Orthorexia nervosa: When healthy eating goes too far

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Paleo, raw, no-sugar, gluten-free? Take your pick from any number of restrictive diets. But some experts say this obsession with healthy eating is anything but healthy.

An increasing obsession with healthy eating, “wellness” and food origin could be creating a new form of eating disorder.

“I think nutrition becomes a monster for some people,” says nutritionist and UNSW lecturer Dr Rebecca Reynolds.

“These fad diets and ways of living, not just eating, are cultish.”

The term orthorexia nervosa was coined by Dr Steven Bratman in 1997. It literally translates as “correct appetite”, and mirrors terms such as anorexia or bulimia nervosa.

“I see a lot of parallels in the definition of orthorexia nervosa and current dieting fads like paleo, clean eating, raw, and no sugar diets,” said Dr Reynolds.

Melanie Cowell, 30, is a Pilates instructor. While she was always conscious of living a healthy life, early in 2013 she developed an obsession with eating “clean food” that was “free of toxins”.

“It was a gradual process,” said Melanie. “As each month went by, I think I got more and more restrictive with food.”

I didn’t want to be ingesting something that was dirty or greasy or toxic.

She first eliminated gluten from her diet, then dairy, sugar and meat. Grains were restricted to brown rice and quinoa, and she subsisted mainly on vegetables, eggs, nuts, and low-sugar fruit.

“I didn’t want to be ingesting something that was dirty or greasy or toxic,” she said. “I was trying to have food that was as organic and pure as possible.”

The first sign that her restrictive diet had become an impediment to her life was a friend’s birthday dinner at a pub, where the menu of unhealthy food caused her weeks of anxiety.

“I knew I was going to have to eat this sort of unhealthy food. I accepted that, but it still stressed me out,” she said.

“A couple of weeks later I was talking to a friend and she said, ‘you do realise it’s not normal? You should be able to enjoy a pub meal with friends no matter how healthy you are’. It was the first time it had dawned on me that maybe what I was doing wasn’t actually the right or perfect way.”

By October, tiredness and a recurring cold, led Melanie to seek a naturopath’s advice, who told her that she was protein deficient and advised her to reintroduce meat to her diet.

Melanie said this was a turning a turning point for her.

It can have really negative consequences on someone’s life, just like anorexia and bulimia.

This experience is common to sufferers of orthorexia. Despite the fixation on healthfulness, cutting out food groups can lead to nutrient deficiencies and malnutrition.

“If you cut out entire food groups like dairy and carbohydrates, you can miss out on important nutrients,” said Dr Reynolds.

There are also psychological consequences such as preoccupation obsession, stress and anxiety.

“It can have really negative consequences on someone’s life, just like anorexia and bulimia,” she said.

Melanie says social media and the proliferation of wellness and ‘fitspiration’ bloggers had a negative impact on her.

Dr Reynholds says these “wellness spruikers” are often people with no background in medicine or nutrition, but have a personal experience designed to inspire.

The non-health educated spruikers of certain ways of eating often give non-evidence based advice which can be dangerous.

“The non-health educated spruikers of certain ways of eating often give non-evidence based advice which can be dangerous,” she said.

“Food has become a religion because it’s a crutch for things we don’t understand and can’t control,” said Dr Reynolds. “We can’t control ageing and death, and is that what nutrition has become - a religion to stoke people’s fears about life.”

Dr Reynolds says orthorexia nervosa is not currently a recognised clinical eating disorder.

“Healthy eating is so glorified at the moment in society. I don’t think it’s glorious. I think it can be really quite poisonous.”