Orthorexia: taking healthy eating to the extreme

We look at the new term 'orthorexia', coined to describe an obsession with certain so-called ‘healthy’ diets, which, in some cases, can lead to nutritional deficiencies or even malnutrition.

In recent years a number of restrictive diets, including the paleo diet, the 5:2 intermittent fasting diet, and various raw food, sugar-free and gluten-free diets have all become hugely popular. 

However, an obsession with healthy eating can be anything but healthy when taken to an extreme. Orthorexia nervosa, or orthorexia, is characterised by excessive fixation with eating healthy food.

Although Orthorexia nervosa is not yet officially recognised as a clinical diagnosis, it is considered a serious mental health condition in a category that experts call ‘disordered eating’, which refers to a wide range of abnormal eating behaviours.
“The main differentiation between disordered eating and a clinically diagnosed eating disorder is the severity and frequency of behaviours,” explains Rosalyn D'Angelo, an Accredited Practising Dietitian at Bupa.

“People with orthorexia often have misunderstandings about food and nutrition, which may sometimes be based on inaccurate information from less reputable sources,” she says.
 “I’m coming across a trend of people avoiding all dairy foods,” says D’Angelo, “because yoghurt, milk and cheese are seen as ‘unclean’ by some ‘wellness gurus’. Trained nutrition scientists know that these foods are essential sources of protein, calcium, protein, iodine, zinc and vitamin B12.”
Calcium, as D’Angelo points out, is essential for heart function. If there isn’t enough available calcium in the blood, we have to take it from our bones, which can lead to osteoporosis – a long-term condition that needs careful management.
“It’s important for people to understand that the decisions they make [about food and nutrition] can affect their long-term health,” she says. “Make sure the advice you are taking is well-informed and backed by solid evidence, not just a celebrity endorser or a photogenic model.”

What are the signs of orthorexia?

Behavioural signs include:
  • An obsession with eating healthy food.
  • A fixation with the quality (not necessarily quantity) of food. 
  • Avoiding certain food groups (e.g. dairy or grains).
  • Severely restricted eating, for example this might include avoiding all foods that contain certain ingredients (e.g. fat or sugar, artificial additives). 

Psychological signs can include:

  • Anxiety or guilt about food choices.
  • Mood swings.
  • Depression.

nuts and a salad

What are the risks?

According to D’Angelo, orthorexia can have serious effects on a person’s social, physical and mental wellbeing.

It can also lead to:

  • Lack of energy.
  • Poor concentration.
  • A weakened immune system and nutritional deficiencies.
  • Can cause other irreversible health problems.
“If people are severely restricting their intake, or cutting out entire food groups, they are at higher risk of malnutrition or nutrient deficiencies, with common micronutrient deficiencies including iron, vitamin D and calcium,” she says.
D’Angelo cautions people against relying on nutritional information found online and suggests always checking the credentials of the author. Familiarise yourself with the Australian Dietary Guidelines, which recommend making meals from each of the five core food groups, including plenty of fruit, vegetables, legumes, and wholegrain breads and cereals, as well as lean meats, fish, poultry, nuts, seeds, eggs, and low-fat dairy, and limiting foods with added sugars, saturated fat, salt and alcohol.
“Take the focus away from what you should be cutting out and focus instead on nourishing your body with foods that it needs,” D’Angelo advises. “Also understand that these ‘extra’ foods can be enjoyed sometimes, and can definitely be part of a healthy diet. What would life be if you couldn’t enjoy a slice of cake at your nephew’s birthday party or go out for a beautiful three-course meal with wine with your partner to celebrate an anniversary?”

What can you do if you, or a loved one, are showing signs of orthorexia?

Eating disorders can affect men and women of all ages, across all cultural and socio-economic backgrounds. If you’re worried about yourself or somebody else, get support and seek professional advice. 

The Butterfly Foundation’s National Support Line (1800 33 4673) and web counselling service provides free, confidential support for anyone with a question about eating disorders or negative body image. More support can be found at http://www.nedc.com.au/helplines.
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