Clean Eating or Eating Disorder?


Most people are familiar with anorexia and bulimia, but there is a lesser known eating disorder which has high prevalence in the world of competitive bodybuilding.  Though it is not classified as an official eating disorder, orthorexia meets the criteria of one:  obsession, social isolation, and emotional lability.

Orthorexia is an obsessive-compulsive disorder which involves an obsession with healthy eating.  The orthorexic will go to great lengths to avoid foods which contain substances he determines to be unhealthy, such as fats, preservatives, processed foods, etc.  For an orthorexic individual, the focus is on the quality of food, which is in stark contrast to the anorexic’s focus on quantity.  Frequently this disorder may begin as a normal diet or an effort to eat in a healthier fashion, but after some time is taken to the extreme.  In the quest for pure, clean foods, the sufferer becomes obsessed and self-imposed food restrictions become a primary focus.

The distinction between normal individuals and orthorexics is that the health conscious person will practice moderation and won’t wallow in guilt if they indulge in a food which may be deficient in healthy nutrients.  In contrast, the orthorexic individual will obsess about the quality of food and will feel extremely guilty after straying from a self-imposed rigid diet.

Physical Signs and Symptoms of Orthorexia:

  • Because orthorexics limit themselves to foods they deem healthy, they may appear emaciated or malnourished

Behavioral Signs and Symptoms of Orthorexia:

  • Social isolation
  • A tendency to eat alone
  • Aversion to certain foods which have been deemed dangerous or disgusting
  • Criticism of people who don’t engage in healthy eating
  • Experience extreme pleasure in eating properly
  • Feel guilty when they deviate from a rigid diet
  • Strong desire to eat forbidden foods when under stress
  • Has difficulty eating foods prepared in a restaurant or by another person

Medical Signs and Symptoms of Orthorexia:

  • Malnutrition
  • Hypotension
  • Weakness
  • Calcium deficieny
  • Anemia in those who avoid animal protein
  • Decreased gastric motility
  • Abdominal bloating
  • Constipation

An essential element in contest preparation for competitive bodybuilding, physique, fitness, figure and bikini divisions is rigid meal planning.  As a result of this, competitors often dance along, and sometimes cross, the fine line that separates clean eating from a psychopathological relationship with food.  When taken to the extreme, sufferers may experience medical signs of malnutrition similar to anorexia.  While it is common for a competitor to experience feelings of guilt when a specific contest prep meal plan is not adhered to, warning flags should go up when a competitor becomes so obsessed with such transgressions that compensatory behaviors are adopted, such as excessive cardio sessions, laxative usage or starvation.   If such behaviors are commonplace for an individual, behavioral intervention will become necessary in order to restore one’s emotional and physical well-being.

Since prepping for competitions places excessive pressure on an individual and underscores the pursuit of “perfection” in the sport, orthorexic behavior may be so irresistible that it is rationalized as a necessary component of one’s prep.  This in and of itself makes orthorexia particularly insidious and dangerous.

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