Orthorexia: are you at risk?

Orthorexia: are you at risk?

There is a new trend in town and it has a name: Orthorexia nervosa, or more simply, orthorexia.

However, it can be hard to diagnose because at its core is a desire to eat more healthily — and most of us want to do that.

The term ‘orthorexia’, originally coined in 1997 by Dr Steven Bratman, describes an unhealthy obsession with eating healthy food. The term is derived from ‘anorexia’ with ‘ortho’ meaning “straight” or “right”.

Despite orthorexia not being recognised as a clinical diagnosis in the DSM-5 (Fifth edition of the Diagnostic and Statistical Manual of Mental Health) — a handbook used by health care professionals in the US and much of the world as an authoritative guide to mental health disorders [1]it is widely accepted that it is an eating disorder.

What is Orthorexia?

orthorexia | 5 Minute FitnessPut simply, orthorexia is an unhealthy obsession with healthy eating. What may start out as a ‘health kick’ or simply an attempt to clean up one’s diet and include more healthy foods, can quickly turn into something sinister.

While anorexia focuses on restricting food intake in the quest to achieve a certain body shape (usually ‘thinness’), orthorexia restricts the types of foods themselves. Orthorexics will only eat foods deemed ‘clean’, ‘healthy’ or ‘wholesome’.

Following a vegetarian, vegan or any other nutritionally sound eating plan is fine. Reading food labels and making informed decisions about which foods to eat, is also fine. However, when a seemingly innocent attempt to clean up one’s diet, turns into a fixation on food purity and quality, alarm bells should ring.

Dr Steven Bratman, author of the website Orthorexia.com says that people with orthorexia have developed “an extreme, obsessive, psychologically limiting and physically dangerous disorder”.[2]

Sufferers become consumed with what to eat, how much to eat and are constantly striving to ‘eat right’ and ‘be good’. Self-esteem becomes a direct reflection upon how well they eat and they may even begin to feel superior to others, based upon their dietary choices.

As the disorder takes hold, food choices become more restrictive and the obsession with food takes precedence over other activities and interests in their life. Because food choices are so restricted, the person’s health may begin to suffer (which is ironic given that the disorder was born out of a desire to be healthy). In some cases, a person may become malnourished, sick and may even die.

According to Bratman, the disorder “has an aspirational, idealistic, spiritual component, which allows it to become deeply rooted in a person’s identity”.

woman holding grapefruit What are the symptoms?

Living a healthy lifestyle doesn’t mean you are orthorexic. However, key signs [3] [4]that you need to look out for include:

  • You find healthy food a primary source of happiness and meaning, even spirituality
  • Your lifestyle interferes with relationships, work, friends or family
  • Food helps you feel in control and eases feelings of anxiety and insecurity
  • You have to take your diet to further extremes to get the same ‘kick’ out of it
  • When you stray from ‘pure’ foods, you feel a compulsive need to cleanse
  • Your interest in healthy food controls your life
  • You sometimes wish you could just eat and not worry about the quality of your food
  • You wish you could spend less time thinking and preparing food and more time on other things
  • You panic if you do not have control over everything that goes into your mouth, particularly when someone else has prepared a meal for you
  • Following the ‘perfect’ diet is the most important thing in your life
  • You feel guilt or self-loathing when you ‘eat off plan’
  • You feel in control when you stick to the ‘right’ foods
  • You feel superior to others, based upon your food choices.

steak being slicedWhat role does social media play?

According to Google statistics, the number of searches for terms such as ‘paleo’, ‘vegan’ and ‘gluten’ has risen significantly over the past 10 years, with a considerable rise since 2011. [5]This is not to say following these lifestyles are bad, but it’s important to remember that orthorexia begins with a desire to eat ‘healthily’ and rightly or wrongly, these terms have become synonymous with health.

apple with stethoscope and measuring tapeWith social media being such an integral part of our lives, orthorexia can be easily fuelled. How many ‘sugar-free’ or ‘carb-free’ or ‘guilt-free’ posts of food you see in one day on your social media feed? A key problem is that many assume that those posting such pictures and recipes are ‘experts’, particularly if they have a large following.

However, as we learned in the case of ‘wellness guru’ Belle Gibson (the young woman who lied about overcoming terminal brain cancer and using that lie to build an empire), not everything is always as it seems. Those who seem to be ‘in the know’ can actually be dishing out incorrect and dangerous advice.

Add to the mix the trend of photographing your ‘clean’ plate and uploading it to Instagram, Twitter or Facebook, and the positive feedback and praise that often follows, it is easy to understand how eating well turns to a dangerous obsession.

How should you eat?

While adopting a healthy lifestyle is great, living a life that centres around restricting food choices is not. Food should be used to nourish and fuel or bodies, but it should also be enjoyed — free from rules, guilt or anxiety.

The Dietitians Association of Australia (DAA) recommends eating a wide range of foods from each food group — lots of fruit and veggies, legumes, wholegrain cereals and breads, lean meat, fish, poultry, eggs, nuts and seeds and low-fat dairy — and limiting foods with added sugars, saturated fat, salt and alcohol. [6]

veggies with measuring tapeRather than excluding food groups, or labelling them ‘good’ or ‘bad’, the DAA encourages enjoying all foods. It recommends categorising foods into two groups; ‘everyday foods’ and ‘extra foods’. Obviously ‘everyday’ foods can be enjoyed every day, while ‘extra foods’ should be enjoyed sometimes and in small amounts.

The DAA also warn against relying upon nutritional information found online, including social media. It believes that many people with orthorexia are mistaken about food and nutrition, which is often caused by inaccurate information from less reputable sources. When it comes to dietary advice, the DAA recommends seeking the advice of trusted health professionals.

Treating orthorexia

The US-based National Eating Disorders Association says that recognising orthorexia can be difficult, particularly given society’s value of healthy eating and thinness[7]. It can also be easy for sufferers to hide behind the thought that they are eating well, and insist that they do not have a problem.

Like many eating disorders, orthorexia can be treated with the help of professionals, although the road ahead for sufferers is not always easy. If you suspect you or someone you know, is suffering from orthorexia, or any other eating disorder, speak to your health care professional.

 

References:

[1] American Psychiatric Association, What is DSM and why is it important? Published unknown; accessed 18 June 2015 http://www.dsm5.org/about/pages/faq.aspx

[2] Stephen Bratman, Orthorexia, What is Orthorexia? published 23 January, 2014; accessed 18 June 2015 http://www.orthorexia.com/what-is-orthorexia/

[3] Karin Kratina, National Eating Disorders Association, Orthorexia Nervosa, published unknown; accessed 18 June 2015 https://www.nationaleatingdisorders.org/orthorexia-nervosa

[4] Stephen Bratman, Orthorexia, What is Orthorexia? published 23 January, 2014; accessed 18 June 2015 http://www.orthorexia.com/what-is-orthorexia/

[5] Google.com, Trends, accessed 19 June 2015, http://www.google.com/trends/explore#q=paleo%2C%20vegan%2C%20gluten&cmpt=q&tz=

[6] Dietitians Association of Australia, Orthorexia, published unknown; accessed 18 June 2015 http://daa.asn.au/for-the-media/hot-topics-in-nutrition/orthorexia/

[7] Karin Kratina, National Eating Disorders Association, Orthorexia Nervosa, published unknown; accessed 18 June 2015 https://www.nationaleatingdisorders.org/orthorexia-nervosa

 

 

Why fitspiration does more harm than good

Why fitspiration does more harm than good

Even if you have not heard of the term ‘fitspiration’, you have probably seen some of the countless images posted on Facebook, Instagram and Pinterest, designed to ‘inspire’ you to take action and get fit.

The common theme among these pictures is they portray men or women (mostly women) wearing tightly fitted crop tops, shorts or even spandex. These people do not have faces (well, they obviously do but they are not photographed), because the pic is too busy focusing on their rock-hard abs or the beads of sweat glistening on their well-toned body.

This trend of collecting pictures, memes and quotes about ‘pushing through pain’, ‘working your butt off’ and ‘staying motivated’ is called ‘fitspiration’ or ‘fitspo’.

Not inspiring at all

However, one of the problems with fitspiration is that it does not inspire. These memes tend to focus on exercise as a form of punishment, or something that has to be ‘borne’, rather than enjoyed. They focus on the physical results (often sexualised), rather than the health benefits. They also aim to guilt people into action (i.e. you are lazy and worthless if you’re not disciplined enough to look like this).

fitspiration

Experts believe the trend is promoting poor body image, increasing the likelihood of eating disorders and impaired mood.

A 2013 study showed that when people (particularly those with eating disorders) view images of models idealising thin or muscular bodies, they experience negative self-esteem, may grow anxious or depressed and their symptoms worsen.[i]

If that’s not bad enough, an Australian study of 156 adolescent girls (mean age of 14.9 years) [ii] showed that viewing these kinds of images on the internet or in magazines causes teenage girls “greater internalisation of thin ideals, appearance comparison, weight dissatisfaction, and drive for thinness”.

Interestingly enough, when girls saw fitspiration-type images on the television, they didn’t experience the same feelings, prompting the researchers to conclude that the internet represents a powerful sociocultural influence on young women’s lives.

The problem with social media

Like it or not, social media is here to stay. While social media is not all bad, there is increasing evidence that it is fuelling a rise in eating disorders among teenagers, as they share images of girls looking dangerously thin.

Recent news from the UK[iii] indicates that the number of those aged 13 to 19 being admitted to hospital with anorexia and bulimia has doubled in the last three years.

fitspiration

The new trend of sharing photographs of excessively thin people and swapping tips on social media is becoming an obsession. Experts say that their desire to achieve the ‘perfectly toned body’ can lead them to develop eating disorders and become terrified of eating particular foods. It is also having a devastating effect on their self-confidence and body image.

What many girls don’t realise is that a vast majority of images on the internet are Photo-shopped to look perfect. This culture of ‘perfection’ is now causing teenagers to amend their own photos to create a slimmer or more attractive image of themselves, before posting to their social media accounts.

Tags such as #fitspiration or #thinspiration abound on social media, with countless individuals sharing and collecting these images of very thin and sexualised women. The practice can become addictive and put enormous pressure on teenagers to look a certain way.

Closer to home, a study from Flinders University revealed that a growing number of girls are turned off sport in high school because Facebook and Instagram are making them feel self-conscious about their bodies.[iv]

It’s not just affecting teenage girls

While evidence shows that teenagers and young women are the most vulnerable, men are also affected. After viewing photos of lean, topless males, they also experience a dip in body confidence and a heightened desire to lose weight.[v]

A Sport England survey found that 75 per cent of women would like to exercise more, but were afraid to for fear of being judged over appearance, ability and concerns that they are being ‘selfish’. [vi]

Researchers at Flinders University are calling into question the fitspo trend and are currently conducting a study of women aged 17 to 29 years to determine whether fitspirational media actually discourages women exercising. [vii]

They believe that the new ideal permeating through media is overly sexualised women with bodies that are toned, fit, strong and skinny — something that the vast majority of women will never be able to obtain or maintain.

Researchers believe that viewing such images will result in greater body dissatisfaction, mood disturbance and lower levels of exercise participation.

fitspiration

Exercise for health and happiness

While it is healthy to exercise, doing so because you feel guilt, ashamed of your body, are chasing unrealistic ideals or because you feel unworthy if you don’t exercise, is not healthy. Feeling guilty about taking a day off or not exercising because you are sick is also not healthy.

Exercise should be about health — all aspects of health. It should be about reducing your risk of chronic disease. It should be about staying mobile, flexible and strong enough to go about your daily activities. Exercise should be about feeling proud of yourself and feeling happy within yourself. Exercise should be about the actual experience and joy that comes from exercising, not about an unrealistic body image that is unattainable.

 

References:

[i] Heather A. Hausenblas, Anna Campbell, Jessie E. Menzel, Jessica Doughty, Michael Levine, and J. Kevin Thompson, Media effects of experimental presentation of the ideal physique on eating disorder symptoms: A meta-analysis of laboratory studies, Clinical Psychology Review 33 (2013): 168-181. http://www.sciencedirect.com/science/article/pii/S0272735812001638

[ii] Marika Tiggermann & Jessiva Miller, The Internet and Adolescent Girls’ Weight Satisfaction and Drive for Thinness Sex Roles 63, nos. 1-2 (2010): 79-90. http://link.springer.com/article/10.1007%2Fs11199-010-9789-z

[iii] ioL Lifestyle, The new alarming trend, selfie anorexics, published 10 June, 2015; accessed 11 June 2015 http://www.iol.co.za/lifestyle/style/beauty/the-new-alarming-trend-selfie-anorexics-1.1869750#.VXjVYvmqqko

[iv] Flinders University, Flinders News, Social media puts body-conscious girls off sport, published 7 October, 2014; accessed 11 June 2015 http://blogs.flinders.edu.au/flinders-news/2014/10/07/social-media-puts-body-conscious-girls-off-sport/

[v] Rachel M. Galioto, The Effects of Exposure to Slender and Muscular Images on Male Body Dissatisfaction . MA Thesis. Kent State University. Ohio, 2013. https://etd.ohiolink.edu/rws_etd/document/get/kent1357582675/inline

[vi] Daily Mail Australia, Scared of being judged at the gym? You’re not alone, published 1 November 2014; accessed 11 June 2015 http://www.dailymail.co.uk/health/article-2815893/Scared-judged-gym-not-New-study-finds-75-women-want-exercise-don-t-fear-think.html

[vii] Flinders University, Flinders News, Strong (and skinny) is the new sexy; the #fitspo effect, published 23 December 2014; accessed 11 June 2015 http://blogs.flinders.edu.au/flinders-news/tag/fitspiration/