Once upon a time a few tough years ago, this writer’s life was drained by an eating disorder.
Some people can realize they have an eating disorder from the first changes in their behavior. Others may not admit it to themselves. And then there are a lot of things that will end in the middle.
For me, the moment of realization came on a hot summer’s day at a White Sox game. I was sitting in the stands amidst a whirlwind of smells – funnel-shaped cakes, sausages, Cuban sandwiches, cotton candy.
By then I was an expert at ignoring my hunger through exercise. The pains will always turn into a stretching or working out session. And here I am again — my stomach is rattling, my mind is telling me to stand up and move — which doesn’t make sense in the middle of a baseball game.
As the game went on, it became too much. I got up and walked around the lobby of the stadium, fixing my exercises. Then I did something I hadn’t done in years: I succumbed to hunger pangs with a bag of salty peanuts.
Returning to my seat, feeling guilty about eating, I began, and for the first time, wondering what the subtle dissonance between “healthy” and “unhealthy” really meant.
What was my relationship with sports and food? When did my best intentions turn into destructive behavior?
With help, I was able to realize I had athletic anorexia: a compulsive desire to exercise, as if I was training to compete in — and win — an Olympic hockey tournament, 10 marathons and a CrossFit all at once. This was accompanied by an obsessive and restrictive relationship with food.
There was more exercise each day than meals, which, when eaten, were intentionally small–a reduced-fat peanut butter and jelly sandwich, half an apple, a few bites of a cereal bar. I’ve been counting calories obsessively, never getting close to the amounts my body needs. As I stared at rehearsals for hours without fear, I succumbed to attacks of mini-anxiety when I encountered salad dressing, pre-made toast, or birthday cake that passed school. If I have already indulged, I am consumed by regret.
For the longest time, I’ve been mixing up my obsessive behavior with personalized training. While I thought I was the best athlete possible, I was actually quite the opposite – lacking a life of balance, fun, and self-fulfillment.
Instead of enjoying lunch with friends, I signed up for an exercise class. I’ve taken great leaps to remove sweets from birthday celebrations. My self-esteem was measured, every day, in what I thought I saw in the mirror.
It took me a long time to recognize the line between healthy behavior and compulsive behavior. This is the same challenge for many who suffer — consciously or unconsciously — from orthorexia, an eating disorder that takes the idea of clean eating too far. Like athletic anorexia, it often suffers from those whose good intentions become an obsession.
The behaviors between the two conditions can overlap in each other. It’s possible for a person with athletic anorexia to show signs of osteoporosis, as I did, or have obsessive-compulsive disorder (OCD), or other combinations.
Although orthoptics is an “informal” eating disorder — not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) — it is recognized and treatable by doctors and therapists.
Grid spoke with experts about how to define orthorexia, the societal pressures that exacerbate it and how to tell if you’re crossing the line between healthy living and orthopedic behavior.
Orthorexia is built on a fallacy regarding the “correct” way of eating…
Unlike anorexia—in which individuals experience body imbalances and focus on the amount of food they eat—orthotics prioritize the perceived health of their meals, which is a personal and moving goal.
Most people with orthotics, said Julie Raymond, licensed therapist and director of eating disorder services at Cityscape Counseling, try to stick to whole foods, such as fruits and vegetables rather than anything refined or processed. She said the focus on foods with buzzwords is also common among her patients: locally grown, fresh and organic.
These types of fears can be summed up as an obsession with purity. The popular characterization of orthotics, taken from a book on the condition published at the turn of the millennium, is that it is “a disease disguised in the form of a virtue.” Those were the words of Stephen Bratman, the doctor credited with first coining the term in the late 1990s, when actress Susan Somers became a New York Times bestseller for pushing an anti-carb diet and a peak in skim milk sales, according to research by Agricultural Economic Insights.
The problem, as expressed by the National Eating Disorders Association (NEDA), is that “people with osteoporosis focus so heavily on so-called ‘healthy eating’ that they actually harm their well-being.”
…and actually leads to unhealthy and incomplete diets
This misinterpretation is included in the name orthorexia – “ortho” is a Greek prefix that can mean “correct” or “correct”. Raymond said it means there is only one right way to eat. But when taken too far, it can actually be very harmful.” Eating only healthy foods doesn’t necessarily translate into an overall healthy diet.
In an effort to achieve their definition of a healthy diet, some osteopaths end up depriving themselves of the important nutrients of a complete diet; Neda cites malnutrition as a risk. Since I took some time to relearn, a balanced diet includes carbohydrates, fats, and sugars – the ones I’ve been missing out on by swearing completely on foods I consider unhealthy.
“Our body actually needs some fat,” said Eileen Astrachan Fletcher, MD, regional clinical director of Eating Recovery Center, Illinois, and lecturer in the Department of Psychiatry and Behavioral Sciences at Northwestern University, Feinberg School of Medicine.
And it took a lot of learning to remember that candy isn’t inherently harmful. There’s a reason the food pyramid contains sweets. Food, after all, is also a social and enjoyable experience.
Is there anyone to blame for these standards?
Most experts agree that there is no one place to point the finger. However, the burgeoning wellness culture that pervades social media isn’t helping, Astrachan Fletcher said.
Social media influencers who share lifestyles that promote restriction bear much of the blame. “Bank marketing is based on persuading people that some things are good,” said Astrachan-Fletcher. “Our society promotes disordered eating. It’s their bread and butter, so to speak.”
last year, a report From the Tech Transparency Project highlights “Thinstagram,” the Instagram communities, powered by algorithmic trends, that encourage disordered eating behavior. It’s not hard to find the next big diet, detox or cleanse – Kim Kardashian doing a juice cleanse To lose a certain amount of weight, or a lot of Gwyneth Paltrow’s weight Controversial Goop Trends Tend to make headlines.
“People are affected by these harmful messages and harmful behaviors,” Raymond said. Can social media make an already vulnerable or vulnerable person develop [an eating disorder]? yes.”
Orthorexia, like all eating disorders, comes into control
At the end of the long, grueling days—complete with multiple workouts and fewer meals in between—I would feel a fleeting sense of relief. This is the common thread that encompasses all disordered eating behaviours, including orthorexia – the desire to reduce one’s anxiety by controlling a particular external component of their life.
Astrachan Fletcher describes this as “emotionally excessively controlling behaviour.” There is a tendency, she said, to “switch off” human contact from certain scenes or behaviors that normally release endorphins – such as exercise or eating.
This balance is particularly difficult for athletes, whose passions and livelihoods are intertwined with nutrition, who exercise and maximize their individual performance.
Saroya Tinker, a professional hockey player on the Toronto Sixth Team of the First Hockey League, said that worrying about her body image – while eating enough to be able to train and play at the highest level of the sport – has been an ongoing negotiation throughout her career.
“Having a healthy body is one thing, and looking at what you think is best is quite another,” Tinker said. Hockey players in particular have what’s known as a “hockey butt” – thicker thighs and glutes that come from skating. The result is a body type that is not traditionally considered skinny. “As an athlete, the most important thing is how you feel, but I still have those tough days where it’s hard to find balance.”
So where is the line between healthy eating and orthopedic?
Raymond and Astrachan-Fletcher agree that the tipping point when healthy eating turns into orthorexia stems from obsession. Avoiding sweets and planning meals with fruits and vegetables in advance is one thing, so you don’t end up stopping, say, for junk food. It’s another thing to let this way of eating rule your life.
And eating healthy foods doesn’t necessarily translate into a healthy lifestyle.
“If you are so occupied with your days that you organize your life around you [ensuring healthy meals]And you’re no longer listening to your body, you’ve reached a threshold,” Raymond said.
“If you’d rather play sports than see a friend; if you can’t break [food] judgment without severe distress; If your mood changes [due to food]”It’s an eating disorder,” said Astrachan Fletcher. “You have to address the possibility of an old story keeping someone stuck.”
Because orthoptics are not found in the Diagnostic and Statistical Manual of Mental Disorders, it remains, technically, undiagnosable. However, that’s a job for the slow-modern world of medicine. Since the first DSM, published in 1952, there have been only five new volumes. The DSM-5 was released in 2013 and updated in March 2022 (DSM-5-TR) with new diagnostic guidelines and language changes for clarity.
Anorexia, bulimia, binge eating disorder, and food avoidance/restriction disorder (ARFID) are among the four diagnosable eating disorders, according to this latest update. The fifth umbrella term – another specific feeding or eating disorder (OSFED) – is an umbrella term that includes orthotic, sports anorexia, and others. The latest DSM-5-TR was updated to say: “Individuals with atypical anorexia nervosa may experience many of the physiological complications associated with anorexia nervosa.”
Most facilities and doctors who work with people with eating disorders understand what orthotics is and how to treat it.
Even if an official diagnosis of anorexia is provided (which, because it is in the Diagnostic and Statistical Manual of Mental Disorders, and therefore, what insurance will typically cover), orthopedic treatment can still be appropriate for the individual. Relearning how to exercise and eat, without being eaten, is a journey for me and many. For those who help put together a name with an embraced challenge – this is orthorexia.
If you think you or someone you know has an eating disorder, Contact the National Eating Disorders Association For help or more information.
Thanks to Alicia Benjamin for the edit version of this article.
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