The dangers of a perfect diet

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First appeared in Sunday Telegraph.

There’s no doubt about it: eating healthily is an important part of achieving all-round wellbeing. Yet anything and everything, however positive and sensible, can become distorted or perverted when taken to extremes. So, today, in advance of National Eating Disorders Awareness week (23rd Feb – 1st March), I’m looking at what happens when healthy eating goes too far and becomes a debilitating obsession – a disorder – in and of itself.

The answer is Orthorexia, a term coined in 1997 by Dr Steven Bratman in an article for the Yoga Journal, which refers to a debilitating and restrictive obsession with eating in whatever way the sufferer perceives as healthy.

“It can in fact often bear more resemblance to Obsessive Compulsive Disorder (OCD) in that it is characterised by a fixation on righteous eating, eating only “pure” foods and trying to avoid contamination by food,” says Susan Ringwood, Chief Executive Officer for UK eating disorder charity, Beat (www.b-eat.co.uk).

Bizarrely perhaps, though Beat agrees that anecdotally professionals are reporting an increase in individuals suffering from symptoms of orthorexia, the condition still does not have a formal medical classification and as such isn’t regarded as an ‘official’ eating disorder. Yet, having seen orthorexia in action, several times, I know only too well that (‘anecdotally’) it can be just as harmful and upsetting as other major eating disorders because it involves the same intense, joy-sucking preoccupation with food and body issues. The only difference is that, unlike with anorexia where food intake restricted, or bulimia where food binges are followed by some form of purging, orthorexia always involves an intense compulsion to stick to any single way of eating food, thinking about food and behaving around food.

When choice and flexibility moves to compulsion and rigidity, it’s usually a sign that something deeper is going on.

Let’s be clear: orthorexia isn’t the same as following a specific eating plan for religious or ethical reasons, or because of food intolerances. Yet the line between the two is often blurry hence why orthorexia can go undetected, or even hide in plain sight as it often does in the fitness industry. Whether one’s particular compulsion is to follow a paleo/caveman, macrobiotic, low fat, low carb or gluten-free diet, doesn’t matter. But when choice and flexibility moves to compulsion and rigidity, it’s usually a sign that something deeper is going on.

Emmy Gilmour, Clinical Director at London’s specialist eating disorders centre, The Recover Clinic (http://www.therecoverclinic.co.uk/), has 15 years’ experience working with sufferers of various eating disorders. She says: “Orthorexia is when a way of eating shifts from being a choice and temporary measure, to becoming part of who you are and how you live. Cutting out entire food groups from your diet under the guise of it being a healthy diet is not necessarily healthy.”

The core issue with any eating disorder, including orthorexia, is usually less to do with eating behaviours (which we might call symptoms) and more what’s going on beneath the flesh, in the heart and head (the underlying cause). In essence orthorexia develops when a person can’t feel good about themselves without adhering to stringent rules around eating; when they fear a type of ‘bad’ food because they don’t feel safe or worthy if they eat it; if they find themselves regularly overriding their body’s needs because they can’t bear the thought of ‘failing’ in a misdirected quest for wholeness via nutritional virtue.

“There’s a really strong connection between what’s going on for you emotionally and how you respond to that in your eating,” says Gilmour. “So thoughts and feelings become translated into ideas and behaviours around food, such as needing to maintain this lifestyle to feel in control of your world. And actually the origins of the problem are how you feel about yourself and your responses to your emotions.”

It makes sense, then, to tackle orthorexia via talking therapies rather than yet another, albeit less restrictive, meal plan.

“Recovery is about developing an ability to eat intuitively based on what you want, what you feel like and what your body needs,” says Gilmour. “We need to trust that our bodies are amazing machines and they really know what we need and want. Patients don’t graduate from the eating disorders programme at our clinic until they are entirely free of (obsessive) eating disorders behaviours and obsessive thoughts. Our goal isn’t about helping people reach a stable weight – it’s about how their head is working and how they are responding.”

So there you have it. As any readers of this column will know, I’m a huge advocate for eating ‘clean’ (unprocessed) foods wherever possible and trying to think about what we put in our mouths. But having worked alongside recreational athletes, personal trainers and members of the general public befuddled and / or intoxicated by the latest diet craze, I’ve realised there’s a big caveat here: true health is an ongoing process and comes about with moderation. We need to be watchful over even the healthiest of eating patterns, to be curious about why we are following or trying a diet so as to ensure it comes from a place of self-nourishment rather than self-punishment.

Signs that you, or someone you know, may be suffering from orthorexia:
• Obsession with maintaining what the sufferer determines to be a ‘perfect’ diet.
• Restricting foods because of allergies which are often not confirmed by a physician.
• Excessive and obsessive use of supplements.
• Often low weight.
• Obsession with exercise.
• Irrational behaviours regarding food preparation and cleanliness.
• Fixation upon foods that they feel are healthy and ‘pure’.
• Obsession about the links between foods and any related health concerns.

– By Lucy Fry

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