by Jessica Cushing-Murray
Anorexia, bulimia, obsessive-compulsive disorder. These are terms that are pretty universally known to the general population. But “orthorexia”? Not so much.
“Orthorexia” is defined by the National Eating Disorders Association (NEDA) as, “an obsession with proper or ‘healthful’ eating.” It is a fairly new term to describe those people you may know who are always looking at the nutritional labels on their food or can’t seem to eat food if they don’t know exactly what ingredients are in it. Orthorexia was coined only in the past couple of decades, and awareness of this term is increasing as the number of people concerned about “healthy” eating increases simultaneously. A deeper definition of the term originates from the man who coined the term himself, Dr. Stephen Bratman, who expressed, “Orthorexia commonly begins as an “exuberant” interest in healthy eating that escalates over time. What was originally a choice becomes a compulsion and the individual can no longer choose to relax their own rules. Eventually, the person’s restrictive eating starts to negatively impact both their health and social and occupational functioning; eating the right foods becomes increasingly important and squeezes out other pursuits.”
So why has orthorexia become a condition recognized by NEDA and important to us today?
It is an interesting phenomenon when a condition such as this one can be tied to society’s standards, as well as growing regulations put in place for nutrition in first-world countries. By this, I mean that all chain restaurants are now required to keep a copy of their nutritional facts in every restaurant for their consumers’ reference. Likewise, most places we eat have the calories, fat, and carbohydrate contents all directly on the menu, where these facts can sway anyone toward or away from certain meals based on the number of calories next to that food. In addition, there is a newer emphasis on vegetarian and vegan options, or a page of the menu that is classified “600 calories or less” and “lite meals.” All of these are ways that calories and nutrition facts are seemingly “thrown in our faces” everywhere we go, which certainly may correlate to the development of orthorexia.
In terms of treatment and diagnoses, Orthorexia is not specifically recognized as it’s own disorder in the Diagnostic and Statistic Manual (DSM) that health professionals abide by. This makes it very difficult to “diagnose” people as orthorexic. However, orthorexia itself is an obsession with healthy eating, so it is often thought of as combination of a classified eating disorder (such as anorexia) paired with a form of obsessive-compulsive disorder (OCD). Therefore, people who are be orthorexic may be constantly reading nutrition facts and ingredient labels, and may refuse to eat certain foods if the nutrition facts or other factors do not meet their ‘health’ standards. In addition to reading labels, someone who is orthorexic likely eats the same few foods or meals every day because they have deemed these specific foods as “acceptable.” People suffering from orthorexia may--in a similar way to those with eating disorders like anorexia-- completely cut out certain food groups from their diets. Things like “carbs” or “all meat” or “all animal products.” Or they may have other ways of deeming foods as acceptable such as if the food is grown organically or locally. They likely do this for a couple of reasons: the foods they are rejecting are not ‘pure’ or ‘healthy’ enough, but also because it makes it easier to continue with their orthorexic behavior in front of other people. Think about it: someone who randomly and completely stops eating meat looks suspicious, but if they can say to their friends that they have decided to adopt a vegetarian diet, now they have a reason to have cut an entire food group out of their diet without looking unhealthy. Lastly, another important sign of someone who may be suffering from orthorexia is someone who will become visibly distressed when there are no ‘healthy’ food options at an event, or if they are unable to find the nutrition facts or ingredients list for the food in front of them.
Orthorexia can look tremendously like a person who simply took the “eating a healthy diet” lifestyle to the extreme and is now obsessed with only eating very specific “healthy” foods. It is important to recognize and educate yourself on terms like orthorexia, because it has a likeliness to develop into other classified eating disorders, can lead to malnutrition based on the restriction and specificity involved, and can be very harmful to individuals suffering from it. Though orthorexia is not yet classified as its own official diagnosis (though it is currently diagnosed under “other specified feeding and eating disorders” in the DSM-5), the obsession our society has today with staying “fit” and “healthy” is sure to lead to increased prevalence of people becoming orthorexic. While reading this post you may have even had certain people in your life come to mind.
Awareness and education are powerful tools to utilize in helping people whose mantra of “living healthy” has ultimately become the dangerous opposite. The good news is: by reading this post, you just took the first step. See the links below for more information and signs/symptoms of people who may be suffering from Orthorexia.
If you need help recovering from Orthorexia, or another kind of eating disorder, reach out to our Dietitians today! Contact Dietitian Libby Parker HERE.
What are important things to know when thinking of performance nutrition for dancers (professional and pre-professional)?
Find out in this video interview with 2 dance-dietitians:
In this video: Registered dietitians, Libby Parker & Emily Harrison, chat about dancer nutrition/health, what to do if a director/choreographer asks you to lose weight, why diets are not a good idea, longevity (with quality of life), and more!
Emily Harrison, MS, RD, LD is a former professional ballet dancer, and has worked as the dietitian for dancers in seven countries, and with prestigious ballet companies. Emily frequently writes for dance publications, and published her own book/video series, Nutrition for Great Performances. Find Emily at: www.dancernutrition.com
By: Jessica Cushing-murray
Jessica graduated from UCLA in 2018 with a degree in Psychobiology and continued her education at University of Hawaii for a Masters in Nutritional Science. Though she loved her first semester studying nutrition, she realized that life is not always a linear process and made the decision to apply for medical school with hopes to be accepted this cycle in 2020. But, as a former collegiate distance runner, Jessica will always have a passion for nutrition and helping people struggling with eating disorders.
I probably have never met you, I don’t know what color your hair is, what your family is like, or where you live. And yet, I know you. A big part of you. The part struggling with an eating disorder, the part that has probably taken over your life and is consuming all your thoughts.
Before you roll your eyes and get ready for a lecture you’ve probably been hearing from your family and friends lately, you should know that I get it. Because I used to be you. You wake up every morning and go exercise and probably put off eating for as long as you can. The question constantly running through your mind is “to eat or not eat.” Some foods are acceptable, you’ve deemed them “healthy” in your mind; other foods are things you will not even consider eating. For me, a big “can’t” food was pasta. I used to love pasta: all kinds, spaghetti and meatballs, fettuccine Alfredo, mac and cheese, you name it, I loved it... But then my ED developed and I just couldn’t, it gave me so much anxiety.
You probably have a routine down filled with things like exercise, coffee, maybe even laxatives. Your friends are worried about you and you’re sick of hearing that “you should talk to someone” or “you need help” because you think you’re fine. I used to think that too.
So I have a question for you: what’s the goal? What’s the end point? Do you even know? How long have you been stuck and unhappy in your eating disorder? Is there an end in sight? I had a goal weight. An “if I hit this weight then I will be done and I will be proud of myself.” Here’s what I know: your goal--whether it’s a weight, a clothing size, a feeling--it won’t feel like you think it will. When I had exercised to the maximum and avoided all the foods I used to love, I hit my ‘goal’ - and I felt more empty and lost than I ever had, and I sure as heck didn’t feel any better about myself. When you’re stuck in an eating disorder, you are trapped in a cycle of dieting, cravings, and exercising, and it seems like there’s no way to stop. You might not even realize yet that life isn’t supposed to be this hard.
Two major things I learned in treatment:
1) Nobody can make you want to get better. You have to want it for yourself. And that’s the hardest part about navigating through an ED: the fact that you have to be the one who chooses recovery. Maybe you think that words like “recovery” and “treatment” sound like total BS things that you don’t need. That’s how I felt too.
But now let me tell you the 2nd thing I learned…
2) There are no shortcuts in life. Every decision you make in your ED is going to have real consequences that you probably don’t know about. I broke bones because of my ED. I have friends with permanent heart problems from their excessive exercise/binging/purging. I know people who’s repeated “I’m fine” and “I don’t have a problem” phrases left them hospitalized.
So yes, it’s your life. And it’s your choice to listen or not listen to the people around you. But it’s your life. Don’t you want to be around to live it and enjoy it? My psychologist once asked me, “Jess, what are some things you are unable to do now [because of your eating disorder] that you would be able to do once in recovery?” The long answer was: I could sleep better, have less anxiety, enjoy ice cream and going out to eat with friends, and again ICE CREAM!
But when I really thought about: what could I do when I finally accept recovery? The short answer was: anything and everything.
This is what I wish for you.
I'm speaking at the adorable local restaurant, Nourish SLO,
on July 19, 2019, and you are invited!
Get your ticket HERE they are going fast!
You can also contact firstname.lastname@example.org
Nourish SLO is excited to host registered dietitian and author, Libby Parker, for an evening of healthy discussion.
Join us at Nourish SLO with Libby Parker, MS, RD, for a Wellness Seminar on Intuitive Eating Friday, July 19 from 6-8pm.
In this seminar, you will learn:
-why you should ditch the tracking apps (never count calories or macros again!)
-how to check in with "what's eating you" before you eat.
-the difference between hunger and appetite, and that they don't always occur at the same time.
-about the physiological body systems that control our hunger and fullness.
-how to eat your favorite foods, and be healthy!
6:00-6:30 Meet & Greet w/ food from Nourish SLO
6:30-8:00 Intuitive Eating Seminar, followed by Q&A and book signing of Permission to Eat with Libby Parker (books will be available for purchase - $15)
Bring a notepad & pen - you're going to want to take notes!
Libby Parker, MS, RD, is a local Dietitian and author of "Permission To Eat: A practical guide to working yourself out of an eating disorder during college, while celebrating the awesomeness that is you!" Libby's private practice in SLO, Not Your Average Nutritionist, specializes in helping young adults and performers recover from eating disorders. Find her at www.NotYourAverageNutritionist.com or get social, @DietitianLibby
We are looking for dancers with former eating disorder, mental health, or substance abuse struggles who want to share their story using the language of dance!
I'm excited to announce that Not Your Average Nutritionist is helping with Dancing With Ed's "Stages of Change: A Dancers Body Journey" Dance Show Fundraiser.
And we are seeking recovery-oriented dance choreography to showcase!
ALL ages, ALL dance styles welcome! NO AUDITION REQUIRED. Go to our website dancingwithed.com/stages-of-change for more details!!
Submissions are due by August 30th, so don't wait!
The show will be in Oakland, CA October 20th, so please check that you are available.
We are also looking for groups to have booths at our resource fair before/after the show, and sponsors to make this event happen (renting a theatre is not cheap we are learning!). More info at the link above.
Want to watch the show? Tickets are on sale, for this once-in-a-lifetime recovery dance event! Support your local dancers and take in an evening of amazing dance like you've never seen before!
More information: dancingwithed.com/stages-of-change
Can't wait to see you there!
By: Lauren MacLeod
Lauren is finishing up her dietetic internship at Cal Poly San Luis Obispo to become a registered dietitian. She hopes to work in outpatient counseling and has enjoyed working with the eating disorder population.
Body Positivity/Body Acceptance - Comes from The Body Positive, which was founded in 1996 as an alternative treatment for anorexia nervosa; it shifts focus away from changing body weight. The core competency of body positive movement is:
“uncover the messages that have influenced your relationships with your body, food, and exercise and develop a weight-neutral, health-centered approach to self-care to become the authority of your own body by sorting out facts from distorted societal myths about health, weight, and identity.”
In summary, body positivity is about accepting your body as it is and encouraging lifestyle choices that focus on health, not weight.
Fat Acceptance - A political movement focusing on equal rights and medical treatment of fat* people. The National Association to Advance Fat Acceptance (NAAFA) was established in 1969, when fat people realized they were being discriminated against in the workplace and medical settings based on body size. NAAFA gives them access to education and support for self-empowerment.
*“Fat” is a word that is being reclaimed, as “queer” has been reclaimed by the LGBTQ+ movement. It is meant to be empowering, not demoralizing.
Health at Every Size - Health is not determined by weight, but rather by healthy lifestyle changes: eating all foods in balance (intuitive eating), and mindful and enjoyable movement. It focuses on taking care of your body at whatever size it is, and looking for actual markers of health, such as blood pressure, rather than a number on the scale. It was established by Linda Bacon, PhD in her book Health at Every Size: The Surprising Truth About Your Weight. She has since written another book to combat the modern fight against diet culture: Body Respect.
Intuitive Eating: A term championed by Evelyn Tribole and Elyse Resch (CEDRDs) in 1995 through their book Intuitive Eating. It is composed of 10 principles that focus on rejecting diet culture, listening to what our bodies truly want and need, and repairing our broken relationships with food. It is not a diet, but rather the way humans naturally eat when listening to their body.
Diet Culture: I think the Eating Disorder Registered Dietitians and Professionals really hit the nail on the head with their definition: “...a belief system that focuses on and values weight, shape, and size over well-being. Variations of diet culture also include rigid eating patterns that on the surface are in the name of health, but in reality are about weight shape or size.”
Eating Disorder vs Disordered Eating: An eating disorder fits the diagnostic criteria as defined by DSM (Diagnostic and Statistical Manual of Mental Disorders). Disordered eating classifies irregular eating behaviors that do not neatly fit in to an existing diagnosis, but may still pose health risks, physical and/or psychological.
No matter which definitions you identify with, I hope to help you find a way to love yourself. Even if you cannot accept the body you’re in now, can you appreciate all the work that it does for you? Maybe you can even work towards loving it tomorrow.
Colleen Werner joined NYAN in early 2019 to be our fabulous on-line ED recovery group leader!
Colleen is a mental health advocate, public speaker, eating disorder recovery coach, writer, and eating disorder therapist-in-training. Her personal experiences with anorexia nervosa, major depressive disorder, generalized anxiety disorder, and trauma led her to want to turn her struggles around to both inspire and help others in similar situations.
In the video below, I interview her about her work, journey with her own eating disorder, and about her upcoming book, Brave Girl Healing.
To join a group Colleen leads for NYAN, check out the online recovery group page here.
Kayla Douthitt is an intuitive eating health coach, and owner of Wisdom ‘N Wellness. Her goal is to inspire and empower others by looking inward to heal negative body image, self-esteem issues, eating disorders, and honoring their body fully. She’s on a mission to help end crazy dieting, stop negative spectators who damage body image, and believes strongly in healing from the inside out. Kayla overcame a 10-year battle with anorexia and binge eating that she hid from the world for so long, and now she truly wants to give back to bring awareness to the community and fight for those suffering low confidence and eating issues. Her positive attitude is infectious, she loves all things chocolate, and finally isn’t afraid to talk about the “F” word…Food, that is. Kayla recently started managing Project Heal, (the Largest US non-profit organization providing funds & recovery support for people suffering from eating disorders) Facebook page and is actively seeking more opportunities to end body shaming and food blaming. Learn more at www.facebook.com/WisdomNWellness
Do you find yourself stuck? Stuck staring in the mirror wondering why you think your butt looks big? Or why you think you arms need to be toned in that shirt? Heck, maybe you often wonder why you can’t look like THAT girl. You know the one that seems to have her “stuff” together. How the heck does she have 4 kids and still able to wear a bikini? How is it that those skinny jeans make her look…well…skinny?
Then you get mad. You get angry at yourself. You compare and perhaps even cry. I’ve been there. It’s human nature to want to look good. I would be doing you disservice if I didn’t say that everyone wants to look good, even if they don’t admit it. Looking good is not the problem. The problem is how you treat your body and what you say TO your body.
I say that to say this - Why are you body hating? You aren’t doing yourself any favors by pin-pointing every little area that you think is wrong. Because I can promise you, it’s society that is wrong! It’s the tabloids, the media, the articles, etc. They have us thinking salad is better than cake and celery juice is the next BIG thing.
Folks, I spent years of my own life wishing I should have, could have, would have, looked perfect. I searched for flawless clothes, the just perfect food choices, the ideal hair, etc. If it was the latest and greatest in terms of lookin’ good, you can bet I probably tried it or attempted to try.
Moral of the story, love you FOR you. Love YOU because YOU are made EXACTLY the way you are suppose to be made. I beg you to start taking into consideration that your body deserves kindness, moved with joy and not hate, cared for in a hot bubble bath, and rest when it’s tired. Your body needs you to trust it. Even just a wee bit means so much to those toes that stay bound up in high heels all day long. Your body needs you to just be. Be as you are, not as what everyone else wants you to be. That’s right. This is coming from the girl who thought she had to impress the world and be just like it.
I finally figured out that I can’t stand being like the rest of the world. It’s DISGUSTING!
I’d rather be called a weirdo. Of course, this didn’t happen overnight, and I’ll be honest, it won’t happen fast for you that fast either. It is POSSIBLE if you start now.
I believe that it’s possible to wear whatever you want, how you want and love your body.
It’s possible to show the world your battle wounds of carrying a baby, falling down that dirt road scars, and getting scratched by a cat. We’re human, inevitability made of flaws, and THAT alone is powerful. From here on out, please do your body and your soul a favor:
Give it love. So much love that you can’t even handle it.
By Miranda Daschian
Daschian is a student-athlete at Cal Poly - SLO majoring in Psychology with a minor in Ethnic Studies. She aspires to work with athletes struggling with eating disorders and promote body positivity to those competing in adolescence and beyond.
Imagine a young student who has recently begun high school. Freshman year, full of
opportunity...and a vast amount of awkwardness and hormones. This student, now
surrounded by peers years older and influences from the world of adulthood, begins to
feel pressure. This pressure is on the appearance of their body. They begin checking
mirrors more often, analyzing their face for any ominous pimples, poking and prodding
at their stomach and arms. Mom and Dad notice their once carefree child is now highly
selective at meals and has been frequently skipping homework and assignments to go on
runs or to the neighborhood gym. Weeks pass, and yet these behaviors only increase.
The student’s body is now changing noticeably, and yet they still don’t feel good enough.
Based on this, what gender do you believe the student is?
If you said girl, you may be one of many who thinks of eating disorders as a cis-gender
female-specific issue. While the problem may effect more females than males to this
day, the rates of disordered eating traits and diagnoses in males is on the rise...and at
alarming rates. According to NEDA (National Eating Disorders Association) around 10
million males in the United States alone will experience disordered eating symptoms,
and rates of sub-clinical eating disorder behaviors are almost as common in males as
females. These rates may even be higher when stigmatization of males with these issues
is taken into account, causing many to suffer in silence.
So if all genders are susceptible, why do we so rarely hear about one of the populations
at risk? Many aspects of masculinity in our culture involve reluctance to be open or
acknowledge illness or weakness. “Just tough it out”, “don’t be a sissy”...all push males
to put their heads down and ignore things that may be going wrong in their lives. This
masculine stereotype not only tells someone how to process their emotions but also goes
as far as to push them into certain physical portrayals of how a “real man” should look.
If you need examples of this, google “dorito body” or “superhero body” and you will see
an endless array of muscular males (in various degree of dress) who we all know don’t
just naturally look that way. Photoshopped and posed images rule the internet and are
presumed to be the ideal, circulated broadly across social media and the internet. We
have assumed a type of sexualized and polished beauty to be superb, yet the influence of
this type of imagery is toxic and can be seen in rates of disordered eating increasing
among the spectrum of gender.
The biggest impact on eating disorders across the board can be made by changing
aspects of our culture. Sound easy? Not likely, but steps are being made slowly. Breaking
down gender roles and body image stereotypes will allow more individuals to develop a
sense of self separate from how they or others view their body. Individuals who identify
as male that deviate from a traditional “built” frame or masculine features won’t feel
devalued or shamed, and students like the hypothetical one I mentioned earlier will base
their self-worth on aspects other than their bodies. Self-love or body positivity
campaigns in groups as young as elementary school can promote the ideal that one
should love their body for what it is and the purpose it serves. Families can take new
approaches to how meals are introduced in the household, emphasizing less on any
critiquing and more on the energy and sustenance gained from these meals. And more
than anything, future generations should be taught that every body is different, but
every body holds worth.
"A question I keep getting is, "when can we talk about specific foods?"
With all the "super foods" for health/weight loss/etc, everyone wants a magic bullet.
But, it's not that simple. There are other things we need to consider before we can think about how turmeric and kale are going to change your life.
I came up with the "hierarchy of nutrition needs" to explain what is most important for you to be working on right now. Start at the top of this upside-down pyramid and see where you are at.
1) Enough food. The most important piece is simply to make sure you are eating enough food/calories to support your body. Low calorie diets, famine, food insecurity, these need to be conquered before we can move on to the following steps (Consult a Registered Dietitian for your unique calorie needs - please don't use a book/article/formula to make up your own).
2) Balance of Macronutrients. Carbohydrates, fats, and proteins are our macronutrients, and we need all of them in proportion to have a healthy diet. In general carbs should make up 45-65% of your calories, fat should make up 20-35%, and protein 10-35%. Where on the range you fall depends on many factors including growth, type of activity, and medical issues like diabetes.
3) Spacing food out over the day. Once you have figured out how much to eat, it will really behoove you to space it out over your waking hours. I don't care how popular intermittent fasting has become, your body likes a continuous trickle of nutrients coming in to keep it running at its best. Our body actually stores more fat when we eat too much food in a short period of time. If you had the same [foods/calories/everything exactly the same] on 2 different days, and one day you spaced it out with meals and snacks, and the other day you ate it all in a short time frame (2-4 hours), you would store more of that food as fat on he day you ate it all in a shorter period of time, and your body wouldn't be able to use all of the nutrients. When in doubt- space it out!
4) Micronutrients. Micronutrients are vitamins, minerals, and phytochemicals in our foods that are a necessary part of our body function. These are nutrients like calcium, iron, and zinc. I'll spare you the long boring lecture, but once you have the above mastered the next step is making sure you get the correct balance of micronutrients. In general, this is not something you need to calculate or be overly concerned about if you eat a wide variety and colors of foods.
5) Specific Foods. Only after figuring out the other steps should you think about what specific foods you are eating for health. As stated before, there are no "super foods" or "miracle foods." That being said, it never hurts to try out different fruits/veggies and dishes. Just don't take it to extremes. Even kale or carrots in excess can cause problems. As it is said, "the dose makes the poison" (-Paracelsus). Try to create balance in your diet and eat a rainbow of foods.
You'll feel better.
Libby is a non-diet Registered Dietitian focusing on eating disorder treatment and prevention. She approaches health from the inclusive standpoint that any "body" can focus on health regardless of size. She is a ally in diversity.
Not Your Average Nutritionist, LLC
All Rights Reserved
Disclaimer: This website is for educational & informational purposes only,
it is not a substitute for medical or mental health advice or treatment.