Do you have friends who seem preoccupied with avoiding foods that are harmful to them?
Do they give you a primer about why your dinner isn’t good for you?
Have they recently lost weight while on a new diet and something seems unbalanced about their new lifestyle?
Maybe you’ve found yourself standing in the grocery aisle looking at the health food section paralyzed by making the wrong choice.
Have you ever gone hungry because the food quality of the choices around you wasn’t up to snuff?
If you answered yes to some of these questions, you and/or your friend could be showing signs of a new eating disorder called Orthorexia.
Orthorexia nervosa was defined by Steven Bratman, MD in 1996. It is not yet recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), however, interest and case idenfitication are growing. Every day through the media, we are bombarded with information about the food we eat. One day a food is healthy, the next day another article says that it is not. By restricting foods that are unhealthy, someone can become so paralyzed by avoiding harmful foods that they end up loosing weight. They are often misdiagnosed as having anorexia nervosa and thus prevented from receiving care that is truely customized to their unique condition.
“For people with orthorexia, eating healthily has become an extreme, obsessive, psychologically limiting and sometimes physically dangerous disorder, related to but quite distinct from anorexia.” Steven Bratman, MD
Does this mean that someone who is on a very restricted diet automatically has orthorexia? No. What needs to be taken into consideration, and is often missed in cases of eating disorders is the relationship to digestive issues. In some cases, an underlying gut dysfuntion or other condition can predispose people to feeling sick after eating certain foods and having a maladapted relationship with food. These conditions can include but aren’t limited to:
- Gut infection/microbiome imbalance from bacteria, parasites, fungi/yeast
- Leaky gut and food sensitivities
- Irritable bowel syndrome
- Anxiety preventing proper digestion
- Autoimmune conditions
What’s interesting reading about orthorexia is that in the past, I would have answered yes to most of the questions below. From my teenage years on, I had an undiagnosed gut infection called Small Intestine Bacterial Overgrowth (SIBO). For a decade, I tried different diets from the Blood Type Diet and Specific Carbohydrate Diet to Paleo and the Candida Diet. I felt like I was doing everything right and still getting sicker.
Naturally, I did what so many people do. I followed the advice of my practitioners and removed foods that bothered my digestion or caused the the hot flashes, anxiety, irritability, difficulty sleeping etc that I was experiencing. Eventually, I was eating only 12 foods for more than a year while I was studying to become a naturopathic doctor. All the while, knowing full well that no one seemed to be able to pinpoint what was wrong. I read blogs and articles and books on diets and food quality. I was terrified of foods that made me feel worse than I already did.
Finally the research about SIBO began to come to light and I eventually was diagnosed with something other than Irritable Bowel Syndrome or “you just need to relax and not think about it so much.”
If you answer yes to any of these questions it’s time to get help from someone like me who understands the scope of all these conditions and can work to determine what is happening in your unique case.
You don’t have to suffer through this alone.
Do I Have Orthorexia?
Consider the following questions from the National Eating Disorders Association. The more questions you respond “yes” to, the more likely you are dealing with orthorexia.
- Do you wish that occasionally you could just eat and not worry about food quality?
- Do you ever wish you could spend less time on food and more time living and loving?
- Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?
- Are you constantly looking for ways foods are unhealthy for you?
- Do love, joy, play and creativity take a back seat to following the perfect diet?
- Do you feel guilt or self-loathing when you stray from your diet?
- Do you feel in control when you stick to the “correct” diet?
- Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?