• Orthorexia is an eating disorder where an obsession with healthy food can become psychologically and even physically unhealthy. (MOODBOARD/AAP)Source: MOODBOARD/AAP
What happens when our quest for "clean eating" and desire for "perfect health" trumps everything else, perhaps without us even realising it?
By
Sharon Verghis

13 Apr 2017 - 12:44 PM  UPDATED 13 Apr 2017 - 1:07 PM

Three years ago, Jordan Younger was a self-styled American wellness guru whose health and fitness blog – The Blonde Vegan – boasted over 300,000 followers.

Younger, in her early 20s, had built a mini-empire on the back of her strict dietary choices and healthy eating lifestyle. Her blog was an evangelical tribute to the benefits of yoga, mindfulness, her raw, vegan diet and weekly juice fasts.

No dietary sacrifice was too much for this photogenic celebrity blogger. Even when a 10-day juice fast left her feeling ill, feverish, light-headed and so physically weak she couldn’t leave her apartment, she was relentlessly gung-ho. “Ta-daaa, I lost about seven to eight pounds,” she announced on her blog, “which definitely feels good”.

“Everyone likes to feel lighter after an extended cleanse – it’s part of the body doing its detoxing job!”

What happens when our solution starts becoming the problem?

Younger’s followers lapped it up, with over 40,00 paying for her $25 cleansing program, including a five-day meal plan.

But Younger soon found that her love affair with healthy eating became an unhealthy, crippling obsession. “I used to do 30-day juice cleanses and walk around New York City with blue lips and thinning hair and imbalanced hormones, and zero energy, because all I wanted was to be the 'purest', cleanest, healthiest, most rigid plant-based vegan there ever was,” she recalled in retrospect.

She eventually saw the light, and to the shock of her fans, renounced her veganism in a blog post, and in 2015, published a memoir, Breaking Vegan, recounting her descent into “extreme” clean eating.

What happens, she asked, when our desire for "perfect health" trumps everything else, perhaps without us even realising it? What happens when our solution starts becoming the problem?

The book sparked hate mail from ex-fans but Younger stood her ground.

Now, through a new lifestyle blog The Balanced Blonde, she offers a more moderate template for healthy eating and general wellness.

Younger is the face of orthorexia, an eating disorder where an obsession with healthy food can become psychologically and even physically unhealthy.

Unlike other more well-known eating disorders such as anorexia nervosa with thinness as the ultimate aim, orthorexics obsess about eating “clean” according to rigid, self-imposed rules, rather than limiting the quantity of food.

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In the pursuit of wellness, sufferers typically begin by restricting one food group – say sugar or wheat or dairy – but soon find themselves on a slippery slope where more and more food groups are restricted in the interests of “wanting to eat the purest, most perfect diet possible,” says dietician Kate Gudorf, spokesperson for the Dietitians Association of Australia.

Gradually, the diet becomes so restrictive that it starts causing serious health and psychological issues, and impacting on social behavior.

Often, it starts out innocently enough, Gudorf says. Someone may simply want to lose a little weight or look good in today’s body-conscious culture. Other triggers can be a serious health scare – a heart attack or finding out you have dangerously high blood pressure or cholesterol.

"Food is religion these days. Because if you're eating healthy, you're not dying, right?”

Moral judgments start being made on “clean” as opposed to “dirty” food, with all the associated connotations of pollution and purity. As Kaila Prins, a recovering orthorexic who now has a podcast, Finding Our Hunger, puts it: "food is religion these days. Because if you're eating healthy, you're not dying, right?”

The term orthorexia was coined in a 1997 Yoga Journal article by Dr Steven Bratman, who initially saw it as a light-hearted descriptor that he could use to show food-fixated patients the errors of their ways. It was derived from the Greek ‘ortho’,” meaning “right,” to indicate an obsession with eating the right foods, he would later say.

But over time, he began to see the condition it described as a genuine eating problem that could even kill – through malnutrition. Although the condition is not included in the mental health bible the Diagnostic and Statistical Manual of Mental Disorders, it is regarded as a genuine eating disorder by mental health officials and dieticians.

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There is no hard data on the number of sufferers in Australia, says Gudorf, “but anecdotally, in my private practice in the last five years, I’ve noticed a shift where people will turn up with increasingly restricted diets, involving everything from gluten to dairy, who are confused and have distorted eating“.

In a 2016 article in the journal Eating Behaviors co-authored with Thom Dunn,  Bratman proposed a number of diagnostic criterion, ranging from “compulsive behavior and/or mental preoccupation regarding affirmative and  restrictive dietary practices”  to the  violation of self-imposed dietary rules causing “exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.”

The key here is the level of emotional distress involved, particularly in terms of its impact on social behavior, says Christine Morgan, chief executive of eating disorders charity The Butterfly Foundation.

To avoid breaching their food rules, sufferers can start avoiding social situations, leading to social isolation.

On a practical level, the condition manifests itself through an obsessive focus on food choice, planning, purchase, preparation, and consumption, says Gudorf. Sufferers can spend over three hours, daily, thinking about food. Time is increasingly spent in supermarkets obsessively examining nutritional labels.

So who is at risk? 

Bratman cites idealistic young women, and those attracted to food movements like ethical veganism, but Morgan and Gudorf say orthorexics come from across the board - women post-pregnancy and those heading into menopause wishing to control changing body shapes, to middle-aged men wishing to lose weight, to people with autoimmune disorders who believe they can control their condition through food elimination.

Are certain personality traits more at risk? Morgan says that orthorexics are often aligned to the sufferers of anorexia nervosa in terms of shared traits of perfectionism and anxiety, though these are not always present.

“There is an underlying vulnerability, and there will be some environmental stressors that will lead that person to start to distort the way they eat…so it might start with a health scare,” Gudorf says.

Morgan says that orthorexics are often aligned to the sufferers of anorexia nervosa in terms of shared traits of perfectionism and anxiety, though these are not always present.

So what cultural factors are fuelling the rise of orthorexia? Morgan and Gudorf cite everything from social media and its “endless images of the perfect body” to the rise and rise of high-profile food gurus touting the miracles of restrictive diets “without any scientific backing” to the general rise of an anti-evidence-based health culture which sees people seeking health advice online from questionable sources.

Gudorf says healthy eating is a noble thing but advocates moderation in all things. Eat well from all food groups and exercise, but also – have that slice of birthday cake or white bread once in a while. Creeping dietary rigidity should sound alarm bells, she says.

Bratman has the final word. “Food, no matter how pure, cannot fill the space in your soul that longs for love and spiritual experience. If you are trying to use it for this purpose, you may have gone astray on your journey.”

If you, or anyone you know is struggling with an eating disorder or body image concerns, you can call the Butterfly Foundation National Helpline: 1800 ED HOPE (1800 33 4673).


To find out more about the downsides of clean eating, watch 'Clean Eating: The Dirty Truth' airing SBS on Thursday 13 April at 8.30pm and streaming after broadcast on SBS On Demand. 

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