SELF HELP RESOURCE - Wellness / Lifestyle

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Kavita was teased by her friends and colleagues as being a fitness and health freak. Since she started working, no matter the deadlines and strenuous work load, she would hit the gym every single day. Her food habits struck some as being healthy, others thought she was just peculiar. She was fixated on food quality and would sometimes punish herself with extra exercise or a stricter diet, if she slipped up and had a snack or treat. Her food choices were restrictive in variety and calories. She would feel weak while at the gym, but kept doggedly exercising not wanting to give up. Eventually she even shut out her friends and gave up her other interests and hobbies. They did not seem to fit in her health plan. This is when her family got concerned and decided to step in.  They asked for medical help for their daughter, after a series of discussions, she was diagnosed with orthorexia nervosa. This literally means- fixation on righteous eating. On further probing, Kavita confessed she was obsessed with healthy food choices. She would leave out whole food groups and was terrified if a food did not fit her idea of healthy eating. This made her avoid going out with friends and family. She sometimes suspected that what she was doing was not right, but never thought of it as a disorder or obsession. She was made to understand, that if left untreated, this could lead to malnourishment or an anxiety disorder.

Healthy eating is important for an active lifestyle. Orthorexia starts out innocently enough, but later on turns into an obsession. An orthorexic can become fixated on food choices, calories, fasting and exercise. They can even look down on others in terms of their eating habits and food intake, as it boosts their self-esteem. 

The term orthorexia was coined by Dr. Steven Bratman in 1996. He came across some of his patients who were overly obsessed with ‘healthy’ eating and tried to make them understand that this was not as good or healthy as they thought. Orthorexia differs from anorexia nervosa or bulimia nervosa, in that, it focuses about ‘healthy’ eating, rather than weight loss or looking thin. This concept of ‘health’ could also be due to self-esteem and other underlying psychological fears. 

Why is Orthorexia harmful?
•    An orthorexic can eliminate certain healthy foods or food groups in case they do not fit into their eating plan. This can cause nutritional deficiencies.
•    Since their lives revolve around their food and food habits, this may lead to social isolation
•    Ironically, an orthorexic may lose sense of the purpose of food. Since they are too caught up in making right choices. They ignore hunger cues and may also distort portion sizes. 
•    Searching for the right ingredients, reading ingredient lists feverishly and stressing on whole clean foods can become an obsession. This can hinder interpersonal relationships, so much that it affects the quality of life. As Dr. Bratman (a former orthorexic himself) describes it- “I was lonely and obsessed…I found it terribly difficult to free myself. I had been seduced by righteous eating” (1)

What are the differences between orthorexia and healthy eating?

Healthy Eating Orthorexia
Is approached with enthusiasm Intial enthusiam becomes an unhealthy obsession
A variety of healthy and whole foods are a part of the diet Uses food to self punish by severely limiting choices and variety
Healthy meals are enjoyed with family and friends Food choices are so limited and strict that one shuns family and friends who do not eat 'healthy'
A balanced diet nourishes the body with vital nutrients for good health and provides energy Orthorexia is extreme as it avoids food groups, leading to irritability and anxiety
Allows for a snack, dessert or treat once in a while without feeling guilty A deviation from the set diet causes intense feelings of guilt and self-loathing
Requires a practical amount of time to prepare and cook healthy foods Orthorexia takes a large amount of time and attention, since one is fixated on 'healthy' food choices


How can Orthorexia be treated?
 

In today’s world where every pop star, film actor and celebrity advocates healthy eating. Orthorexia can be missed or easily glossed over and even applauded. An orthorexic can think they are doing themselves a service and taking care of themselves by avoiding unhealthy foods. However, when confronted, an orthorexic needs to understand what has caused the obsession and any other emotional issues that could have led to this self-imposed strictness in diet. This makes the transition back to healthy and normal eating easier. They can be encouraged to know that healthy eating is important, but within limits of one’s time and energy. One approach for counselling is to explain that- food does not define who you are or make you a better/ worse person.  They can also be made to understand that there is more to life than being obsessed with their strict ‘diet’ or food choices. 

A sense of balance is important while achieving good health. As with any good thing, while trying to improve on it, don’t lose it. It reminds us of celebrities who go under the knife to look better. In some cases, it works, for others it has been disastrous! The same approach works for healthy eating. Use food to nourish and strengthen your body. Do not let food become an obsession and prevent you from enjoying life!


With inputs from:

1.    http://www.orthorexia.com/healthy-eating-vs-orthorexia/
2.    https://www.eatingdisorderhope.com/information/orthorexia-excessive-exercise/understand-orthorexia
3.    Håman L, Barker-Ruchti N, Patriksson G, Lindgren E-C. Orthorexia nervosa: An integrative literature review of a lifestyle syndrome. International Journal of Qualitative Studies on Health and Well-being. 2015;10:10.3402/qhw.v10.26799. doi:10.3402/qhw.v10.26799.
4.    Thomas M. Dunn, Steven Bratman, On orthorexia nervosa: A review of the literature and proposed diagnostic criteria, Eating Behaviors, Volume 21, 2016, Pages 11-17, ISSN 1471-0153, http://dx.doi.org/10.1016/j.eatbeh.2015.12.006. (http://www.sciencedirect.com/science/article/pii/S1471015315300362)
5.    https://en.wikipedia.org/wiki/Orthorexia_nervosa
6.    http://www.abc.net.au/radionational/programs/allinthemind/when-a-healthy-diet-becomes-an-unhealthy-obsession/8530762
7.    Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric Disease and Treatment. 2015;11:385-394. doi:10.2147/NDT.S61665.
8.    http://www.health.com/health/article/0,,20556862,00.html
9.    http://www.timberlineknolls.com/eating-disorder/orthorexia/signs-effects/
10.    https://www.nationaleatingdisorders.org/orthorexia-nervosa
11.    Brytek-Matera A, Donini LM, Krupa M, Poggiogalle E, Hay P. Orthorexia nervosa and self-attitudinal aspects of body image in female and male university students. Journal of Eating Disorders. 2015;3:2. doi:10.1186/s40337-015-0038-2.

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