Sage Meanderings: Orthorexia and the New Rules of Clean Eating (Part 1)

October 15, 2011

Orthorexia and the New Rules of Clean Eating (Part 1)

Clean eating has no official definition, but it's usually described as avoiding processed foods, chemicals, preservatives and artificial ingredients. Instead, clean eaters choose natural foods, the way they came out of the ground or as close to their natural form as possible. Vegetables, fruits, legumes, 100% whole grains, egg whites, fish, and chicken breast are clean eating staples. Clean eating appears to be a desirable, sensible, even noble goal. Eating clean is what we should all strive to do to achieve optimum health and body composition isn't it? Arguably the answer is mostly yes, but more and more people today are asking, "is it possible to take clean eating too far?"

Physician Steven Bratman thinks so. In 1997, Bratman was the first to put a name to an obsession with healthy eating, calling it orthorexia nervosa. In his book, Health Food Junkies, Bratman said that whether they are trying to lose weight or not, orthorexics are preoccupied with eating healthy food and avoiding anything artificial or "toxic."

Orthorexics are not only fanatical about eating the purest, healthiest, most nutritious (aka "clean") foods available, says Bratman, they often feel a sense of righteousness in doing so.

Whether orthorexia should be officially classified as an eating disorder is controversial. The term appears in pub med indexed scientific journals, but it's not listed in the DSM-IV as are anorexia and bulimia. Opponents wonder, "Since when did choosing a lifestyle that eliminates junk food become a disease?"

Media coverage and internet discussions about orthorexia have increased in the past year. Websites such as the Mayo Clinic, the Huffington Post and the UK-based Guardian added their editorials into the mix in recent months, alongside dozens of individual bloggers.

In most cases, mainstream media discussions of orthorexia have focused on far extremes of health food practices such as raw foodism, detox dieting or 100% pure organic eating, where some folks would rather starve to death than eat a cooked or pesticide-exposed vegetable.

But closer to my home, what about the bodybuilding, fitness, figure and physique crowd? Should we be included in this discussion?

In their quest for adding muscle mass and burning fat, many fitness and physique enthusiasts become obsessed with eating only the "cleanest" foods possible. Like the natural health enthusiasts, physique athletes usually avoid all processed foods and put entire food groups on the "forbidden" list. Oddly, that sometimes includes rules such as "you must cut out fruit on precontest diets" because "fruit is high in sugar" or "fructose turns to fat".

According to Bratman's criteria, one could argue that almost every competitive bodybuilder or physique athlete is automatically orthorexic, and they might add obsessive-compulsive and neurotic for good measure.

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As you can imagine, I have mixed feelings about that (being a bodybuilder).

If I choose to set a rule for myself that I'll limit my junk food to only 10% of my meals, does that make me orthorexic or is that a prudent health decision?

If I plan my menus on a spreadsheet, am I a macronutrient micromanager or am I detail-oriented?

If I make my meals in advance for the day ahead, does that mean I'm obsessive compulsive, or am I prepared?

If I make one of my high protein vanilla apple cinnamon oatmeal pancakes (one of my favorite portable clean food recipes) and take it with me on a flight because I don't want to eat airline food, am I neurotic? Or am I perhaps, the smartest guy on the plane?

Some folks are probably shaking their heads and saying, "you bodybuilders are definitely OCD." I prefer to call it dedicated, thank you, but perhaps we are obsessive, at least a wee bit before competitions. But aren't all competitive athletes, to some degree, at the upper levels of most sports?

Athletes of all kinds – not just bodybuilders - take their nutrition and training regimens far beyond what the "average Joe" or "average soccer mom" would require to stay healthy and fit.

What if you don't want to be average – what if you want to be world class? What then? Is putting hours of practice a day into developing a skill or discipline an obsessive-compulsive disorder too?

Okay, now that I've defended the strict lifestyle habits of the muscle-head brother and sisterhood, let me address the flipside: being too strict.

Where does the average health and bodyweight-concerned fitness enthusiast draw the line? How clean should you eat? Do you need lots of structure and planning in your eating habits, or as Lao Tzu, the Chinese philosopher said, does making too many rules only create more rule-breakers?

Debates have started flaring up over these questions and as inconceivable as it seems, there has actually been somewhat of a backlash against "clean eating." Why would THAT possibly happen? Eating "clean" is eating healthy, right? Eating clean is a good thing, right?

Well, almost everyone agrees that it's ok to have a "cheat meal" occasionally, but some experts - after watching how many people are becoming neurotic about food - are now clamoring to point out that it's not necessary to be so strict.

The diet pendulum has apparently swung from:

"Eat a balanced diet with a wide variety of foods you enjoy."

To:

"You MUST eat clean!"

To:

"Go ahead and eat as much junk as you want, as long as you watch your calories and get your essential nutrients like protein, essential fats, vitamins and minerals."

Talk about confusion! Now we've got people who gain great pride and a sense of dedication and accomplishment for taking up a healthy, clean-eating lifestyle and we've got people who thumb their nose at clean eating and say, "Chill out bro! Live a little!"

The current debate about how clean you should eat (or how much you should "cheat") reminds me of the recent arguments over training methods such as steady state versus HIIT cardio. Whatever the debate of the day, most people seem to have a really difficult time acknowledging that there's a middle ground.

Most dieters, when they don't like a certain philosophy, reject it entirely and flip to its polar opposite. Most dieters are dichotomous thinkers, always viewing their endeavors as all or nothing. Most dieters are also joiners, plugging into one of the various diet tribes and gaining their sense of identity by belonging.

In some cases, I think these tribes are more like cults, as people follow guru-like leaders who pass down health and nutrition commandments that are followed with religious conviction. Seriously, the parallels of diet groups to religious groups can be downright scary sometimes.

Whether the goal is to optimize health, to build muscle or to burn fat, there's little doubt that many individuals with all kinds of different motivations sometimes take their dietary restrictions to extremes. Obviously, an overly restrictive diet can lead to nutrient deficiencies and can adversely affect health, energy and performance.

In some cases, I can also see how swinging to any extreme, even a "healthy obsession" with pure food could lead to distorted views and behaviors that border on eating disorders. If you don't believe it's a real clinical psychological problem, then at the very least, you might agree that nutritional extremes could mean restricting social activities, creating inconvenience or making lifestyle sacrifices that are just not necessary.

I believe there's a middle ground - a place where we can balance health and physique with a lifestyle and food plan we love and enjoy. Even more important, I believe that your middle ground may not be the same as mine. We all must find our own balance.

I believe that going back to BALANCE, but this time with a better definition of what balance means, is the approach of the future.

I also believe that some new rules would help us find that balance.