oh and just one square of dark chocolate?! Yikes.
I agree! You MUST treat yourself and enjoy the food you eat! So–keep up the variety and don’t feel bad about the mini-Twix!!! And, personally–I think more than one square of dark chocolate is A-Okay! Expecially, when you’re in the mood! And, a bonus is that the dark is packed with antioxidants
Great post! I learned so much! Hope you’re doing well!
Just added you to my Blogroll. 
Great post! I had recently read an article on orthorexia and I think it is becoming more and more common as people are getting more into organic and natural foods, etc.
I think this is something that can get out of hand easily. Unfortunately, I see fellow dietitians who have taken to the extreme of healthy eating. I agree it is not the way to live but there are some dietitians who disagree. I would not do so well without a piece of chocolate or glass of wine on occasion.
I am sure we will be hearing more on this topic in the future.
Great post, very informative! I have heard of this before. Looking back when I first got interested in nutrition I now know that I had this to an extent, not that extreme, but definitely limited because I wanted to eat healthy, but I wasn’t eating enough!! I was eating for a 30yr old non-active woman, not a dancer in highschool. Anywho, I don’t have that problem anymore and eat it all up
Thanks for the comment Kristen
Glad to hear you EAT IT ALL UP
!!!
“My rule of thumb is eat 90% healthy and allow for a daily 10% indulgence.”
In this context what exactly is meant by “healthy”? Does it include GMOs, or factory farm meat (often unnaturally high in Omega-6, and absolutely covered in fecal materials)? Does it include conventionally grown produce, or, highly processed foods that happened to be low in saturated/trans fat?
I’m not confident that some of these practices are necessarily bad for us, but I am most certainly not convinced that the food stuffs which make up so much of our daily diets are, in fact, healthy. So, does that 90% include those products, or, not? Obviously this classification is up to the individual consumer.
That being said, as nutrition health professionals (RDs and future RDs alike) can we justify recommending foods that are genetically modified, covered in pesticides, or produced from animals that are fed unnatural diets and spend their lives living in their own feces? I’m not sure, but I am sure that as nutritional professionals these facts must be taken into consideration when calling anything healthy, or recommending foods and diets.
It easy to see how such a disorder could arise and perhaps is the most unfortunate part of our current situation.
I agree.The term “healthy” will differ for each person, as it does even for health professionals. In my opinion, healthy revolves around eating mostly plant based foods as close to their natural form as possible. Is organic necessary? Maybe. But, what I believe is way more important is if the food is grown using sustainable practices. Some farmers use “organic” farming methods as well as sustainable practices, yet just can’t afford the process of becoming organically certified. Personally, I rather eat the locally grown sustainable product than the organic one flown in from across the country days after picked off the vine or produced.
Regarding meats, should you try to eat grass-fed products without added hormones? Of course! But, let’s be real, some people can’t afford it–so they’re best off buying just lean products. Going vegetarian and eating mostly plant proteins would perhaps be ideal. But, let’s be real–not all people are vegetarians. In fact, most are not. So, in a perfect world–there would be no GMOs and no factory farm raised animals, but with the population expected to increase by about 50% in 2010, causing a consequential decrease in land and increase in food needs, the ability for this concerns me. It seems almost inevitable that more and more food will be “contaminated.” The goal is to stop this, but how?
Regarding GMOs, according to the World Health Organization (WHO), GMOs are organisms in which the genetic makeup, DNA, has been altered in a way that does not occur naturally. “Modern biotechnology,” “gene technology,” “recombinant DNA technology,” and “genetic engineering” are terms typically used to describe GMO technology. In 2008 a remarkable 125 million hectares of biotech crops were grown a 9.4% increase from 2007 with the top crops being soybean, maize, cotton and canola at 53%, 30%, 12%, and 5% of global biotech crop area, respectively. From 1996, when the first GMOs were commercialized, to 2008, a 74-fold increase resulted in the global area of planted biotech crops. Hence, even if you think you’re GMO free–I doubt it, as the US is a top consumer of these seeds.
Also, obviously, the food stuffs that make up most of our daily diet aren’t healthy! Look at the state of our health! So, to me, it seems backwards to set unrealistic goals with people and have them eat all the time 100% GMO, pesticide, hormone, insecticide free. A good goal, yes. Also, even organic foods have chemicals in them, less yes, but they’re still there.
I agree that there are MANY MANY factors to consider regarding what is healthy. But, I also agree that each has their own food philosophy. Perhaps ours just differ.
Thanks for the comment.
Corinne,
I must disagree with your largely fatalistic attitude toward our current food situation. We have an immense problem with our current agricultural system; however, accepting its flaws as necessary evils should not be the case. And, as food “experts” we must help guide the public’s opinions toward one that is more sustainable and, perhaps, healthy.
For example, you write, “Regarding meats, should you try to eat grass-fed products without added hormones? Of course!” Later in the same paragraph you continue, “but with the population expected to increase by about 50% in 2010, causing a consequential decrease in land and increase in food needs, the ability for this concerns me. It seems almost inevitable that more and more food will be “contaminated.” The goal is to stop this, but how?” The answer is quite simple (although much more difficult to implement), we must move toward a plant based diet. Regardless of the benefits of grass fed beef, or proper farming husbandry, they are inherently less efficient at generating calories than plants. It may be healthier to eat grass fed beef (due to the EFA profile), and the animals may be better treated, but it still does not address the fact that is a horribly inefficient way to produce calories.
As for GMOs, you’re absolutely right, there are problems with cross contamination of GMOs on organic product, and the soybean market is absolutely dominated by GM soybeans, but that does not mean choosing organics does not help attack the GMO problem. A higher consumer demand for organics is also a vote for non-GMOs and given the immense rate of growth in organics this is something important to the American people. Additionally, we as nutrition professionals need to lobby our congress people for better regulation and labeling for GMOs. Americans wouldn’t buy margarine when it first hit the shelves because it was required to be called “imitation butter.” I have a strong feeling that a big bright tag that says, “This product contains Genetically Modified Organisms” is going to make people have second thoughts when making food choices.
But creating an agriculture system that is pesticide, GMO free, and much more plant dependent cannot happen without our advocacy. We must not be afraid to provide recommendations that include comments that promote organics, local produce, deride GMOs and are favorable toward vegetarian/vegan diets. Telling people that they should eat plants is not enough today and if we are to be the world’s leading nutrition body we must include all of these factors in our recommendations. Additionally, we must form better public policy measures, lobby more effectively, and become more visible to the public. We cannot just be (in the public’s perception) the people who tell you whether eggs are bad or good for you this year, we must be the experts in all aspects of food and nutrition.
Perhaps a good start to this trend would be to cancel the keynote speakers at FNCE 2010 who are absolutely irrelevant to our profession – Suze Orman, Soledad O’Brien, and Pamela Jett – and replace them with talks of how to tackle the agricultural problems and how to better effectively advocate legislative change.
We cannot just accept these problems as necessary evils and we cannot accept that Americans are not willing, able, or intelligent enough to understand the complex problems that affect their lives daily.
Cheers,
Aaron
Ps. I recommend everyone read Don Lotter’s “The Genetic Engineering of Food and the Failure of Science.” http://www.ijsaf.org/contents/16-1/lotter1/index.html
Aaron,
We do have an immense problem. I agree. And, in fact, I do lobby for sustainable health and nutrition practices, which promote clean, pure, locally grown food. As “experts” I think we all do or at least should. However, this article, under which comments were made, is essentially discussing people with eating disorders. I assure you did not mean this, but you CANNOT set more limitations with foods for those with eating disorders. In fact, with the RD/psychologist/MD help you need to go in the opposite direction.
Regarding your comment, you brought up my point on “grass-fed animals with no added hormones.” You did not add what I also wrote: “Going vegetarian and eating mostly plant proteins would perhaps be ideal.” I agree that eating a mostly plant-based diet is best. That’s actually what I promote along with sustainable, locally grown, GMO-free products. I agree.
As I wrote before, to me, “healthy revolves around eating mostly plant based foods as close to their natural form as possible.” So, perhaps we actually do share similar views.
Lastly, each health professional does weigh-in with their own opinion regarding food and has different counseling/public health approaches. And, each eats differently. We share similar views in some aspects and perhaps differ in other. Yet, this is somewhat hard to tell over a blog. Regardless, I will say my views on food/nutrition/health are reflected in my blog. Perhaps our opinions simply differ.
You bring up very valid important questions that should be addressed regarding farming, food production, pesticides, etc. I think you should start your own blog about this, as this is not the intention/focus of this blog.
Also, that is a good article. Thanks for putting it out there for people.
Happy Holidays, Corinne
Corinne,
First, thanks for the timely response.
Regarding your comment on vegetarianism being ideal, the sentence you wrote, which I previously quoted, read as follows:
Regarding meats, should you try to eat grass-fed products without added hormones? Of course!
If an argument for vegetarianism was actually being made the following sentence would rebuke the idea that we should eat grass-fed beef at all; rather, it would declare given the current state of affairs meat-eating should be abandoned all together.
Regarding the irrelevance of my post to orthorexia and the intentions of the blog I refer you to Barthes’ “Death Of The Author” (PDF: http://bobbybelote.com/!!teaching/Readings/BarthesAuthor.pdf).
Cheers,
Aaron
Aaron,
I believe you have valid points, I respect your opinion, and agree with you on many of the statements you made. If you do not like what I have to say, I simply suggest you no longer read what I have to say. There are thousands of health and nutrition blogs out there. I am sure you will find one you like. Or, I believe you should start your own.
Best, Corinne
great post!!!
i know many people (myself included) that would fit some of the listed criteria for othorexia. Its something I think we dietetics students really struggle with. How do we urge people to eat more healthy foods, yet not cross that line? A lot of it has to do with your relationship with food, and level of self/body acceptance. Its a tough topic. I probably do spending too much time thinking about healthy food and planning out meals. I do limit some of my food options. But I also do allow myself treats. But the treats I choose are healthier versions of the normal. I feel totally guilt-free indulging in raw desserts, but don’t eat regular ice cream…. Is this a problem-I don’t know. I do know however that I feel great and am happy! In the past I have been more severe in my restrictions and know that was unhealthy. Its really about finding that balance and moderation (that golden word).
there’s my two cents. Thanks for sharing yours! I think your 90-10 rule is a good one, and one that clients could easily achieve!
Thanks Elizabeth