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Healthy Eating - The Wordsmith's Forge
The Writing & Other Projects of Elizabeth Barrette
ysabetwordsmith
ysabetwordsmith
Healthy Eating
I came across this article about healthy eating being labeled as an eating disorder

Now, my benchmark for whether a behavior is sane or insane is practical: 1) Does it cause a serious problem with everyday life?  If not, it's sane.  2) If it causes a serious problem, is that problem greater or lesser than the problem quotient of life without said behavior?  If greater, it's insane.  If lesser -- and no other solution produces better results -- then it's sane.  Sometimes the best you do is damage control and the results are never going to be actually "good" just "less worse."

With food, the basic goal is body maintenance.  You need to eat enough, and the food needs to be safe and nourishing enough, to support the maximum level of health your body can attain.  So if you're avoiding foods because they would make you sick, that's preferable to eating them, even if it throttles your diet down to nearly nothing.  (This is, sadly, far more common than it used to be, as food allergies are skyrocketing.)  If you're avoiding foods for philosophical rather than physical reasons, and you cut your diet down so far that it undermines your health, that's bad and you should change it.

A key problem today is the food supply is so trashed that it's easy to wipe out most of a supermarket with just one or two allergies.  Seriously.  We have a friend who's allergic to high-fructose corn syrup, and we're trying to minimize our consumption of it too.  There goes about 95% of foods on the shelf, including some whole product categories.  What's left are single-ingredient things like raw vegetables, raw meat if it's actually packaged pure, and staples like flour or milk.  You have to read EVERY item on EVERY label because it's put in places it doesn't belong, like vanilla extract (which should have 2 ingredients: vanilla and alcohol).  Gluten is another allergen that's in a huge number of foods.  If you're sensitive to artificial colors, flavors, preservatives, etc. there goes almost everything except raw ingredients.  If you're averse to genetically engineered foods or think you might have an allergy to them, you're down to buying organic and praying that there wasn't any contamination.  And for any of those things, forget eating at a restaurant: it's a gamble, people are not careful, and if you do it then you will get sick sooner or later.  Ditto eating at a friend's house unless said friend can be relied upon to be meticulous about your health needs (unlikely unless they have their own dietary issues and realize the importance).  The lucky people just throw up or itch if they consume allergens; the unlucky wind up in the emergency room or dead.

So by the time you've thrown out the 95% or more of the food products that you can't eat, that's expensive and it looks crazy.  It's better than being sick all the time, but dealing with other people bitching about your "eating problem" just makes things a thousand times worse.  I have near-zero tolerance for that kind of harassment, not just of myself, but other people around me. 

Here's the bottom line: if a person's dietary choices make their health as good as it can be, that's fine, no matter how weird it looks.  If their choices make their health worse, that's a problem and should be addressed.  But unless you are their immediate family or health care provider, chances are you won't know which just from watching, and it's none of your business anyhow.

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31 comments or Leave a comment
Comments
msstacy13 From: msstacy13 Date: April 28th, 2011 08:21 pm (UTC) (Link)
Coincidentally,
it's not unusual for scabies to be misdiagnosed as a neurotic disorder.

Unless you've actually had little bugs get under your skin
and drive you crazy with the itching,
or are well enough informed to know that it's possible,
it just doesn't seem sane.
lyonesse From: lyonesse Date: April 28th, 2011 08:26 pm (UTC) (Link)
....ok this is me being a snob.

as an eating disorder diagnosis, this is presumably a category created for the use of healthcare professionals. it is not intended for amateur- or self-diagnosis any more than say basal cell carcinoma is. but science popularizers get ahold of any behavioral diagnosis and all of a sudden your second cousin who manages a quizno's thinks they get to be your diagnostician. feh.
lupagreenwolf From: lupagreenwolf Date: April 28th, 2011 08:29 pm (UTC) (Link)
It's one guy trying to get word out there (and maybe his name) about this behavior pattern. Those of us who are MHPs are skeptical of things that aren't in the DSM or ICD. (Hell, we're often skeptical of things that ARE in those books.) While laypeople can certainly be knowledgeable about mental health care--any MHP who thinks they can't learn from their clients is in denial or lying--the tendency for the media to jump on headlines like "DOCTORS PERSECUTING HEALTHY EATERS" distorts the actual information and deliberation involved in diagnosis.
lyonesse From: lyonesse Date: April 28th, 2011 08:44 pm (UTC) (Link)
i quite agree with all your points. what i fear is that pop press (and yeah, possibly fame-hunting by the person involved) will distort the diagnosis from a useful health tool into a way for randoms to hassle people (incl. perhaps themselves) with social tactics.

(i'm more on the research than the practice end, so i *have* to learn from the patients; they are the one true data source -- ghu knows no diagnostic manual can ever be mistaken for data :)
ysabetwordsmith From: ysabetwordsmith Date: April 29th, 2011 05:33 am (UTC) (Link)

Thoughts

>> Those of us who are MHPs are skeptical of things that aren't in the DSM or ICD. (Hell, we're often skeptical of things that ARE in those books.) While laypeople can certainly be knowledgeable about mental health care--any MHP who thinks they can't learn from their clients is in denial or lying <<

I think the industry would be in a great deal better shape if that were a more pervasive viewpoint.

>> the tendency for the media to jump on headlines like "DOCTORS PERSECUTING HEALTHY EATERS" distorts the actual information and deliberation involved in diagnosis. <<

Agreed. Current media policy runs to "print whatever will make the most money," not the need for a well-informed populace. This displeases me greatly.
ysabetwordsmith From: ysabetwordsmith Date: April 29th, 2011 05:15 am (UTC) (Link)

Thoughts

>> as an eating disorder diagnosis, this is presumably a category created for the use of healthcare professionals. it is not intended for amateur- or self-diagnosis any more than say basal cell carcinoma is.<<

Yes.

>> but science popularizers get ahold of any behavioral diagnosis and all of a sudden your second cousin who manages a quizno's thinks they get to be your diagnostician. feh. <<

It occurs to me that my opinion of the press has plummeted so far that it is approaching the abyssal depths of my opinion of the health care industry. I knew it was dropping, but hadn't really noticed it was that far down until I thought of the two together. Yee.
lupagreenwolf From: lupagreenwolf Date: April 28th, 2011 08:26 pm (UTC) (Link)
As a mental health practitioner, I really, really, really hate it when the media distorts things like this; orthorexia seems to be particularly bandied about, possibly because it sounds more "official". As the article says, orthorexia isn't even a formally recognized condition in the DSM-IV or ICD-9, and IIRC it's not going to be in the DSM-V, either. It's one doctor's term for a particular condition, and it is NOT about "healthy eating" as so many of these panicked headlines like to make it. Like other disorders, it is about taking a particular behavior to an unhealthy degree--in this case, instead of restricting food based on trying to lose weight, it's restricting food based on perceived "healthy" properties of that food. The restriction leading to ill health isn't the issue, not the type of food being eaten or avoided. Same thing with, say, pica--it doesn't matter whether the person with it is eating drywall or paper, the defining characteristic is a compulsion to eat non-food items.

Any ethical mental health or other health care provider isn't going to assume that eating well is a disorder. They're going to look at the behavior patterns around it and determine whether those patterns are healthy or not. And ethical practitioners are going to keep themselves educated on new developments on psychological/etc. care; if they encounter something they haven't before, they're going to either refer the client to someone already competent, or they're going to do research to improve their own competency.

It should speak volumes (pun intended!) that these disorders aren't in the DSM or ICD. It's because there isn't enough research to back them up as formal diagnoses yet. Ethical MHPs are well aware of the weight of a formal diagnosis, and won't give such a thing lightly, and even the DSM and ICD aren't seen as magic books that hold all the answers; they're compendiums of common patterns of behavior seen repeatedly and upon which significant research has been done.

tl;dr: orthorexia is not synonymous with persecution of eating healthy, and MHPs know this.
ysabetwordsmith From: ysabetwordsmith Date: April 29th, 2011 05:24 am (UTC) (Link)

Thoughts

>> As a mental health practitioner, I really, really, really hate it when the media distorts things like this; orthorexia seems to be particularly bandied about, possibly because it sounds more "official". <<

I suspect that one is also getting attention because food allergies are skyrocketing and trust in the food supply is (justifiably) dropping. So more people are choosing -- or being forced to -- change their dietary habits as a result.

>>And ethical practitioners are going to keep themselves educated on new developments on psychological/etc. care; if they encounter something they haven't before, they're going to either refer the client to someone already competent, or they're going to do research to improve their own competency.<<

That would be terrific, if it were common. I've almost never seen it, and heard of it only occasionally. It seems to run counter to the training most providers get, which inclines them to act like they know what they're doing even if they do not, because most people find that reassuring.

>> It's because there isn't enough research to back them up as formal diagnoses yet. <<

It sounds like a simple variation on "eating disorder." That shouldn't require a separate diagnosis, just a description of the individual symptoms in hopes of figuring out how to fix that particular issue for that person. It's why the nested listings are useful -- sometimes you can fit something into a broad category but not a narrower one.

>> tl;dr: orthorexia is not synonymous with persecution of eating healthy, and MHPs know this. <<

Not initially or intentionally, but the name and the discussion are highly liable to create such a result. People have a tendency to take things out of context (which all of us are complaining about here, just from different directions based on our different experiences) and that gets nasty. Neither the social ties, the health care industry, nor the food supply are in great shape. That's going to make it hard to identify and solve problems, and not hack at things that may not be the kind of problem they superficially resemble. I wish that people would be more careful.
jilara From: jilara Date: April 29th, 2011 01:30 am (UTC) (Link)
Heh. My mom always claimed that my often becoming sick from eating eggs was because of a psychological problem, a.k.a. I "psyched myself into it." Except I never got sick from eating organic eggs. Or now, my own eggs from my own chickens. Is there an opposite, for third parties who create disorders concerning what people eat?
ysabetwordsmith From: ysabetwordsmith Date: April 29th, 2011 05:49 am (UTC) (Link)

Thoughts

>> My mom always claimed that my often becoming sick from eating eggs was because of a psychological problem, a.k.a. I "psyched myself into it." <<

That claim goes out the window when someone gets sick from eating something deceptively presented as not containing allergens.

>> Except I never got sick from eating organic eggs. Or now, my own eggs from my own chickens. <<

Ah, now that's interesting! I had not heard that before with eggs. I have heard it with some other foods. I have a suspicion that some of the huge leap in allergies is due to people reacting to food distortions -- the chemicals that get passed through animals or plants, the genetic changes to some plants, etc. Some people have a really erratic allergy to corn, for instance, that makes me suspect they could be allergic to one of the GE strains; but there's no way to tell which kind of corn is in any given food item. You'd wind up thinking you were allergic to corn, period. Some people can eat organic versions of a plant but not commercial versions. With eggs, hrm ... could be carryover chemicals, or something from the grains used in the food.

Thanks everso for the new datapoint.

>> Is there an opposite, for third parties who create disorders concerning what people eat? <<

I don't know. I do know that every person I've ever known with any kind of special dietary need has been hassled about it by other people. It can be a minor nuisance or a life-wrecking disaster. People will not STFU about it, without drastic action. *ponder* It may be partially due to the fact that women's bodies are traditional battleground for control, and the vast majority of eating disorders involve women.
jilara From: jilara Date: April 29th, 2011 05:33 pm (UTC) (Link)

Re: Thoughts

I've wondered if the eggs thing is something to do with salmonella contamination, either in the feed or the birds themselves (they having now found that one of the laying strains now essentially has systemic salmonella).

I really think the GMO foodstuffs are going to be highly problematic. Pretty much all the wheat is going to GMO varieties, and suddenly people in later life are developing gluten/wheat allergies. As a friend in his 40's said: "I've been eating this stuff my entire life, and so have my ancestors for hundreds of years, with no problems. And suddenly, I'm allergic? It's got to be some genetic modification!"
the_vulture From: the_vulture Date: April 29th, 2011 09:37 am (UTC) (Link)
I avoid many processed foods in order to reduce my sodium intake (happy, happy high blood pressure). I avoid gluten and gratuitous amounts of lactose because my gut just runs happier that way. Yes, my grocery budget is a bit more demanding, but I still eat a rich and tasty range of foods that keeps me healthy. It's actually fairly easy to do, as local supermarkets support a surprising range of these kind of foods. I think the producers of these food items might have an issue of contention with pathologizing healthy eating.
rowyn From: rowyn Date: May 1st, 2011 04:49 pm (UTC) (Link)
In fairness, the article is not discussing pathologizing healthy eating. The example given for orthorexia is a woman who dropped down to 68 pounds after restricting her diet to raw broccoli and cauliflower. I don't think that anyone is going to be diagnosed with orthorexia unless their obsession with avoiding perceived 'unhealthy' foods leads to severe malnutrition.
endlessrarities From: endlessrarities Date: April 30th, 2011 03:22 pm (UTC) (Link)
Does this mean that vegetarianism is also an eating disorder?

There seem to be some folk out there who say stoopid things for the hell of it - suggesting that people are in some way unhinged just because they're trying to live a healthy lifestyle makes me want to tell them to get a life and do some research that's actually useful for a change!!
ysabetwordsmith From: ysabetwordsmith Date: April 30th, 2011 03:51 pm (UTC) (Link)

Thoughts

>> Does this mean that vegetarianism is also an eating disorder? <<

In general, no. The part of the article that makes sense is that food selection can be taken to an unhealthy extreme, not that healthy eating is a problem (despite the article's slant). A vegetarian diet can be perfectly healthy. However, it's not necessarily right for everyone. Just as some people can't digest meat, other people need it. Understand your own body and choose a diet that works for you.

>> There seem to be some folk out there who say stoopid things for the hell of it - suggesting that people are in some way unhinged just because they're trying to live a healthy lifestyle makes me want to tell them to get a life and do some research that's actually useful for a change!! <<

Sometimes just for the hell of it, but far more often for money or power. The media are far more concerned with what will sell than with what is accurate or helpful. And there is entirely too much interest in controlling women's bodies.
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