Orthorexia: Fixation On Righteous Eating

Orthorexia Nervosa (fixation on righteous eating), is not yet a DSM diagnosis. It’s a phrase coined by Dr. Steven Bratman which describes an eating disorder in which the sufferer fixates on eating only what they define as “healthy food.” The avoidance of certain foods is quite often extreme, ultimately resulting in malnutrition and even death.

“Such people are sometimes affectionately called ‘health food junkies.’ However, in some cases, orthorexia goes beyond a mere lifestyle choice. Obsession with healthy food can progress to the point where it crowds out other activities and interests, impairs relationships, and even becomes physically dangerous. When this happens, orthorexia takes on the dimensions of a true eating disorder, like anorexia nervosa or bulimia,” explains Dr. Bratman.

“Unlike people with anorexia, patients with orthorexia are generally unconcerned about their weight, and do not feel fat. For raw foodists, vegans and fruitarians, what matters most is feeling pure.”

People suffering from this obsession may display the following signs:

* Spending more than three hours a day thinking about healthy food
* Planning tomorrow's menu today
* Feeling virtuous about what they eat, but not enjoying it much
* Continually limiting the number of foods they eat
* Experiencing a reduced quality of life or social isolation (because their diet makes it difficult for them to eat anywhere but at home)
* Feeling critical of others who do not eat as well they do
* Skipping foods they once enjoyed in order to eat the "right" foods
*Eating only foods regarded as healthy
*Relying on only natural products to treat an illness
* Feeling guilt or self-loathing when they stray from their diet
* Feeling in "total" control when they eat the correct diet

“The defining feature of orthorexia is obsession with eating healthy food and avoiding unhealthy food. The definition of healthy and unhealthy food varies widely depending on which dietary beliefs the patients has adopted. The usual immediate source of orthorexia is a health food theory, such as rawfoodism, macrobiotics, non-dairy vegetarianism, Ornish-style very-low-fat diet, or food allergies. Note that, in most cases, the underlying diet is itself reasonably healthy (if unreasonably specific). It's in the obsessive approach to diet taken by an orthorexic that the disorder lies,” says Dr. Bratman.

"We're certainly seeing more of this behavior," says Dr Yellowlees. "Like other eating disorders, the issue at the heart of it all is obsession. Part of it is to do with the way we're constantly bombarded with media messages about what's healthy and what isn't. People don't quite know what to believe, so they lose a sense of perspective. They also take a certain enjoyment from refusing food in front of others, as a way of demonstrating their superior commitment to the purity of what they eat.”

“It’s not that I don’t support eating healthy food. It's only that when healthy eating becomes an obsession, it's no longer healthy, "says Dr. Bratman.

Please see sidebar for Resources and Tools.


Sources: http://www.orthorexia.com/index.php?page=katef
http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2008/02/22/hfood122.xml
http://www.eatingdisordershelpguide.com/orthorexia.html
Signs and symptoms: http://www.pamf.org/teen/life/bodyimage/orthorexia.html
http://www.nedic.ca/knowthefacts/definitions.shtml
picture:
http://www.flickr.com/photos/grafixer/5189263412/
http://www.flow4theworld.com/2007/08/22/Eating%20an%20apple.jpg
http://spokane-county.wsu.edu/spokane/eastside/images/fruits%20and%20berries.jpg
http://www.seasonedpioneers.co.uk/assets/recipes/roasting%20vegetables%20on%20the%20grill.jpg

ADD/ADHD and Eating Disorders



It is not uncommon to find that those suffering with eating disorders are also dealing with underlying psychological disorders. ADD or ADHD, studies have shown, often co-exist with eating disorders. Food is used as a form of self-medicating, temporarily calming the restlessness that someone with ADD/ADHD experiences both physically and emotionally.

WHY FOOD?

“Food is legal. It is a culturally acceptable way to comfort ourselves. For some people with ADD, food is the first substance that helped them feel calm. Children with ADD will often seek out foods rich with sugar and refined carbohydrates such as candy, cookies, cakes, and pasta. People who compulsively overeat, binge, or binge-and-purge also eat these types of foods.

It is no accident that binge food is usually high in sugars and carbohydrates, especially when you take into consideration how the ADD brain is slow to absorb glucose. In one of the Zametkin PET scan studies, results indicated that "[g]lobal cerebral glucose metabolism was 8.1 percent lower in the adults with hyperactivity than in the normal controls..." [[1]] Other research has also confirmed slower glucose metabolism in adults with ADD, with and without the hyperactivity component. This suggests that the binge eater is using these foods to change his or her neurochemistry,” says Wendy Richardson MA, LMFCC, in her article THE LINK BETWEEN ADD/ADHD AND EATING DISORDERS.

She discusses eating to increase serotonin levels in an attempt to feel better, “One way to temporarily increase our serotonin level is to eat foods that are high in sugar and carbohydrates. Our attempts to change our neurochemistry are short-lived, however, and we have to eat more and more to maintain a feeling of well-being.”

Adult vs. childhood ADD / ADHD

“The symptoms of ADD / ADHD change as someone with ADD / ADHD develops from a child into a teenager and then into an adult. While the core problems of hyperactivity, impulsiveness, and inattentiveness remain the same, the specific symptoms manifest differently. Typically, the symptoms of hyperactivity decrease and become more subtle, while problems related to concentration and organization become more dominant,” according to helpguide.org

Hyperactivity in adults:
* inability to relax
* restlessness, nervous energy
* talking excessively

Impulsiveness in adults:
* volatile moods
* blurting out rude or insulting remarks
* interrupting others

Inattentiveness in adults:
* “tuning out” unintentionally
* inability to focus on mundane tasks
* constantly losing and forgetting things

Signs and Symptoms of Adult ADD/ADHD

According to Dr. Thomas E. Brown of the Yale University School of Medicine, "ADHD is essentially a name for developmental impairment of executive function." Executive functions are the skills involved in planning, selective attention, motivation, and impulse control. Adults with ADHD have problems in six major areas of executive functioning:

* Activation – Problems with organization, prioritizing, and starting tasks.
* Focus – Problems with sustaining focus and resisting distraction, especially with reading.
* Effort – Problems with motivation, sustained effort, and persistence.
* Emotion – Difficulty regulating emotions and managing stress.
* Memory – Problems with short-term memory and memory retrieval.
* Action – Problems with self-control and self-regulation.

Symptoms in children can be found here.

COMPREHENSIVE TREATMENT

"It is essential that both ADD and eating disorders are treated. Too many people are struggling with their eating disorders because they have undiagnosed or untreated ADD. When ADD is properly treated, the individual is better able to focus and follow through with treatment for their eating disorders. They also have greater control of their impulses and less of a need to self-medicate their ADD symptoms," according to ADD.org

Coping Alternatives

From Something-fishy.org:
Here are some more positive methods of dealing with your emotions and stress, rather than turning to such Eating Disordered behaviors like starving, binging and purging, or overeating.

Stop, Swap and Console!

* Use the ideas below, and your own ideas, to make a COPING BANK!

* Write in your Journal
* Listen to your favorite music
* Tell one person how you feel
* Call an old friend
* Read a book
* Remind Yourself "It'll be OK"
* Take a deep breath, count to 10
* Ask your therapist to make a tape with you that you can use during difficult times
* Go to a favorite "safe" location (beach, park, woods, playground, etc.)
* Think of advice you'd give someone else... and take it!
* Say something good about yourself
* Use Self Affirmation tapes and books... and make your own affirmations (use notebooks, index cards, tapes, post-it notes, journal)
* Meditate, use Relaxation
* Call a Hotline
* Stay in touch with others through contact - don't isolate yourself

Grounding Methods

Ideas for when you feel out of control, are having a flashback and/or need grounding...

* Remind yourself "I'm going to be OK" and "I'm not crazy"... this is a normal part of the recovery process
* Call someone on the phone
* Don't be afraid to ask for help
* Hug someone safe
* Hold someone's hand (someone safe)
* Call your therapist
* Call a Hotline
* Pray, talk yourself down or yell
* Say what you feel out-loud, even if you have to yell or cry!
* Change your environment
* Do self-affirmation... read books, listen to tapes and write down good things about yourself
* Identify your triggers (things that make you feel badly or have bad memories or flashbacks)

The above lists can be seen in full here.




Sources:
http://www.addconsults.com/articles/full.php3?id=1105
http://www.something-fishy.org/isf/mentalhealth.php
http://psychcentral.com/disorders/sx1.htm
http://www.helpguide.org/mental/adhd_add_adult_symptoms.htm
picture source: MrsMenopausal