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Got Orthorexia? Not so fast.

An article titled “10 Ways to Recognize Orthorexia” by Sarah Horne Grose came to my attention recently. If you’re not familiar with the term, according to the National Eating Disorders Association, Orthorexia Nervosa is a “fixation on righteous eating.” It is healthy eating taken to an extreme, so much so that putting any food in one’s mouth becomes a fraught exercise.

In reading through the 10 signs of orthorexia, I qualify for three-and-a half of them. I read food labels obsessively, always skip the birthday cake, worry about what I’m going to eat when traveling, and (the half), I have eliminated whole categories of food from my diet, but not in “the sublime pursuit of clean living”. Sign me up for an eating disorder, right? Especially given that I have been underweight most of my life and have been accused with great regularity of being anorexic.

Not necessarily.

Let’s back this up a bit and analyze exactly why I’m following a restrictive diet.

Growing up, I ate pretty much everything. My parents encouraged me and my siblings to try new foods. We had to clean our plates before leaving the table. I have a large appetite for my 105-pound body, sometimes out-eating my husband. Because of genetics, I burn off calories efficiently and my weight has hovered between 100 and 110 pounds since high school, with the exception of pregnancy, wherein I gained a good amount of weight and promptly dropped it all as soon as each child was born. I’m lucky that I have never had to diet to lose weight. Never had to diet, period.

Until the past few years.

I developed eczema four summers ago, a first for me. Welcome to middle age. In the course of trying to figure out the cause of this distracting and unsightly annoyance, I was prescribed an elimination diet.

An elimination diet requires you to take the most common allergens, typically dairy, soy, gluten, corn, nuts, sweeteners, most meats, citrus, and a number of other items, out of your diet for a certain period of time in order to see if any of them are affecting your health. After the elimination period, you add foods back on a particular schedule one at a time and watch for reactions.

In trying to figure out what’s causing the eczema, the only test that has come back positive was one that shows I have candida, a systemic yeast infection. Oh, goody! If the elimination diet seems restrictive, check out the Candida Diet, which practically whittles your diet down to nothing but avocados and unsweetened coconut in order to cure the infection. Hey, if you die of starvation, the yeasts will die too!

Functional medical specialists, naturopaths, and other natural healers are very fond of their elimination diets. Whereas your garden variety medical doctor will immediately reach for drugs to deal with what ails you, a medical professional with a natural bent will pretty much always start you on an elimination diet in order to see whether the Standard American Diet (SAD) is causing your problem. Poor nutrition is behind many chronic diseases, so this is a good starting strategy.

However, elimination diets can be overdone. I’ve been told to do elimination diets, as well as the Candida Diet, several times in the course of figuring out the cause of my eczema. I have dutifully done so, and have been following a gluten-free, corn-free, sugar-free diet for the past 7 months in hopes of clearing my skin. While I’ve seen some improvement in my health, particularly in my blood sugar levels after eliminating sugar, my skin is still not healed and periodically flares for no discernible food-related reason.

Further, natural healers tend to encourage patients to stay on them long-term because supposedly all of the eliminated items cause inflammation in the human body. One of my doctors prescribed the book “Clean” for me to read because he had run out of ideas regarding cause of my eczema. “Clean” is the work of Dr. Alejandro Junger and it takes readers through a 21-day dietary detox using two liquid meals (super smoothies, juice or soup) a day and one uber-healthy lunch. And, yes, it’s based on the elimination diet. While the book (and accompanying website) does not suggest staying on a mostly liquid diet for longer than three weeks, it does suggest keeping the eliminated foods out of your diet permanently. You know, because you’ve gotten used to going without them for three weeks, so why not the rest of your life?

When you’ve got doctors like Junger, whose work has been endorsed by actress Gwyneth Paltrow, and other natural healers prescribing these restrictive diets, it’s no wonder a disorder like orthorexia arises. The White Coats have people afraid to eat because that whole-grain wheat bread is going to kill us. As will the peanut butter. And sugar. And soy. But not the coconuts. Coconuts are our friends.

I have no doubt that some people have orthorexia proper, an actual eating disorder following all the points in Grose’s article. However, what appears to be orthorexia in a person may actually be situational defensive eating with a real purpose.

If you have a peanut allergy that causes anaphylaxis, you’re going to avoid peanuts like the plague, because for you, peanuts are as deadly as the plague. You are not orthorexic.

If you’re a celiac or have a gluten sensitivity in which ingesting gluten causes physical symptoms, you’ll do your best to avoid all sources of gluten. You are not orthorexic.

If your doctor has prescribed a restrictive diet for a specific disease process, you are not orthorexic, although you need to be careful not to let your doctor unnecessarily scare you about food. Doctors don’t know everything. Remember the whole movement to eat fat-free for heart disease? Turns out that wasn’t such a good idea. Likely, a future researcher will find that cutting out all gluten or corn or beans for those without a sensitivity isn’t a good idea either.

The most sensible guide to eating that I’ve seen is Michael Pollan’s “Food Rules.” His rules boil down to the following:

  1. Eat food, food that your grandmother or great-grandmother would recognize as food, not that highly processed stuff masquerading as food.
  2. Mostly plants.
  3. Not too much.

That’ll do it for most of us. For those who have to follow a restrictive diet, whether for a short time or for life, you already know what a pain in the ass this is. Don’t let normal eaters label you as orthorexic just because they don’t want to have to cook for you.

Writer, artist, historian, thought-gatherer.

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