There has been a lot of discussion in recent years about how strict you should be in eating healthy. Is there a point when being fixated on eating well is actually harmful, and a sign of an obsessive preoccupation, or even a form of an eating disorder?

Along those same lines, a term, orthorexia nervosa was developed to describe people who obsessively try to control their diet for purity's sake.

What is orthorexia nervosa?

According to the National Eating Disorder Association (NEDA), this can be described as the following:

"Those who have an "unhealthy obsession" with otherwise healthy eating may be suffering from "orthorexia nervosa," a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake. "
This isn’t an officially recognized eating disorder yet, but I believe that it can be a big problem for some. According to NEDA, the root cause of it can be a desire to control one’s life, as a way of finding safety, for an escape from fears, using food to create an identity, or trying to find spirituality through food.

Is there a difference between an eating disorder and having strict guidelines in your eating habits? 

I have been really thankful to see this addressed. Sometimes those who purposefully chose a certain lifestyle, or who have food allergies and intolerances are lumped in with those who have an obsessive, fearful relationship with food that causes them to make some of the same choices (such as eating an organic diet).

So what’s the difference? Some have claimed that any who eats a “pure diet,” or would be unwilling to eat a meal here or there without worrying about it (unless they had a life-threatening food allergy) should be labeled as orthorexia nervosa.

I disagree. And here’s why.

There is a difference between making choices out of fear and a desire to control, and making choices out of a risk-benefit analysis. There are many people, using a risk-benefit analysis of food choices, who decide to eat a certain way (whether it be a paleo diet, vegan, or a whole foods “pure” diet) and stick with it.  

Why I often choose to strictly avoid certain foods

Take me for example. I know that if I eat certain foods that bother my digestion, I will suffer certain digestive issues that I would rather avoid. I have unfortunately found that I don’t feel well after eating most sweets, even those from natural sources. That’s just how my body responds to food right now. To the outsider, perhaps my behavior of turning down dairy, avoiding gluten (my gluten intolerance is likely linked to my past iron issues), and not eating many sweetened foods, could seem like I am “obsessive and being controlled by my food decisions.” While my diet could look pretty normal compared to how people ate a couple hundred years ago, in comparison to the average American today, it could appear limited and even obsessive.

But nothing could be further from the truth. For example, it was my dad’s birthday recently and so I took him to a restaurant that he had been hoping to try. I made the choice to try out a few foods that had some dairy and corn in it, and enjoyed my homemade, lightly sweetened cake along with him. That day of compromise lead to digestive discomfort and loss of energy, demonstrating to me once again that it really may not be worth it for me to eat those foods considering their effects on me. By choosing most of the time not to eat those foods, I am simply weighing the benefits and risks and making my choices from there.

For someone with orthorexia nervosa, they would view a decision as I made yesterday as a “slip up” and one in which they would have to punish themselves for. It would be viewed as “getting out of control” and there would follow a hardening of will to not make such a slip-up again. For me, I feel no self-condemnation for the decision I made yesterday, but rather thoughtfulness about whether eating cake is really worth the sugar crash later in the day for me personally. Someone with orthorexia nervosa would be disdainfully aware of the “rightness” of their food choices and look down on others for their food choices, whereas I am happy to serve cake to others even if I have to abstain myself.

Are 'slip ups' viewed with shame? 

NEDA says that, “Following a healthy diet does not mean you are orthorexic, and nothing is wrong with eating healthfully. Unless, however, 1) it is taking up an inordinate amount of time and attention in your life; 2) deviating from that diet is met with guilt and self-loathing; and/or 3) it is used to avoid life issues and leaves you separate and alone.”

I think that their second point is huge. If you are feeling guilt and self-loathing for “slip-ups,” I think it’s time to reconsider why you are making the choices you make. Food choices should always be made out of freedom and choosing the best for yourself, not out of fear and unhealthy restraint.

Are you choosing a diet that's too strict to be healthy? 

I found it interesting that the MD who coined the term orthorexia nervosa, based it on his own experience of obsessing over his diet while he cut out meat, fat, and chemicals from his food. He found that intrusive thoughts about food were taking over his life. He learned to recognize that his food purity rules were actually causing nutritional issues for him. And I think for me that begs the question of what happens in our minds when we cut out food groups we never were meant to cut out entirely. Our bodies absolutely need healthy fats, and I understand completely why food cravings and food thoughts would take over if you were fat-starving yourself. For me, eating a well-balanced and healthy diet has done so much for me in terms of thinking about food less. If you find that the diet you chose for yourself – whether it’s a really low carb-diet, really low-fat diet, raw vegan, etc. – leaves you obsessive and fearful about food, perhaps you should reconsider taking such a strict line towards a food group.

What do you think? Where is the line between eating healthy, and obsessing about food choices? 

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