Orthorexia: Eating clean, but crumbling on the inside

By Kate Becker
Tom Brady, arguably the best quarterback in the history of professional football, isn’t shy about sharing his “core nutritional philosophy.” No white sugar or white flour. He shuns peppers and tomatoes. He won’t cook with any oil other than coconut, and never lifts a saltshaker unless it’s filled with Himalayan pink.
It’s a diet that legions of fans and “clean eaters” try to mimic. Whether they buy his nutrition manual (at $200, with a laser-etched wood cover, it’s currently sold out), subscribe to his vegan, gluten-free, plant-based, high-protein meal delivery service, they all want to achieve their own humble version of the Brady experience — without the personal chef.
After all, if it works for Tom Brady, it must be good.
But is it, really? Or can healthy eating cross the line into an unhealthy obsession?
According to nutrition researchers, it can. They are seeing a surge in what they call orthorexia: an obsession with healthy eating that becomes so consuming it takes over almost every part of a person’s life.
Ultrastrict rules feed social isolationWhile better-known eating disorders like anorexia and bulimia tend to focus on food quantity, orthorexia is all about quality and selecting foods that are “pure” and “clean.” Orthorexia isn’t recognized as a disorder by the American Psychiatric Association, but Paula Quatromoni, associate professor and chair of the department of health sciences at Boston University College of Health & Rehabilitation Sciences, thinks it will eventually be listed as a distinct diagnosis.
Orthorexia can be difficult to spot because it often begins quite innocently, with healthy choices like cutting out red meat. But the list of off-limits food just keeps growing.
“More and more gets pushed off the plate, and eventually all you’ve got left is this very narrow range of foods that you’re willing to eat,” says Quatromoni.
This can lead to nutritional deficiencies, compromised bone mass, extreme weight loss, and malnourishment. It takes a mental toll, too. Quatromoni has seen students who can’t sleep because they lie awake, ruminating about what they ate that day. Others struggle through their classes, unable to focus.
“They are literally starving their brains,” she says.
Because food is often central in our social lives, people with orthorexia may reject time with friends and family, shunning restaurants, parties, and even vacations.
“It causes people to become socially withdrawn, to become socially isolated,” says Quatromoni. “They can’t possibly eat unless they have controlled every aspect of the meal down to the very last bite.”
And this is where they cross the line from simple healthy eating into an eating disorder, she says.
Social media stokes body anxietyYet the internet is full of toned, glowing celebrities trumpeting their own versions of clean eating. You can Google what Gwyneth Paltrow eats for breakfast (smoothies plus her own branded “superpowder” supplements), what Jennifer Lopez has for lunch (kale salad), or what Dwayne “The Rock” Johnson chows down for dinner (a ten-egg-white omelet). And social media outlets like Instagram make a picture-perfect case that all it takes to get a celebrity body is a “clean,” rainbow-esque plate of pretty fruits and veggies.
“It’s the influx of these pictures of what an ideal plate should look like and these pictures of what an ideal body should look like,” says sports nutritionist Mary Ellen Kelly, who worked as a nutritionist for the Miami Dolphins until 2018. “The intersection of all this information — or misinformation — leads people to believe that this is achievable by eating this way.”
Though they’re celebrated as the pinnacle of the human form, athletes aren’t immune to eating disorders, says Quatromoni. In fact, the intense focus on their body size and shape can set both female and male athletes up for restrictive eating and overtraining that ultimately sabotage their performance.
If even top athletes can get wrapped up in fad diets and disordered eating, how is a “regular” person supposed to sort out good nutrition advice from bad?
“Get offline!” says Kelly. “If you’re really serious about making changes, sit down and talk with a professional.”
If that isn’t possible, she advises taking a close look at what you eat. Eat more fruits and vegetables, choose water over sugar-sweetened beverages, and cook for yourself when you can.
And remember that those “perfect” lives on Instagram don’t tell the whole story.
“Everyone is after the likes and the thumbs-up,” says Quatromoni. “It’s just a snapshot of what someone wants to portray in one instant in time. It doesn’t show you how that person may be crumbling from the inside out, physiologically or emotionally.”
Source: Boston University: bu.edu