Healthy
Hausfrau: What is orthorexia
nervosa?
Dr.
Lampert:
Orthorexia
is thought of as an obsession with eating healthy food. While not a clinically
defined eating disorder nor an official diagnosis-it is a term coined to
describe an emerging issue of over-concern with food. The obessionality with
which some people approach their eating can be highly problematic. People
described as struggling with orthorexia strive to eat only ‘clean’ or ‘pure’
food, shunning many foods and sometimes entire food groups. This type of ‘food
perfectionism’ can lead to nutritional deficiencies, difficulties in
relationships, and unnecessary or excessive weight loss.
HH: Statistics pertaining to the prevalence of
orthorexia seem to be scarce. Can you give me any idea of how common this
problem is?
Dr.
Lampert:
It is
hard to assess since it is not an official diagnosis. Over concern with food is
seen in many people struggling with eating disorders and disordered eating,
problems that impact at least 14% of women and 8% of men.
HH: How common is orthorexia in Emily Program
patients?
Dr.
Lampert:
Clients
with eating disorders often have preoccupations regarding the types of food
they will eat. In that sense, it is exceptionally common, given that
preoccupations and obsessions with food are hallmarks of eating disorder
behaviors. We describe the obsessional quality people have with food as ‘food
perfectionism’. This can be seen when people refuse to eat certain foods
because they aren't exactly right. At The Emily Program we help people to make
peace with food; to let go of needing to achieve perfectionism and find peace
in a variety of food, eating situations, and settings.
HH: In your tenure, have you seen an increase,
decrease, or no change in patients presenting with orthorexia behaviors?
Dr.
Lampert:
As our
societal focus on eating ‘fresh’, ‘healthier’ food has intensified, clients
presenting with eating disorders increasingly are describing these concepts as
part of what led them to change the way the eat in the first place, e.g.,
decreasing fats, eating only ‘whole’ foods, eating raw foods only, etc. Eating
disorder behaviors often reflect the societal nutritional fads. In the days of
the low-fat craze, many clients struggled having fat in their diets and sought
to severely limit their fat intake. In the days of the high-protein, low carb
craze, carbohydrate foods became increasingly difficult for people to consume
and they had to be the ‘perfect’ carbohydrate. Since eating disorder behaviors
are often the extremes of normal human behavior, any dieting or food craze that
impacts the general public is likely to show up exaggerated in clients with
eating disorders. Over the past 20 years, I’ve seen this kind of obsession with
food follow the tide of the latest diet craze; the craze changes but the
obsession and over-concern with food, eating, and weight continues. We’ve seen the
numbers of people with eating disorders increase over the same time period.
Fortunately, recognition is changing somewhat and more people are accessing
help when they need it.
HH: In your experience, how does a person usually
progress into orthorexia?
Dr.
Lampert:
It starts
with a diet or an effort to change the way one eats. This change typically
prompts more changes, which spiral into food obsession and limited intake of a
variety of foods.
HH: What are the key differences between orthorexia
and someone who just tries to eat a very healthy diet?
Dr.
Lampert:
Someone
who would be described as struggling with orthorexia, or overly obsessional
about eating healthy food would likely have this obsession impact their
relationships and their ability to interact socially with friends and family,
particularly around food. As with many eating disorders, this difficulty with
relationships and social and/or food related activities leads to isolation for
the sufferer.
HH: Do you feel our health-obsessed society contributes
to orthorexia?
Dr.
Lampert:
Absolutely
our health obsessed society contributes to the eating behaviors of the members
of that society. Those that become most obsessed with ‘doing it right’ in terms
of eating and health are likely to become swept away by a tide of over-concern
about food, health, weight, and shape.
HH: Do you think that fad diets, "pop
science" books demonizing foods and entire food groups (ie Wheat Belly,
Grain Brain, The Sugar Detox), and sensationalistic media-driven messages such
as "sugar is the new tobacco" fuel orthorexia?
Dr.
Lampert:
They do
seem to fuel an obsession with ‘getting it just right’ and finding the magic
bullet to our nutritional woes. Packaged in slick-sounding solutions to complex
solutions, these kinds of books fuel the idea that there is one solution to an
overly simplified problem.
HH: If you think you or someone you know may be
suffering from orthorexia, what are warning signs or questions to ask?
Dr.
Lampert:
Does my
eating impact my ability to be with family and friends?
Does my
eating keep me limited to a small array of foods such that I can’t enjoy myself
in the presence of a typical meal?
Does my
concern about eating lead me to less interaction with people and limit my
functioning?
How do
others view my eating?
Can I take
their feedback objectively or do I get defensive when someone attempts to ask
me about my eating from a place of concern?
HH: What does recovery from orthorexia look like and
how does one get there?
Dr.
Lampert:
Recovery
is individualized for any kind of eating disorder behavior. Peace with food is
the ultimate goal. Eating when hungry, stopping when full, eating what appeals
to you, in a way that is nourishing and balanced emotionally and physically.
Typically recovery involved taking risks to express emotion, asking for help,
learning new skills, and practicing without perfection.
HH: What is your advice for people who are very
health/diet/fitness-conscious but don't want to overdo it?
Dr.
Lampert:
Be
moderate. Have fun. Don’t forget to enjoy a balanced array of foods and enjoy
your food-not just for the nutrients, but for the taste, texture,
socialization, and connection it brings.
About Dr.
Lampert
Jillian G. Lampert, PhD, RD,
LD, MPH, FAED is the Senior Director, Business and Community Development
for The Emily Program, a comprehensive eating disorder treatment program with
multiple Minnesota and Washington locations. Additionally, Dr. Lampert is President
of the Residential Eating Disorders Consortium (REDC), an organization whose
main goal is to ensure access to residential care for individuals by working
collaboratively to address issues that impact the residential eating disorder
treatment community. She is a current Board Member of The Emily Program
Foundation and a member of the Eating Disorder Research Society (EDRS). She
holds an adjunct graduate faculty position in the Department of Food Science
and Nutrition at the University of Minnesota. One of her major goals in life is
to have her 9 year old daughter grow up loving her body and herself.
