Taking healthy eating to an unhealthy extreme

Helen Yeung | February 6th, 2018

As a dietitian working with children, youth, and families for over 20 years, I have observed orthorexia, a phenomenon where healthy eating becomes an unhealthy obsession. Dr. Steven Bratman coined the term, orthorexia nervosa, in 1997 and wrote a book on this topic. Most current nutrition research confirms that eating a diet based on whole, minimally processed foods is “healthy.” However, someone who suffers from orthorexia may fixate on the quality of food they eat and avoid foods they have deemed “unclean” or “unpure”. This can lead to diets so restrictive that nutritional deficiencies arise.

The transition between healthy eating to disorder eating

So where does healthy eating end and disordered eating begin? The answer may vary depending on the individual. I would say that eating is a problem when enthusiasm for healthy eating turns to an obsession; when your list of “acceptable” foods become shorter and narrower so that entire food groups are missing; when planning/preparing food interferes with one’s life (work, school, social, and other endeavours); or when eating is associated with excessive guilt and self-loathing.

Another question to consider is: “Do you think healthy eating is defined by what you include in your diet, or by what you exclude?”

When a person tells me that they cut out all sugar from their diets and then they felt much better, I ask them what they ate instead. So if you cut out all cookies, cakes, sugary drinks, and instead eat salads, fruit, legumes, nuts, and seeds, then you not only eliminate sugar but you add a lot of fibre, nutrients, and phytochemicals into your diet. It’s hard to determine whether that improved sense of well-being is due to the elimination of sugar/fat/sodium or the addition of nutrient-dense, high-quality foods.

The reality is that healthy eating is defined by both what we include and exclude in our diets.

Dietary patterns are more important than one single food

Rather than thinking that a particular food is healthy or unhealthy, what matters is how much and how often you eat that particular item, and the other foods in your diet. The totality of the other foods that you eat matter more than one particular food! That is, one’s whole dietary pattern is more important than one single food. To be healthy, we need to eat a variety of foods, and it is best to vary our meals and snacks. By choosing a variety of foods from the different food groups, you are more likely to get the different nutrients your body needs without getting an excess of any one nutrient.

Useful language when talking about food

Rather than thinking of a food as “good” or “bad,” I like to think of foods as nutrient-dense, or helping to meet our nutritional needs and improve our health. To avoid a moralistic tone when talking about eating, you could use language such as “Always” or “Everyday” foods versus “Sometimes” foods.

Questions to ask yourself

Healthy eating differs from restrictive dieting in several ways–in the quality, quantity, purpose, approach, and language used differ. To determine if you are taking “healthy eating” too far, you can ask yourself these questions:

  • Does my way of eating promote health?
  • What does health mean to me?
  • Is my current approach helping me to meet my goals (what are my goals)?
  • Are my behaviours and attitudes around food consistent with good physical, mental, and emotional health?

Food is more than nutrients. Health is more than what you eat.

Health is a resource for everyday life. Being healthy enables us to learn, work, care, play, and do the things that are important to us. Food is more than nutrients. Health is more than what you eat.

While I promote an inclusive and balanced diet which emphasizes more plant foods, I believe that there is room for all foods in moderation. It is important to recognize that food is social, cultural, and has many meanings and roles in addition to promoting physical health. Food nourishes, strengthens, and connects us. Both how and what we eat are important to our overall health.

For more information

For more information about developing eating competence, I recommend reading Ellyn Satter’s article. VCH has a handout for youth and adults,“Digging Up the Dirt on Dieting—The Truth About Dieting and Healthier Alternatives.

A version of this article can be found at Jessie’s Legacy Eating Disorder Prevention and Awareness website. I blogged to add to the conversation about promoting healthy eating while preventing disordered eating: I invite you to do the same.

About the Author

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Helen Yeung
email iconhelen.yeung@vch.ca  

Helen Yeung (MHSc, RD) is a dietitian who has worked with children, youth, and families for over 20 years.

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