Tag Archives: healthy eating disorder

Orthorexia: when healthy eating is not healthy.

If you read my blog regularly you will know that healthy eating is definitely something that I promote. Sometimes, there can be point where healthy eating goes a step, or several steps too far. Can we be too healthy with our eating? 

The rise of healthy eating blogs, clean eating movements and instagram gurus has led to there being almost too much access to information, recipe and tips. As well as the not always qualified voicing their nutritional opinions. This can lead to confusion and information overload.

Dietitian UK: Orthorexia

What is Orthorexia?

Orthorexia Nervosa is a relatively new term meaning a “fixation of righteous eating”.  It was first used in 1996 by Steven Bratman, MD. It is not yet recognised as a fully fledged eating disorder in the diagnostic criteria, but is definitely something that is on the increase. 

People with orthorexia may not notice they have an issue with their eating, in face they may think the opposite. They can start out trying to eat a healthier diet but get drawn into the spiral of trying to eat a healthier and healthier meal plan. They become consumed with food, trying to eat right, being strict with their food intake and restricting the foods they are allowed to have. Purity, eating the healthiest foods they can and guilt if they stray off the plan are hallmarks. This can lead to an obsession with weight, shape and calories. Weighing food and adding in specific “health” foods can also creep in.

There are usually underlying issues that precipitate Orthorexia. This could be a need to escape, feeling out of control and needing to control an area of life, feeling a loss of identity. Suddenly finding an outlet in the form of control via eating can help fill that void. It starts out seeming like a healthy way to deal with your feelings, but then spirals out of control.

Why is it a problem?

Although on the surface a diet may sound healthy, when you dig down it is usual to find nutritional deficits in the diet. A lack of calcium for example, that can affect bone health. A lack of essential fatty acids, affecting brain function, skin and blood flow.

More noticeable is often the weight loss that ensues and the affects on socialisation. Physical side effects of weight loss can include: poor circulation, feeling cold, hair loss, poor concentration, memory and reactions times, low mood and mood swings, being unable to eat out, wanting to isolate yourself, fatigue and a general lack of lustre. People can feel consumed with the need to know what they are eating each day, needing to prepare it all themselves, planning meals and recipes far in advance and this becoming all-consuming. There can be a loss of hunger and fullness signals, with increased anxiety around meals. 

Dr. Bratman, who recovered from orthorexia, states “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong. The poetry of my life was disappearing. My ability to carry on normal conversations was hindered by intrusive thoughts of food. The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach. I was lonely and obsessed…I found it terribly difficult to free myself. I had been seduced by righteous eating. The problem of my life’s meaning had been transferred inexorably to food, and I could not reclaim it.” (Source: www.orthorexia.com)

So a healthy diet is bad for me?

Well it can be, if it takes over your life, your thinking, your time and leaves you with feelings of anxiety, guilt and self-loathing. If you are not able to relax and eat cake now and again then that is not normal eating.

How to get help?

  1. Recognise the problem. This is a huge step.
  2. Talk to your GP and ask for advice. They may be able to refer you to a local eating disorders team.
  3. Look for an eating disorders specialist who can work through your food beliefs and give you the confidence to make changes.

Healthy Eating for Anorexia Nervosa

I’ve worked in the field of eating disorders for about 10 years. It’s an area that both frustrates me and brings me to life. I find it challenging work, emotional at times and I have to constantly remember to celebrate every small thing. Yet I absolutely LOVE this work.

In a world where obesity is on the increase, healthy eating and low fat eating predominates. The Eat Well plate has been developed as a way to demonstrate healthy balanced eating. I use this visual guide as a talking point but with the emphasis that this is aimed at a healthy population trying to maintain weight or at overweight people trying to lose a little weight. Therefore the proportions may not be correct if you are trying to gain weight.

 

Here is my walk through the Eat Well Plate for Anorexia Nervosa:

 Fruit and Vegetables:

Most people with anorexia nervosa I come across have no problems in meeting the 5 a day target, in fact they can have the reverse issue and be eating too many portions!

  • These foods should make up about 1/3 of your plate at each meal and no more.
  • It’s important to eat a range of colours and types so you get the full range of nutrients.

Dietitian UK: Healthy Eating in Anorexia Nervosa, Fruit and Veg

 

Starchy Foods/Carbohydrates:

These foods are often thought to be the villains. Yes over-eating these will lead to weight gain, but not eating them will mean your body does not have enough energy. Carbohydrate foods (bread, rice, pasta, cereals, potatoes etc..) are the bodies preferred energy source so that means it will choose to burn them off as fuel over anything else.

  • Include them at every meal.
  • Go for wholemeal, whole grain versions where possible.
  • The more active you are the more you will need.

 

Dietitian UK: Healthy Eating for Anorexia Nervosa

Dairy Products:

Dairy foods are important as they provide the body with calcium, protein and in some cases Vitamin D. Super important for your bones. When you are a low weight and not eating enough the kidneys remove calcium from your bones to supply the body with needed calcium, leaving your bones weakened. This needs replacing!

 

  • Eat 3-4 portions per day (e.g. 1 glass milk, 1 small yoghurt, 30g cheese).
  • If you are weight gaining steer away from the low fat options, often these just have more sugar and additives in them anyway.
  • Think about the long term impact of having weak bones, it’s a great motivator.

 

Dietitian UK: Healthy Eating for Anorexia Nervosa

Meat, Fish and Other Proteins:

This includes eggs, tofu, soya, beans, pulses, lentils, nuts and seeds. Include these foods twice a day in your meal plan either as a main meal or a snack.

Dietitian UK: Healthy Eating for Anorexia Nervosa

 

Fats and Sugars:

These are included as part of healthy eating. Your body needs fat and sugar in order to function. There is a layer of fat around your internal organs acting as insulation and protection, there are essential fatty acids that your brain needs to function well and monounsaturated fats are good for your heart – so fat is not all bad.

 

  • Work up to including healthy fats in your diet – avocado, olives, oily fish, rapeseed oil, nuts and seeds.
  • Build in a challenge each week to eat a “scary” food.

Dietitian UK: Healthy Fats