Orthorexia Nervosa

[minderly]

Orthorexia Nervosa

 

I was reading and ran into this term...then I found this article. Though it is not in the DSM (so not a mental disorder like most EDs), it is considered a medical disorder by doctors.

 

The article suggests ON negatively affects people by limiting social engagements and can lead to poor eating habits (refusing food even when hungry).

 

Do you think this is really a problem? I know people that fit the criteria for ON but I'm unsure if it's all that negative as long as you manage it.

[riotgrly]

I wouldn't be surprised to find it in the new DSM, due out in May....I think the crux of anything being considered a problem/disorder is whether or not you find yourself changing your life around to accommodate it. If previously social people stop going out to eat or drink with others due to this issue, resulting in increased isolation and possibly depression, I think it qualifies as a problem. If they're spending so much time shopping for the "right" food that they're missing work or missing sleep, yeah, it's a problem. Just my opinion. 

[minderly]

What if they don't have BDD, OCD, or are clinically depressed? Is it okay to be so concerned with health that you arrange your schedule around it?

 

I don't know. It annoys me when people behave like this...but I'm not sure if their dedication is a negative?

[Maris Stella]

I first ran into this term very recently, in this context:

 

http://alexandrajamieson.com/im-not-vegan-anymore/

 

Sneaking Around

My mind and morals popped up and batted down those overwhelmingly positive body sensations, but it became like a world-class tennis match.

Cravings from my body would SHOUT for meat, and my brain and logic would violently shove it away.

This went on for months.

I would secretly visit restaurants or stores and buy “contraband†animal foods, scurry home, and savor the food in solitude.

It’s so strange now to realize that, after working for 12 years as a health and wellness professional, I’d developed an eating disorder.

It reminds me of that new term orthorexia â€“ the idea that we can become unhealthily obsessed with eating the “right, perfect foods.â€

 

I was reminded immediately of my aunt and uncle, who are devotees of the China study. They eat a plant-based diet with no added oil and few "oily" foods (like, no nuts except walnuts, no avocados). They are obsessed.  I don't use the term lightly. They think about "the right" foods and attaining perfect health all the time. They cannot have a conversation without talking about it. They are judgmental and rude to other people who do not think the way they do. Etc etc. (It also reminded me of a recent court case in which a judge argued that veganism is a religion. I'm all for people being vegan if they can do it and be healthy, but I do not think it qualifies as a religion.)

 

Frankly, I think I have developed a little bit of it, myself...but it's mostly manifesting itself as extreme guilt about some foods (animal products, non-organic anything) and fear of giving myself cancer. 

 

So I don't think it's just devoting time and energy to eating healthy, or just being a "health nut."  It's more of a fanatical devotion and/or paranoia. 

[PrincessHeather]

I read that article by Alex Jamieson, and holy crap the comments were a mixture of total compassion and unbridled hatred. Sad to see.

 

Anyway, I think it all boils down to having an unhealthy relationship with food. Being mindful of macros, or calories, or choosing to eat paleo and avoiding products X, Y, or Z is not necessarily bad or unhealthy, and its the way that many of us have found to be sucessful in weight loss or other goals.

 

But it becomes unhealthy and obsessive when you feel any kind of constant dread, worry, or guilt associated with things you do or do not eat. If (barring allergies) you can't enjoy a small piece of cake at your sister's wedding without feeling remorse, that's not a very healthy attitude towards food.

[Zorch]

I wouldn't be surprised to find it in the new DSM, due out in May....I think the crux of anything being considered a problem/disorder is whether or not you find yourself changing your life around to accommodate it.

 

Typically a couple primary factors in diagnosis of a psychological disorder are:

 

1. That this behavior/syndrome has negative impacts on the individual, be they social, work-related, or otherwise

2. That the individual feels distress because of the behavior and/or its effects

 

"Changing your life around" is not necessarily a symptom of a disorder - unless it's disruptive and actually screwing up your life..  If you're skipping going out with friends, or making a scene at lunch meetings at work, then you're pushing into what might be considered disorder territory.  But if the you're enjoying your life, are healthy, and functioning in society, it generally doesn't meet the qualifications for a disorder, regardless of how much crap people give you for ordering steamed broccoli and a chicken breast cooked without any oil when you're out at a restaurant.

[Raincloak]

This may sound tautological, but it's only a problem if ... well ... it's a problem.

 

Habits are fine and normal and everyone has them.  If you have a habit that has gotten out of control and is damaging your health (physical or mental), then it's a disorder.  If the habit has taken over your life to the degree that it is the only thing which makes you happy, then it's probably a bit pathological ... but no one knows better than a nerd that obsession can be perfectly healthy

 

A lot of mental illness is about how you feel.  Everyone is different, so activities that would make one person really unhappy might be just right for the next person. 

 

A lot of it is also about social standards.  In some countries, demonic possession is a legitimate medical complaint.  Earlier editions of the DSM guide classified homosexuality as a mental illness.  And some genius in the 19th century pathologized "the irrational desire of slaves for freedom."  So ... a lot of mental health is really more art than science.  This is one reason why it's good to have a social circle that can tell you if you're getting too far off the track, but then again, friends don't know everything.  (If your eating habits are estranging you from people who used to be your friends, something is out of balance for sure, but it might be you ... or it might be them.)

 

If your eating habits make you feel good and don't ruin your body or your social life, you're probably okay.  Bear in mind that you're guaranteed to die some day no matter how well or poorly you eat.  If you plan your whole life around food, you might have orthorexia, or you might just be a very devoted foodie.  If it crosses the line from interest to compulsion, you will probably know.

[riotgrly]

Yes, Zorch, I should probably have clarified better-what I should have clarified was not just that one changes their life around to accommodate it-if that bald a statement were true, children would be considered a disorder!!

 

What I should have clarified was....if it rules your life to the extent where it interferes with everything else you either

1. Have to do to live, like obtain an income somehow (for most of us, this means having a job)

or

2. Used to enjoy, and now don't do directly because of your obsession with healthy eating-I am thinking here of social things, not so much food choices.

 

Examples of #1 that come to mind:

-often being late to work or leaving early because you've spent so much time poring over food logs, completing calorie or nutrient counts, etc

-quitting your job because you can't get people to stop eating food that's not on your diet in the communal break room, and that being the only reason, and doing so without another source of income in place

-paying rent or bills late in order to purchase items that "go with" this obsession, such as more books on the topic, or very expensive foods or supplements, etc.

 

Examples of #2:

-no longer seeing close friends you've had for years due to fear that they will want to eat at a place where you don't feel you can eat

-refusing to see friends or family because they do not follow or enjoy discussing your lifestyle of food choices. 

 

I guess what I'm saying is, anything that points to an unhealthy addiction or obsession with any other substance can also be applied to diet, just as it can to sex or any number of other human behaviors. Whether you don't pay rent because you've spent all your money on alcohol or because you've spent it all on organically processed purple kumquats from Zambezi, the end result is the same-you've changed your life around in a negative way that impacts you badly.

 

I do agree that it seems we're developing "disorders" for everything under the sun. A lot of it is cultural too. Studies of the DSM itself can almost be as interesting as studies of the conditions in it!

[Waldo]

If it crosses the line from interest to compulsion, you will probably know.

 

Generally the problem with ED's is that people don't know, or do know but refuse to believe, that they have a problem.

 

Raw veganism is a classic diet that has Orthorexia issues.  It is very hard to actually eat a healthy diet eating raw vegan.  While all the components may be very healthy, you just can't eat enough of them, and for many it ends up being severe calorie restriction.  Done over a very long time this can be very bad.  Which leads to a trap, all foods that would help increase calories are not raw vegan and therefore unhealthy, however continuing on the same path of pure raw vegan is itself unhealthy.

 

Some people following other diets share all the mental symptoms of orthorexia without the obvious major physical decline in health (though minor physical decline can be present).  Paleo is noted as the other diet that can have orthorexia problems, though people don't tend to physically decline nearly as severe as raw veganism (bad cases of orthorexia among raw vegans tend to be just as bad as anorexics physically).  Any diet though that demonizes foods unpure to the diet is prone to it.

[andygates]

Seen plenty of instances where someone has changed their lifestyle from anorexic and skinnyfat to orthorexic and skinnylean.  The underlying problem persists and is managed by control.  

 

In the best instances the health/body boosts are so great they break the cycle and yay, happy fit person.  

 

Strict (and weird) eating plans can be a bit of a gateway.  Like raincloak said, it's a problem if it's a problem.  DSM-inclusiveness isn't the be-all-and-end-all of mental shenanigans.  

[riotgrly]

Bonus points for use of the word "shenanigans"