Orthorexia — Healthy eating gone awry

Everyone can benefit by paying more attention to choosing healthy foods, right?

For the most part, yes. However, a small number of people seem to become obsessed with the "perfect diet." These individuals fixate on eating foods that make them feel pure and healthy — to the extent that they avoid foods with any: 

Artificial colors, flavors or preservativesPesticides, genetic modificationUnhealthy fat, sugar or added salt

For some people with orthorexia:

Preparation techniques must result in "clean food," meaning it's been washed multiple times, cooked to ensure no bacteria and minimally handled.Eating out is out of the question because it's important to avoid food that they don't buy and prepare.

The term "orthorexia" has been used to describe this disorder. It comes from the Greek words "orthos," meaning straight or proper, and "orexia," meaning appetite. According to experts including Dr. Steven Bratman, the doctor who first described and named this disorder, what tips the balance from being committed to healthy eating and having orthorexia is the extreme limitation and obsession in food selection. Orthorexics find themselves being unable to take part in everyday activities. They isolate themselves and often become intolerant of other people's views about food and health.

Studies have looked to at whether this disorder is more common in groups more likely to have a keen interest in a healthy diet, such as medical residents, dietitians, students in nutrition, fitness club members and those in the performing arts (ballet, symphony orchestra and opera singers). Each of the professions studied showed some incidence. However, the studies were unable to determine if the incidence was higher than that in the general population.

Health professionals have proposed that orthorexia be officially recognized as a new mental disorder. Currently it remains controversial and grouped with other not yet accepted disorders such as night eating syndrome, muscle dysmorphia (obsession with muscle building) and emetophobia (constant fear of vomiting).

Whether it's recognized as a true medical problem or not is beside the point. It's important to seek professional help when striving for a healthy diet becomes an overwhelming drive that takes over. Orthorexia that features obsessive compulsive behaviors can be effectively treated with medication and cognitive behavioral therapy by a trained therapist.

blog index References Bartrina JA. Orthorexia or when a healthy diet becomes an obsession. ALAN. 2007;57(4):313.What is orthorexia? Journal of the American Dietetic Association. 2005;105(10):1510.Bosi ATB, Derya C, Guler C. Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine. Appetite. 2007;49(3): 661.Kinzel JF, et al. Orthorexia nervosa in dietitians. Psychotherapy and Psychosomatics. 2006;76(6):395.Korinth A, et al. Eating behaviour and eating disorders in students of nutrition sciences. Public health Nutrition. 13(1): 32-37. 2009.Eriksson L, et al. Social physique anxiety and sociocultural attitudes toward appearance impact on orthorexia test in fitness participants. Scandinavian Journal of Medicine and Science in Sports. 2008;18(3):389.Aksoydan E, et al. Prevalence of orthorexia nervosa among Turkish performance artists. Eating and Weight disorders-Studies on Anorexia, Bulimia and Obesity. 2009;14(1):33.Vandereycken W. Media hype, diagnostic fad or genuine disorder? Professionals' opinions about night eating syndrome, orthorexia, muscle dysmorphia, and emetophobia. Eating Disorders. 2011;19(2):145.

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Pregnancy and you: Pregnancy weight gain — Know the factors

A prenatal visit can be a joyful experience. You get to listen to your baby's heartbeat, and you're reassured about your baby's well-being and your own health. Still, you might dread getting on the scale. You might wonder why you never weigh the same on the scale at the office as the scale at home — or if the scale will reveal your dietary indiscretions.

Why the focus on pregnancy weight gain? The risk of pregnancy complications is higher in the upper and lower extremes of weight gain. If you gain too much weight during pregnancy, it can be challenging to lose the excess pounds afterward — and those pounds have the potential to stay with you for a lifetime.

Your health care provider will give you an idea of the amount of weight gain that's ideal for you and your baby. Generally, the amount of weight you're encouraged to gain depends on your pre-pregnancy weight:

Underweight (BMI less than 18.5): 28 to 40 pounds (about 13 to 18 kilograms)Normal weight (BMI 18.5 to 24.9): 25 to 35 pounds (about 11 to 16 kilograms)Overweight (BMI 25 to 29.9): 15 to 25 pounds (about 7 to 11 kilograms)Obese (BMI 30 or more): 11 to 20 pounds (about 5 to 9 kilograms)

So what should you do if you realize you're gaining too much weight? Start by forgiving yourself. Then look at the past few weeks to see if you can pinpoint any major contributing factors to your pregnancy weight gain. Brainstorm ways to deal with those issues. Remember, it might be easier to curb excess weight gain during pregnancy than it is to lose the pounds after pregnancy.

Likewise, what should you do if you're not gaining enough weight? My advice is the same. Look back on your eating habits and consider what you can learn. Remember that sometimes changing to a healthier diet can cause weight loss.

If you find you're having trouble managing your pregnancy weight, ask your health care provider for a referral to a nutritionist or dietitian. Also remember that weight gain is just one part of your pregnancy. Don't let the scale ruin the joy and excitement of pregnancy.

What are your strategies for gaining a healthy amount of weight during pregnancy? What are your struggles? Share your stories so that we can learn from each other.

blog index References Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board, and Board on Children, Youth and Families. Weight gain during pregnancy: Reexamining the guidelines. Institute of Medicine and National Research Council. http://www.nap.edu. Accessed June 29, 2011.

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