What parents and caregivers need to know about orthorexia

What parents and caregivers need to know about Orthorexia

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The term Orthorexia is encouraging more discussion in the medical community. The term was coined in 1997 by Dr. Stephen Bratman.  The term is used to describe someone who has become hyper focused on the quality of their food. The concern for food quality can eventually lead individuals to place food choices above personal relationships and daily activities resulting in social withdrawal.

There is nothing wrong with striving to eat healthy and caring about the origin of our food, but for those with orthorexia the anxiety about eating food that is not pure leads to extreme feelings of guilt and shame for not following the self-determined rules for eating.

4 phases of orthorexia

Phase 1- A devotion to thinking about what foods will be eaten during the day and the days following.

Phase 2- An individual will become over critical and questioning of ingredients in foods.

Phase 3- Careful concern regarding the preparation and procurement of the foods and making sure methods are not related to any perceived health risks.

Phase 4- Extreme satisfaction when able to comply with pre-determined food rules and excessive feelings of guilt and concern if not able to consume what is considered to be pure foods.

What parents and caregivers need to know

It is thought that a hyper focus on good vs bad foods in the media could contribute or influence the development of orthorexia tendencies. Therefore, referring to foods as poisonous, forbidden, unclean, or dirty may be triggering for some individuals. Some of the food characteristics those with orthorexia may be focused on include: decreased pesticide residue, non-GMO, low salt, low in sugar, or perceived as “natural.” The following are some suggestions about how to talk about food around children in a way that does not increase their anxiety about what they eat.

Use food neutral language- Do not call a food “good” or “bad”. Instead talk about the characteristics of food like their color, shape, or texture.

Display positive self- talk about your body in relation to food- Avoid repeating phrases such as, “I will need to go on a cleanse after eating this cookie” or “After I eat this dinner roll I need to go on a run to work it off.” These statements make it sound normal to be ashamed of your food choices.

Avoid using fear based language about food and nutrition- Phrases such as “Do not eat that candy bar it will give you diabetes” or “Do not ever eat a hot dog because it is filled with chemicals and not good for you.” These statements may be effective in discouraging a child to not eat these foods, however, it may lead to anxiety when they see others they know and love eating these foods because they have been told they are dangerous.

Laurie Dunham, Registered Dietitian with the Eating Disorders Program at Cincinnati Children's Hospital Medical Center reports that she has seen this play out in her practice:

“Our culture has become overly fixated on emphasizing the importance of eating only "healthy" or "clean" foods, forgetting that balance and enjoyment are also essential for whole body health. I've seen a number of adolescents and young adults in our program afraid to eat various foods because of health messages they have received from well-meaning adults about foods being unhealthy or too processed. When extreme messages are imparted on youth, especially those with pre-existing anxiety, this can interrupt their natural ability to recognize and respond appropriately to hunger and satiety cues and negatively affect their relationship with food. If not brought to parents' attention early, this could contribute to the development of an eating disorder.” 

Overall, it is best to demonstrate healthy and positive eating habits for the children in your life. Enjoy a variety of foods in your diet with an emphasis on fruits, vegetables, whole grains, lean meats, and dairy products, but model how to include more indulgent foods in a healthy way. Do not deprive yourself of white bread or cookies and then overindulge and then follow with an intense exercise to “work it off” or a “cleanse” to rid your body of toxins.

Orthorexia is not an official medical diagnosis at this time; however, many who suffer from it share some of the same characteristics as those with anorexia nervosa and obsessive compulsive disorder. Therefore, successful treatment includes a multidisciplinary team to address behavior, nutrition, and medical concerns.

To find out more about orthorexia refer to the following resources:

National Eating Disorders Association: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

International Association of Eating Disorder Professionals: http://www.iaedp.org

The Academy for Eating Disorders: http://www.aedweb.org

For resources about talking to kids about food choices in positive ways:

Jill Castle: https://jillcastle.com/

Maryann Jacobsen- http://www.maryannjacobsen.com/

Crystal Karges- https://www.crystalkarges.com/