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Too much of a good thing: Sometimes eating healthy can become unhealthy

Illustration Carrie Snyder / The Forum

FARGO – It starts off as a seemingly healthy habit: eating more vegetables and avoiding foods with artificial colors, preservatives, unhealthy fats, sugars or added salt.

But what starts out as the desire to improve one’s diet can cross a line into a risky behavior with the potential for deadly consequences.

Those who have an unhealthy obsession with otherwise healthy eating may be suffering from orthorexia nervosa, a term that means “fixation on righteous eating,” according to the National Eating Disorders Association.

Orthorexics, the association states, are consumed with food quality and purity, what and how much to eat, and how to deal with perceived slip-ups.

They punish themselves for those slip-ups with stricter eating, fasts and exercise, according to Dr. Karin Kratina, who wrote about orthorexia for the National Eating Disorders Association.

Research has shown that about 5 percent to 7 percent of the population could be dealing with orthorexia, but because it starts off as a healthy behavior, it’s hard to diagnose, said. Kelly Kadlec, a licensed psychologist who provides consultation, education, assessment and treatment for adults and adolescents with anorexia nervosa, bulimia nervosa, atypical eating disorders and binge eating disorders at the Sanford Eating Disorders & Weight Management Center in Fargo.

“It’s still not talked about quite as often as it should be,” Kadlec said.

With media talking about the obesity epidemic, genetically modified plants and hormones in animals, “people start to think it’s something to aspire to – to eat very clean and healthy,” Kadlec said.

“It can at some point, not for everybody, but it could turn into that controlling the person instead of the person being in control of their eating,” Kadlec said.

It becomes an obsession when sufferers start to socially isolate themselves and worry not only about what they’re eating today, but also what they’ll eat tomorrow and the next day. Sufferers worry about how food is prepared to the point where it takes up all their time, Kadlec said.

They may also go through mood changes and become anxious or depressed, she said.

People with orthorexia can become malnourished because by limiting certain foods, she said, they could be missing out on vital vitamins and minerals.

Following a healthy diet doesn’t make someone orthorexic, Kratina writes.

People with orthorexia fixate on eating foods that make them feel pure and healthy and often avoid foods with any artificial colors, flavors or preservatives; pesticides or genetic modification; unhealthy fat, sugar or added salt, according to Mayo Clinic’s website.

They might also insist on preparation techniques that result in “clean food,” meaning it’s been washed multiple times, cooked to ensure no bacteria and minimally handled. Eating out is out of the question because it’s important to avoid food that they don’t buy and prepare, Mayo Clinic states.

It seems to be motivated by health, Kratina wrote, but there are underlying motivations like the compulsion for complete control, an escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.

Health professionals have proposed that orthorexia be officially recognized as a new mental health disorder, Mayo Clinic states, but it is currently considered controversial and grouped with other disorders that are not yet accepted, such as night eating syndrome.

The number of people with Orthorexia is growing, Kimberley Quinlan, a psychotherapist at the OCD Center of Los Angeles, said in a Feb. 14 Los Angeles Times article.

Dr. Steven Bratman first described and named orthorexia in the October 1997 issue of Yoga Journal. Bratman, who says he suffered from an unhealthy obsession with healthy eating, released the book “Health food Junkies, Orthorexia Nervosa, Overcoming the Obsession with Healthful Eating” with writer David Knight in 2004.

The emphasis, Bratman wrote on his website, is on the unhealthy obsession with something that is otherwise healthy, similar to exercise addiction or workaholism.

At times, he wrote, orthorexia seems to have elements of obsessive-compulsive disorder and it may have elements of standard anorexia, but it is often not very much like typical OCD or typical anorexia.

“It is this transference of all life’s value into the act of eating which makes orthorexia a true disorder,” he wrote.

Bratman also wrote about a woman named Kate Finn, who died of heart failure brought on by orthorexia-induced starvation.

“Most often, orthorexia is merely a source of psychological distress, not a physical danger,” he wrote. “However, emaciation is common among followers of certain health food diets, such as raw foodism, and this can at times reach the extremes seen in anorexia nervosa.”

Kadlec, the Fargo psychologist, says orthorexia is treated with cognitive behavioral therapy and visiting with a dietician. A medical provider also should be involved because of the potential for malnourishment, she said.

Possible signs of orthorexia

  •  Spending more than three hours a day thinking about healthy food.
  •  Wishing occasionally you could just eat and not worry about food quality.
  •  Wishing you could spend less time on food and more time living.
  •  The quality of your life has decreased as the quality of your diet increased.
  •  Skipping foods you once enjoyed in order to eat the “right” foods.
  •  Being unable to eat meals prepared by others.
  •  Constantly looking for ways foods are unhealthy.
  •  Feeling virtue about what you eat is more important than the pleasure you receive from eating it.
  •  Feeling guilty or self-loathing when you stray from your diet.
  •  Feeling in control when you stick to the “correct” diet.
  •  Putting yourself on a nutritional pedestal and judging others for the foods they eat.

Source: National Eating Disorders Association and WebMD