By the Blouin News Science & Health staff

Extreme dieting is too much of a “good” thing

by in Fitness & Wellbeing, Medicine, Research.

Customers shop vegetables displayed in the fresh foods section at Carrefour's Bercy hypermarket in Charenton, a Paris suburb on February 8, 2024

(REUTERS/Jacky Naegelen)

In a March 24, 2024 article for FoxNews online, health coach and chef Jennifer Iserloh warned of the dangers of orthorexia, characterized by an overwhelming concern about gaining weight or getting sick from preservatives and other ingredients in food. Orthorexics may spend hours each day thinking about what to eat, whether it be organic, raw, whole or low-calorie food. They may not get the nutrition they need for their lifestyles, and may experience stress that triggers the stress hormones cortisol and adrenaline, which can suppress the digestive and reproductive systems. Characteristics of orthorexia nervosa may also include ritualistic eating like chewing food a certain amount of times, and feelings of guilt and low self-worth after falling off the bandwagon of a diet that calls for eating only organic or raw food.

Orthorexia, not yet listed in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), was coined by Dr. Steve Bratman, a physician in Colorado, with his article in the October 1997 issue of Yoga Journal and his 2004 book Health Food Junkies. He wrote the article after being a chef at a commune, where on a daily basis he “encountered a chaos of contradictory nutritional theories.” Dr. Bratman has come up with a test to help determine if one has orthorexia. But Tim Walsh, a professor of psychiatry at Columbia University, says the condition remains unlisted because we do not have “extensive scientific knowledge” of orthorexia, and because it lacks “broad clinical acceptance.”

Many people with orthorexia restrict needed sugar, fat, gluten and salt. But the brain needs glucose; hypoglycemia leads to trouble concentrating, blurred vision and slurred speech. Salt is needed to maintain our fluid balance and for our nerves and muscles to function properly. People on gluten-free diets may miss out on important nutrients present in whole grains such as magnesium and manganese. And fat is needed to line our nerve cells, to make steroids, to insulate organs, to have healthy skin, to store vitamins A,D, E and K and for energy.

People with orthorexia may not get the needed daily nutrients and may be so obsessed with eating “correctly” that they stop enjoying their lives, often being afraid to eat socially. Orthorexia may even lead to death in extreme cases. Whether it is officially characterized as a disease is not as important as ensuring that those in the midst of extreme dieting get help. The Mayo Clinic recommends seeking treatment with medication and cognitive behavioral therapy by a trained therapist.

In 2005, George Mason University historian Peter Stearn marked the trend and pressure to stay thin with his book Fat History. He pointed out that societal emphasis should be on being healthy, not skinny. He wrote that people use “thinness” as a measure of personal responsibility and morality. Through the decades models, for instance, have gotten thinner and thinner. Examples of women on fitness magazines include only those that have gotten their body fat percentage down to unhealthy or borderline levels. And media coverage on what encompasses a healthy diet and healthy physique affects how people view their bodies. A Spring 2012 article in the American Communication Journal reviewed studies of body image in the movie and fashion industries, finding that many celebrities and models over the years were underweight or anorexic. So what is in the media often reinforces people’s prevalent experiences, comments and attitudes from family, friends and coworkers. With positive qualities such as happiness, attractiveness and success associated with an underweight or thin ideal, many people develop low self-esteem and eating disorders, and Orthorexia may just be the latest manifestation of that phenomenon

Health and media professionals must work together to control or eliminate this disorder, so that people can live full lives without the stress that accompanies extreme dieting. Fortunately, there are some encouraging trends out there. Officials in Spain in 2006 banned models from having a BMI of under 18. In March 2012 Israeli legislators banned female and male models with BMIs below 18.5 from working. Continued collaboration between educators, health professionals and public figures can help keep orthorexia in check.