When Perfect Eating Eats Away At Us

by Dr. Corey Schuler, MS, DC, CNS, LN

Healthy eating is best approached with a proper balance

Healthy living is simple, right? Eat right and exercise. Done and done. However, with the ever expanding information in nutritional science, and purveyors of specific dietary tribalism and dietetic dogma, a new challenge has arisen. A condition known as orthorexia nervosa is not even a diagnosis code yet, but it is indeed very real.

Orthorexia nervosa is a cousin of similarly named anorexia and bulimia nervosa. It is disordered eating, but this time, instead of a focus on minimal eating or purging, there is obsessive, almost religious, focus on “right” eating. Increased dietary consciousness can be extraordinarily valuable to one’s health, but it can have consequences beyond the intended improved physical health. Some personalities are prone to take healthy eating to a whole new level.

The healthcare industry is not blameless. In fact, orthorexia may be fueled by medical field. The cardiologist suggests low salt; the nephrologist suggests low oxalates; the naturopath recommends dairy and gluten free; and the nutritionist recommends no sugar. Vegetarian, vegan, and fruitarian groups lament the consumption of meat. Paleo, Atkins, and South Beach dieters revel in it. The health enthusiast who craves not only healthy food but also information in a world where information (good and bad) freely flows, is easily caught in a vortex of self doubt, lack of power, and straight up confusion.

If reasonable integration of new diet patterns into one’s social habits are not achieved, the eater develops “rules” for him or herself, rituals and even self-punishments for breaking one’s own rules. The perfect plan, the perfect foods, the best way of eating is what sets orthorexia apart from other eating disorders.

Often extreme health seekers go through a period of isolationism, finding that it is just plain easier to eat alone. Orthorexics often look down on others who do not have what they believe to be the same level of discipline for health and eating. They seek the approval from providers about how “good” they are and may surround themselves only with like-minded eaters.

Other examples of orthorexia symptoms include:

• A drastic reduction in what are deemed acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods.
• Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils.
• Feelings of guilt when deviating from strict diet guidelines.
• Fear that eating away from home will make it impossible to comply with diet.

It is important to acknowledge when professional help is warranted. Recognizing that personal food rules that overtake social experiences and severely impact a person’s quality of life are a form of psychological pathology is a first step for health care providers as well as loved ones of those suffering from orthorexia.

Just like drug and alcohol addiction, orthorexia is serious. Dr. Kate Johnson, Child and Adolescent Psychiatry Fellow at University of North Carolina Hospitals explains, “Eating disorders are not actually about food. They’re about … anxiety, control, obsessiveness, self-soothing, self-preserving, and self-destructiveness, etc. So while the obsessive health focus and rigidity of various industries and providers may be one contributing factor, it is only one of many. This should be treated as seriously as any other eating disorder.”

Andy Bellatti, MS, RD, writes, “we are often told to pick one food system issue and privilege it over all others, rather than make space for multiple, complex possibilities.”

It seems that Andy is on to something. Perhaps it is time that we give ourselves some room to explore and discover new eating patterns, experience and enjoy real food surrounded by loved ones as we’re so naturally inclined.

We don’t need chemicals and processed foods in our diet. And while it is important to have a good knowledge of where our food comes from, what’s in it, and what works for you, we don’t need to stress over each and every detail. Severe allergies or other health conditions aside, we can relax about what’s on the menu tonight, do our best in the given situation, make room for the occasional treat, and have a great time with our friends and family. Life is supposed to be fun, and eating is too.

About the author...

 is a board-certified nutrition specialist and functional medicine clinician. He is a frequent radio and podcast guest on the topic of connecting the dots between mood, hormones, and metabolism. He has appeared on Underground Wellness, Elevate Your Energy, Five to Thrive Live, Primal Diet Modern Health, Doctor Health Radio, Let’s Get Healthy with Bill Swail, Good News Health Show, Healthy Choices, and The Opening Door. He teaches for the School of Applied Clinical Nutrition and The Institute of Transformational Nutrition, is a frequent speaker at functional medicine and nutrition conferences for practitioners, and consults for nutritional supplement companies. Growing up on a family farm, followed by a stint in research chemistry at NASA, taught Dr. Schuler to combine nature and science in a systems approach to health and healing. He is the creator of the Clear Mind Diet and the author of When Nutrition Doesn't Work: What Went Wrong and How to Find a New Doctor available on Kindle. He is the clinic director for Metabolic Treatment Center which uses food-based, functional medicine approaches to bipolar, depression, and anxiety, PCOS, food sensitivity recovery, and thyroid disorders.

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