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When does clean eating go too far?

6 min read

What is orthorexia?

Although acknowledged by the National Eating Disorders Association, orthorexia has not yet been recognized in the Diagnostic and Statistical Manual of Mental Disorders that clinicians use for diagnosis and treatment of eating disorders.

The term evolved just over 20 years ago as a way to describe obsessive traits attributed to healthy eating. Often times, people who find themselves in an orthoexic state become fixated on the purity or cleanness of their foods. The condition differs from other eating disorders in that it does not include body image obsessions or overly secretive behavior (as seen in anorexia) or binging and purging (as seen in bulimia). Studies however, do show some overlaps between anorexia, orthorexia and obsessive-compulsive disorder such as perfectionism, rigid thinking or depression.

When healthy eating becomes an obsession

Is there such a thing as being too healthy, or too clean, when it comes to our diet? The answer is yes. When the quest for clean foods involves cutting out food groups or severely restricting certain foods within a food group, nutritional deficiencies and ultimately illness, can arise. When you can’t go to a friends house for dinner anymore because you can’t control what will be served, quality of life is impacted, and when more brainpower is given to food than it is to family and friends, relationships may suffer.

Pam is not the only patient I have seen take healthy to a somewhat dangerous level. The question is, do you think you have it, and if you do, what do you do next?

How to add flexibility to a clean eating plan

Proponents of clean eating believe that a clean eating approach is the answer to preventing disease and managing weight. There is a difference however between cleaning up your diet and a highly restrictive approach to clean eating. The difference may lie in flexibility. A non-organic fruit or vegetable may be totally acceptable sometimes and having a genetically modified snack at a backyard barbecue won’t cause irreversible harm to your health.

I recommend my patients embody a balanced, healthy eating pattern at least 85-90 percent of the time, focusing always on progress, not perfection. Approaching your diet in this manner may facilitate a healthier approach to food. This is easier said than done, but as with all things in life, we can in fact take good intentions too far. Lessons from across the globe show that it’s balance, not restriction that increases happiness and longevity.

Getting help

When do good intended healthy behaviors become a problem? A first step may be to look at whether your clean eating goals are taking up the majority of your time with restrictions and planning and/or impacting relationships.

For Pam, her husband telling her how worried he was for her health and well being helped her bring back moderation into her life but for others, more intensive treatment may be necessary. There is no validated treatment to date for orthorexia but seeking guidance from a professional may help to identify, and change unhealthy practices.

Kristin Kirkpatrick, MS, R.D., is the manager of wellness nutrition services at the Cleveland Clinic Wellness Institute in Cleveland, Ohio, and the author of “Skinny Liver.” Follow her on Twitter @KristinKirkpat.

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