Daily Archives: November 14, 2006

Orthorexia

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I have to start out noting that I’ve got problems with the received medical dogma about eating disorders.

I spent a few weeks in a children’s hospital ward where I was one of two kids (the other had cystic fibrosis) who wasn’t anorexic. The kids were encouraged to talk about what made them not want to eat, but then taught firmly that whatever reasons they brought up were not the real reasons. Except one: Control. Body image, no, that could never be it. Pressure to be thinner than your natural body type as a model, dancer, actor, or gymnast, no, that could never be it either. It was always some combination of a desire to control everyone around you, and OCD. That was it. It was final. It was all about you, never about your surroundings, and always a disease that you had totally independent of other factors.

I have watched a staff person who is insecure about her body and often doesn’t eat because of this, being taught the same thing by her therapist — she is “learning” (she did not know this, but apparently her therapist did) that it’s all about being a control-freak.

(If people wonder why I dream about being put on trial and having evidence submitted that I’ve done something I’ve never did, that is to be taken more seriously than I am… yeah.)

Anyway, that’s all to say, that conceptualizing a thing in this manner can automatically depoliticize it, and shift any and all responsibility off of the people who are encouraging a person to think in this way. With anorexia, there are tons of pressures, some quite explicit, to be thin at all times. Not that nobody can be a control freak in that particular manner, but it seemed strange to me that people’s bosses who told them to lose weight or else they’d be out of a job, were not the ones considered control freaks.

There are a number of pressures on autistic people and families of autistic people (but pressure on family becomes the family pressuring the autistic person, often against that person’s will) to adhere to strict diets of various sorts. Some are stricter than others.

There’s the gluten-free casein-free diet. There’s diets based on plenty of dubious forms of allergy testing. There’s “candida diets” given to people who don’t really have systemic candida overgrowth to begin with (such a thing is very rare, generally too dangerous and obvious to be overlooked for decades, is not the same as localized candida overgrowth such as on the skin, and occurs mainly in severely immunocompromised people, which means people such as people with AIDS, not even most people with autoimmune disorders or anything like that), but whose doctors tell them that the natural candida or other fungus in their system is really an infection. There’s all kinds of food additives that get considered absolutely unsafe and impure. There’s diets based on the color of the food. Fad/quack diets are really common and almost endless in their permutations.

This is not to say that nobody should change their diet, or that nobody has food allergies or intolerances, or diseases (such as, in my case, migraines, reflux, and early-onset gallbladder disease) that can react certain ways to certain sorts of foods. But when a person is told because they are autistic (or because they have some other incurable condition) then they must have these other things, something is wrong here. And even, for instance, with migraine triggers, not every migraine trigger triggers migraines in everyone. I don’t avoid the entire list of foods, just the ones that make my headaches worse, and just in the quantities that actually do make them worse (which for some is any at all, but others it’s okay to eat a little bit). A friend and I both have migraines, but have totally different food triggers. It’s also a safe bet that most people who claim you’re allergic to a huge number of different foods, or else prescribe diets based on your “electromagnetic field”, are incorrect. Real food allergies exist, but are often very severe (for instance, eating a peanut causing anaphylactic shock), and usually are a few very specific kinds of foods (and which ones, vary by age among other things).

Enter the idea of orthorexia. The term was coined about food fads, particularly spiritual and health-food food fads, but it applies equally here. It’s an obsession with eating only the most proper and pure kind of foods. You can read this Original Essay on Orthorexia by the guy who coined the term. He himself has experienced it.

He describes one of his patients, whose asthma he treated with a strict elimination diet:

Recently, Andrea came in for a visit and described the present state of her life. Wherever she goes, she carries a supply of her own food. She doesn’t go many places. Most of the time she stays at home and thinks carefully about what to eat next, because if she slips up, the consequences continue for weeks. The asthma doesn’t come back, but she develops headaches, nausea, and strange moods. She must continuously exert her will against cravings for foods as seemingly innocent as tomatoes and bread.

She was pleased with her improvement and referred many patients to me. But I began to feel ill whenever I saw her name on my schedule. The first rule of medicine is “above all, do no harm.” Had I really helped Andrea, or had I harmed her? If she had been cured of cancer or multiple sclerosis, the development of an obsession might not be too high a price to pay. But when we started treatment, all she had was asthma. If she took her four medications, she also had a life. Now all she has is a menu. She might have been better off if she had never heard of dietary medicine.

There is also an entire page called The Psychology of Idealistic Diets with links to articles about orthorexia.

Basically, a lot of these diets appear at first to make people feel better, because of the same thing that happens to people who starve: There’s a sort of giddy euphoria and extra clarity that happens in early stages of nutritional deprivation. Probably occurs in order to get people clear enough to go find more food. But then when that goes away, then they feel like they need to eliminate more foods in order for it to work again. And so on and so forth.

Also, when you’re not getting enough food, you get obsessed with it, so that all you can think about is what you’re going to eat, and how you’re going to get it. This is why dieters in general are so food-obsessed, and one reason I refuse at this point to restrict my diet any more than absolutely necessary. It’s like that guy said, do you want a life or do you want a menu?

A lot of people also start to feel superior to, and look down their nose at, people with less restricted diets. They say that either those people aren’t as committed spiritually, or are throwing their health away, or aren’t committed enough to their values. I’ve received more than one impassioned lecture from people who insist if I don’t do such-and-such a diet then I only have myself to blame if (insert horrible thing and/or health problem here) happens to me People can become evangelical about diets, much like Luke Jackson’s insistence in one of his books that every autistic person of any kind should try the gluten-free casein-free diet, and many parents’ insistence that parents who don’t do the diets on their kids are to blame if their kids remain autistic.

I am, by the way, an ex-vegetarian, an ex-vegan, and an ex-adherent to all sorts of quack diets that were pushed on me pretty hard. I have had people who adhere to all of those diets insist that I ought to go back to them, and in a few cases insist that I “wasn’t doing vegetarianism and/or veganism properly” if I was unhealthier that way (and believe me, I was unhealthier, and not for lack of supplements — although I note, with all of these diets, it’s way easier to adhere to them the more money you have, so there gets to be an element of classism in this stuff too). Some people become adamant that it’s the person’s fault if various diets make them unhealthy, and feel superior to people who “do those diets wrong”. (Note: I don’t care if other people are vegetarians or vegans or anything else, but I do care when they insist that if I am not, there is something wrong with me. Or that I don’t care about animal rights — in fact part of my reasons for lack of vegetarianism are on animal rights grounds that I find more compelling than animal rights arguments for vegetarianism.)

People also substitute dieting for political or spiritual action. They feel more pure, on both political and spiritual levels, if they adhere to exactly the right diet.

At any rate, I mean this post as a warning, especially to autistic people, who are both over-targeted for fad diets (just like with anyone with an incurable condition) and more likely to carry anything of this nature through in the most absolute manner possible. Having been through this, as well as pressure to act like this (especially when I totally rejected orthorexic eating patterns), I’ve meant to post a warning like this for a long time. For whatever flaws there are to it, orthorexia is a useful concept to keep in mind.

Disability Blog Carnivals

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I didn’t post links to any of these while they were happening, so here they are:

Disability Blog Carnival #1 was hosted at Disability Studies at Temple U..

Disability Blog Carnival #2 was hosted at The Gimp Parade. The theme was “The Cure”.

Disability Blog Carnival #3 was hosted at Growing Up With a Disability. The theme was spirituality and disability.

Disability Blog Carnival #4 will be hosted at Diary of a Goldfish. The theme will be “different ways of going about things”. Here is more elaboration on what is meant by that theme, and instructions on how to submit an article (your own or someone else’s) to the carnival. A reminder that some people don’t submit their own, so submitting other people’s stuff is really useful. (I didn’t find out disability blog carnivals existed until someone other than me submitted my writing to the first one.) Submission deadline is Monday November 20th.