Obsessive healthy eating a mental-health pointer?

TORONTO — While we should all strive for a balanced diet, York University researchers say the extreme pursuit of healthy eating can be a sign of mental-health struggles.

Jennifer Mills, an associate professor in York’s psychology department, co-wrote a recent paper on orthorexia nervosa, which she describes as an unhealthy obsession with healthy eating, published in the journal Appetite.

In reviewing academic literature on the subject, the authors found that people with a history of eating disorders, obsessivecompulsive tendencies, perfectionism and other psychological and behavioural tendencies were at higher risk of developing orthorexia.

“There is nothing wrong with healthy eating. Healthy eating is something we should all aspire to,” Mills said.

“But (we need) to be aware that mental-health difficulties can manifest through food.”

Orthorexia has not been recognized in the standard manual psychiatrists use to diagnose mental disorders, and the York study found research on the subject is limited.

But as so-called clean diets have picked up steam, Mills said there’s been growing interest in medical and research circles about the social and psychological side-effects of a “pathological” preoccupation with healthy eating.

While there’s overlap between the risk factors for orthorexia and certain eating disorders — such as poor body image, a drive for thinness and dieting — Mills said the conditions differ in key ways, particularly their motivations.

People with a restrictive eating disorder like anorexia will typically reduce their food intake in order to reach a low body weight or change their appearance. But for those with orthorexia, Mills said the focus on food is about quality rather than quantity.

Many people with orthorexia are proud of their bodies, she said, but are decidedly picky about what they put in them.

This often involves eliminating certain types of food from their diets, such as sugar, saturated fat, gluten, animal products, artificial flavours and preservatives.

For some, she said, the list of forbidden foods can grow so long that their diet may be lacking in essential nutrients, which in severe cases can lead to health hazards such as anemia, vitamin deficiencies or excessive weight loss.

But Mills said one of the reasons orthorexia tends to go overlooked, including by medical professionals, is that many people with the condition are physically healthy, even though they may be suffering psychologically.

“When people go to their doctors and say, ‘I eat really healthy,’ the most typical response they’ll get is, ‘That’s great … Keep doing what you’re doing,’” said Mills.

“But they may be struggling more privately with just this sense that they’re starting to lose control, that this is actually taking away from their life.”

For individuals with orthorexia, eating foods that conflict with their diets is likely to cause extreme guilt or anxiety, said Mills.

This distress is usually bound up in perceived risks of disease or physical impairment.

But in treating their bodies as temples of health, some may lose sight of their mental welfare, she said.

They may spend a lot of time and money planning and preparing meals, and can find it difficult to eat food made by others, Mills said.