When eating too healthy becomes harmful

Orthorexia, an unhealthy obsession with eating healthfully, leads to mental stress

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>> on "today's health," good nutrition called orthorexia, taking healthy eating to the extremes. the diet and nutrition editor and robbie ludwig is a social therapist. this is a new one. orthorexia. it's hard to imagine eating healthfully could be bad for you.

>> what could be bad? it's under the radar. healthy eating , that's a good thing. the key thing here is moderation. the obsession with healthy eating but it's reflected in many ways that can restrict your intake. you cut down what you eating so you can get nutritional deficiencies and the mental strain coming with being a perfect eater. most importantly, the way that's different from eating disorders is an orthorexia is the quality of food. it's not about the call lories.

>> not about weight loss.

>> it's a virtuous person, a better person if i restrict. not about the pounds or the amount of food.

>> before we turn to robbie, what are some of the characteristics of some of who is orthorexic.

>> someone who spends three or four hours a day reading labels, cutting out things focusing on healthy foods. maybe there are pesticides on produce. fat is going to be in cheese. cutting down on salt. taking some healthy things and saying i'm going to eliminate most things. that's not a good thing. it's socially isolating. people are starting to lecture others about you shouldn't be eating this. so if you see these kinds of signs in people you know, you have to wake up again because you think, how could that be bad? it can be because it can be horrible for your quality of life .

>> this is, we should point out, a disorder, not a disease. but one imagines there is a psychological aspect underlying this.

>> absolutely. we were talking about this earlier. very often it's similar to an obsessive compulsive disorder so the focus is food. it's anxiety driven. sometimes these people are depressed or trying to take real control of their lives.

>> anorexia is supposed to be about control.

>> yeah, they're perfectionistic and have low self-esteem and are isolated because of the eating behaviors. so it's really it takes over their life where they're not living life because they're overly focused on food.

>> how do you know -- i imagine there's a spectrum, right, of people who aren't very concerned about healthy eating and how to get something that's orthorexia. how do you know it's something you need treatment for?

>> in part, some of the people are medically impaired and are putting themselves at risk. that's the first thing to consider. they're somewhat socially isolated. if they're not able to live life normally and they notice they can't work normally or they're not connecting with other people and they are depressed or anxious because of this, then there's a problem.

>> everybody's got some food quirks. we all have them. but when it starts to interfere with your life and others may be telling you this, because sometimes people don't want to recognize it. they say i'm a healthy eater and defend this, you have to take action because it's going to be a physical problem you can get nutritional deficiencies , protein deficiencies. you won't be good physically and your mental health suffers as well.

>> some children may be more prone to this?

>> children can be prone to this. it's growth and development. parents want to do the right thing. they see their parents doing it, they do it. it could be something that's fulfilling in the whole family. you have to fight against it. but moderation is key in everything. especially in healthy eating .

>> right. right.

>> the difficulty is that these people are resistant, they feel they're in the know. that's a challenge.

>> indeed it is.

Show transcript

By Lisa A. Flam

TODAY contributor

updated 8/25/2011 1:25:44 PM ET

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We hear it again and again: A proper diet is important for good health and to keep our waistlines in check. But can you imagine becoming all-consumed with eating healthy foods?

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Orthorexia, though not an official mental disorder, is what some people call an unhealthy obsession with eating healthy food. While healthful foods are good for our bodies, orthorexics take the concern to an extreme by restricting their diets, which can lead to nutritional deficiencies and create mental stress from trying to be a “perfect” eater.

What’s missing from their diets is moderation, Madelyn Fernstrom, TODAY’s diet and nutrition editor, told TODAY’s Savannah Guthrie.

“The way that it’s different from eating disorders like anorexia and bulimia is that an orthorexic focuses on the quality of food,” she told TODAY. “It’s not the calories. It’s not about weight loss. It’s all about how they feel as a virtuous person, as a perfect person. 'I’m a better person if I restrict.'”

An orthorexic may spend three to four hours a day obsessively reading food labels, worrying about everything that’s in food, cutting out lots of foods, including even healthy ones like produce if they're worried about pesticides or cheese because of the fat, Fernstrom said.

To feel clean and pure, orthorexics may avoid food with artificial coloring or flavoring or added salt and sugar, according to the Mayo Clinic. They may require food to be washed several times and cooked to kill bacteria, the clinic says, and some won’t go to restaurants to avoid meals they haven’t prepared themselves.

In addition to potentially causing physical and mental problems, eating this way can be socially isolating. “It can be horrible for your quality of life,” Fernstrom told TODAY.

Orthorexics may be depressed, have low self esteem or they may be trying to be perfectionists, to get some control over their lives, psychotherapist Robi Ludwig told Guthrie.

“It’s very similar to an obsessive-compulsive disorder only the focus is really food,” she said. “It takes over their life where they’re not living life because they’re overly focused on food.”

While everyone has food quirks and there’s so much attention paid to healthy living these days, obsessing over eating healthy becomes a problem when it’s interfering with your daily life, Fernstrom said.

And if parents are eating this way, they should be mindful if their children are too, she said, because it can hurt their growth and development.

Orthorexia does not appear in the American Psychiatric Association’s Diagnostic and Statistical Manual-IV, and there hasn’t been much study on the subject, says association spokeswoman Dr. Evelyn Attia, director of the Center for Eating Disorders at New York-Presbyterian Hospital.

Orthorexia is a label used by the lay public that has gotten more attention in recent years, Attia told TODAY.com. There are no figures on how many people feel they suffer from orthorexia.

“It’s been used to describe folks who feel very committed to healthy eating and that can mean a range of things from a little bit of change ... to sometimes really rigidly applied rules or practices that may bring the behaviors closer to an eating disorder that we do recognize clinically, that being anorexia nervosa.”