"I made her favorite pasta and she wouldn't take a bite." "All she'll eat is broccoli and fish." "Maybe she'll outgrow it."
These are among the typical concerns that I hear from parents whose child has been diagnosed with an eating disorder. It seems so simple, "just eat!" I wish it were simple. In fact, eating disorders are a complicated mental illness that have biological, psychological and cultural influences. Dr. Laura Hill, chief clinical officer of the Center for Balanced Living, a clinic specializing in eating disorders in Columbus, Ohio, adeptly explains eating disorders and the importance of a meal plan in this TED TALK.
“I’m not trying to lose weight, I’m eating clean and healthy.” While good nutrition is the cornerstone for health, can eating “clean and healthy” go too far? Where is the line between healthy and rigidity, and, where is the line between “clean” and an eating disorder?
Orthorexia is defined as an exuberant interest in healthy foods. People with orthorexia tend to idealize certain foods. For example, kale is a superstar antioxidant that not only fights cardiovascular disease, asthma, and rheumatoid arthritis but also prevents premature agng. Simultaneously people with orthorexia tend to demonize other foods; ice cream causes weight gain, cavities, heart disease, and (horrors!) is made from milk.
Orthorexia itself is not considered an eating disorder, however in susceptible individuals, transforms into an eating disorder. Madison, for example, began substituting fruit for her usual snack of chips or sweets. She progressed to eating only organic foods, whole grain foods, and foods without gluten. Soon she began eliminating entire food groups and making more food rules for herself. Her intake declined and she began losing excessive weight. Food became her primary source of self worth, happiness and value. Madison crossed the line between eating healthy to orthorexia and then crossed the line to an eating disorder. Madison was not interested in losing weight, she had modified her diet in order to eat healthier. She initially was concerned about the quality of her intake and then became concerned about the quantity of her intake.
The good news is that recovery is possible. People can learn to eat in a balanced way so that food and nutrition is valued, but does not interfere with living life.
Pam Chin-Lai, MS, RD, LD, CEDRD specializes in the nutritional rehabilitation of eating disorders in children, adolescents and adults.