Can You Try Too Hard to Eat Healthy?
By Jessica Setnick, MS, RD, CEDRD-S
Messages about food can be so complex! They intermingle dimensions of health, “fitness,” nutritional content, size, shape, and physical appearance… misusing scientific terms to make a food seem better or worse than others… and blatant marketing tactics like labeling cherries “gluten-free.”
I’m a dietitian and I’m not immune. I find it impossible to avoid food messages, even as I am cursing them silently in my mind. They are right here in my home, I see them as I drive down the highway, and they’re almost everywhere in stores and in the media. They are very “sticky” since many of them are intended to cause an emotional response. It’s not a coincidence that magazines have delicious foods on the cover and weight loss articles on the inside.
You may be the kind of person who can ignore food messages – you choose, purchase, and eat foods based on your personal preferences, occasionally branching out to try something new. Or, you may be someone who tries to keep up with food news when you can, replacing outdated information with newer thinking, opting for ‘Meatless Monday’ or ‘Taco Tuesday’ to spice up your routine, trying to feed yourself and your loved ones to the best of your abilities while maintaining balance in other aspects of life.
There is a third group among us, and you may be or may know someone like this… This person sticks to a certain way of eating no matter what, does not want to be flexible or try something new, and believes so strongly in a certain way of eating that they miss out on other parts of life due to this dedication.
There are many reasons you may eat so strictly. It may have developed over time as a response to confusing food messages, a sort of protective group of foods that are unequivocally nutritious and safe. It may be a response to a health scare, either your own or a loved one’s, facing the fact that eating is one of the few aspects of health that we can control. Or, it may have been prescribed by a doctor, such as foods to avoid or eliminate due to an allergy, medical diagnosis, or preventative measure.
Some of us are able to adhere to a specific diet on a lifelong basis, happy and healthy, and balanced. And others of us become consumed by the demands of eating and limiting and avoiding and controlling, continuously shortening the list of foods that are acceptable to eat, and ultimately the quest for “eating healthy” morphs into an archenemy of the original goal. This enemy is orthorexia.
Orthorexia nervosa was coined and first used by Dr. Steven Bratman in 1997 to describe an “obsession with healthy eating” that he observed among his family practice patients. The obsession was actually impairing their ability to eat normally or appropriately, due to a fear of doing something wrong.
Dietitians often notice this type of obsession and restriction among our clients, even those who do not meet criteria for eating disorders. Individuals who come to us for help with their chronic illness, sports nutrition, or just to “eat right” can associate eating certain foods with guilt and shame, disease, anxiety, fear, and death.
They are often surprised when we tell them that the excessive focus they are putting on food is actually the problem, not the individual foods they are eating. Some clients refuse to further meet because they feel we don’t understand proper nutrition, or we have an ulterior motive to get them to violate their rules.
These feelings are understandable in the context of orthorexia. Anyone who wants, asks, or expects you to change your eating against your will can be viewed as your enemy. It is wise to be suspicious of anyone who tells you his or her food or product will cure disease, save your life, or make you a good person. But what about the voice inside your mind telling you the same things?
- Do you feel bad about yourself depending on what or how you eat? Do you ever punish yourself after eating something you shouldn’t have?
- Do you eat differently when you are alone as opposed to when there are other people around?
- How much of your day do you spend on food planning and preparation? Is this enjoyable or does it feel pressured and stressful?
- What happens when you are at a social function and you aren’t able to control what is served? Can you manage or do you feel nervous or guilty?
Honestly answering these questions might clue you in to something you might not want to know, something you might be hiding from yourself. Look at the chart describing Positive and Pathological Nutrition. If your quest for health through eating has become pathological, it’s time to get back in control of your eating instead of allowing eating to control you.
There’s no shame involved in how you eat. It doesn’t make you bad or good or anything else. You are a good person already; the way you eat reflects that when you are following a combination of your internal senses, your wealth of personal experience, and your knowledge of food and nutrition.
If you have become detached from listening to these cues, an eating disorder specialist can help you return to your roots. If you feel that you were raised with food in an unhealthy manner, that same person can help you craft a new, personal way of eating now.
Ultimately your goal is to find the sweet spot of healthy eating that balances good nutrition and a good attitude. It may take time, but it’s worth it to invest in your health and your future. You already know that, you just need someone to help you find the right direction. If that person is a dietitian, you can find one in your area or someone to meet with virtually at www.IFEDD.com/treatment-finder. And if you are concerned about someone in your life, a consultation with an eating disorder specialist can help you find ways to approach that person and support them in recovery.
About the author:
Jessica Setnick, MS, RD, CEDRD-S, is the creator of Eating Disorders Boot Camp and Making Food Your Friend Again workshops. In 2013, she published the first proposed criteria for orthorexia in The Eating Disorders Clinical Pocket Guide, Second Edition.
Wonderful commentary about a disorder more common than one might think. Thank you, Jessica!
This is a topic near and dear to my heart as I have watched several people I love battle eating disorders. I would say some dietitians may even fall into this Pathological Nutrition category. It’s wonderful that there are now dietitians that have become experts in this area.
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