Orthorexia: When Eating Healthy is Unhealthy By: Sarah Crissinger RN

Seattle is the fourth healthiest city in the United States and Seattleites are the second healthiest eaters according to a recent survey by Sperling’s Best Places (2013). You can’t go far without seeing a cross fit gym, yoga studio or a high end grocery store. The Paleo Diet, “eating clean”, and The Raw Foods Diet are commonplace in the Seattle culture and have undoubtedly helped some ward off early disease, increase health, vitality, and quality of life.  For some, what starts as eating healthier can become an all consuming obsession. The paradox is eating healthy can be unhealthy.

Orthorexia is an unofficial diagnosis that was named by Steven Bratman MD, who discovered the disorder after recognizing his own unhealthy obsession with healthy eating. Orthorexia is derived from Greek meaning right/proper appetite (Bratman, 2013). Obsession with being healthy and pure is what differentiates Orthorexia from other eating disorders. Like other eating disorders Orthorexics often have a need for control, and make food/way of eating a source of identity and validation. Perfectionism and black and white thinking often keep Orthorexics obsessed with following a diet strictly or they can struggle with accepting themselves.

Orthorexia embodies traits of Anorexia and Obsessive Compulsive Disorder as foods allowed in the diet are reduced to a point where unhealthy weight loss and malnutrition ensue.  Some attributes of Orthorexia can be; extremely limiting the types of foods eaten, such as any food with the possibility of having pesticides, GMO’s, being non-organic or specific ingredients and entire food groups (Nelson, Zerasky, 2011). Dr. Steven Bratman describes how some Orthorexics limit food intake to a dangerously low and even fatal level of nutritional variety by only allowing themselves to eat a couple types of food items (2013).  Additional components of the disorder are obsessive compulsiveness regarding food preparation such as excessive washing of foods and not being able to eat out or eat food prepared by others, and spending excessive time thinking about healthy food (Nelson, Zerasky, 2011).

 Healthy diets, such as the ones mentioned earlier, in and of themselves are not necessarily disordered but can cross the border into Orthorexia when; 1) Fixation on food becomes all consuming. 2) Personal relationships and other areas of life suffer due to rigidity to the diet often resulting in isolation. 3) Immense guilt, anxiety, mood swings and self loathing persist when the diet is not followed.

The tricky thing about eating disorders including Orthorexia is the denial of having one. Especially due to the food restriction in Orthorexia often stemming from a medical condition, food sensitivity, allergy, or wanting better health. If you feel like you follow a very strict diet to be healthy and other’s have shared concerns or you have noticed that the obsession in healthy eating is taking away from important areas of your life, Ramey Nutrition is here to support you. Ramey Nutrition offers individualized care that begins with an individual session with one of our Dietitians. We work with many therapists specializing in eating disorders in the Seattle area that we can refer you to in order to address deeper underlying emotional issues. Ramey Nutrition offers you a full recovery that results in a restored relationship with food, ownership over your health, and freedom to begin living your life fully again.

References:

Bratman, S.(2013) Orthorexia. Retrieved on 09/04/10 from: www.orthorexia.com

Nelson, J., Zerask, K.(2011) Orthorexia: When eating healthy goes awry. The Mayo Clinic.Retrieved on 09/04/2013

from:  http://www.mayoclinic.com/health/orthorexia/MY00768

California Shines, Ohio aches in battle for healthiest city (2013). Sperling’s Best Places. Retrieved on September

12, 2013 from: http://www.bestplaces.net/docs/studies/healthy.aspx

Signs and Symptoms of Anorexia, Bulimia, and Binge Eating Disorders

Signs and Symptoms of Anorexia, Bulimia, and Binge Eating Disorders

Eating disorders are a group of conditions marked by an unhealthy relationship with food. Eating disorders tend to develop during the teenage and young adult years, and they are much more common in girls and women. No one knows the precise cause of eating disorders, but they seem to coexist with psychological and medical issues such as low self-esteem, depression anxiety, trouble coping with emotions, and substance abuse.

For some people, a preoccupation with food becomes a way to gain control over one aspect of their lives. Although it may start out as simply eating a bit more or less than usual, the behavior can spiral out of control and take over the person’s life. Eating disorders are a serious medical problem that can have long-term health consequences if left untreated.

It’s common for people with eating disorders to hide their unhealthy behaviors, so it can be difficult to recognize the signs of an eating disorder, especially early on.

Anorexia Nervosa (AN): This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. Someone with anorexia can never be thin enough and continues to see herself as “fat” despite extreme weight loss.

People with anorexia nervosa have an extreme fear of gaining weight. They often diet and exercise relentlessly, sometimes to the point of starvation. About one-third to one-half of anorexics also binge and purge by vomiting or misusing laxatives. People with anorexia have a distorted body image, thinking they are overweight when in fact they are underweight. They may count calories obsessively and only allow themselves tiny portions of certain specific foods. When confronted, someone with anorexia will often deny that there’s a problem.

The signs of anorexia can be subtle at first, because it develops gradually. It may begin as an interest in dieting before an event like a school dance or a beach vacation. But as the disorder takes hold, preoccupation with weight intensifies. It creates a vicious cycle: The more weight the person loses, the more that person worries and obsesses about weight.

The following symptoms and behaviors are common in people with anorexia:

• Dramatic weight loss
• Wearing loose, bulky clothes to hide weight loss
• Preoccupation with food, dieting, counting calories, etc.
• Refusal to eat certain foods, such as carbs or fats
• Avoiding mealtimes or eating in front of others
• Preparing elaborate meals for others but refusing to eat them
• Exercising excessively
• Making comments about being “fat”
• Stopping menstruating
• Complaining about constipation or stomach pain
• Denying that extreme thinness is a problem

Because people with anorexia are so good at hiding it, the disease may become severe before anyone around them notices anything wrong. If you think someone you care about has anorexia, it’s important to have them evaluated by a doctor right away. If left untreated, anorexia can lead to serious complications such as malnutrition and organ failure. However, with treatment, most people with anorexia will gain back the weight they lost, and the physical problems they developed as a result of the anorexia will get better.

Bulimia Nervosa (BN): The condition is marked by cycles of extreme overeating, known as bingeing, followed by purging or other behaviors to compensate for the overeating. It is also associated with feelings of loss of control about eating.

People with bulimia nervosa have episodes of eating large amounts of food (called bingeing) followed by purging (vomiting or using laxatives), fasting, or exercising excessively to compensate for the overeating.

Unlike anorexia, people with bulimia are often a normal weight. But they have the same intense fear of gaining weight and distorted body image. They see themselves as “fat” and desperately want to lose weight. Because they often feel ashamed and disgusted with themselves, people with bulimia become very good at hiding the bulimic behaviors.

The following are common signs of bulimia:

• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics
• Skipping meals or avoiding eating in front of others, or eating very small portions
• Exercising excessively
• Wearing baggy clothes to hide the body
• Complaining about being “fat”
• Using gum, mouthwash, or mints excessively
• Constantly dieting
• Scarred knuckles from repeatedly inducing vomiting

If left untreated, bulimia can result in long-term health problems such as abnormalheart rhythms, gastroesophageal reflux disease, and kidney problems. However, bulimia can be treated successfully through cognitive-behavioral therapy,antidepressants, or both. It’s important to seek help if you think someone you care about has bulimia.

Binge Eating Disorder (BED): This is characterized by regular episodes of extreme overeating and feelings of loss of control about eating.

Rather than simply eating too much all the time, people with binge eating disorder have frequent episodes where they binge on large quantities of food. Like people with bulimia, they often feel out of control during these episodes and later feel guilt and shame about it. The behavior becomes a vicious cycle, because the more distressed they feel about bingeing, the more they seem to do it. Because people with binge eating disorder do not purge, fast, or exercise after they binge, they are usually overweight or obese.

Unlike other eating disorders, binge eating disorder is almost as common in men as it is in women. According to statistics from the National Institute of Mental Health, the average age at onset for binge eating disorder is 25, and it is more common in people under age 60.  

Common signs of binge eating disorder include:

• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Hoarding food, or hiding large quantities of food in strange places
• Wearing baggy clothes to hide the body
• Skipping meals or avoiding eating in front of others
• Constantly dieting, but rarely losing weight

Because binge eating leads to obesity, it can have serious health consequences if left untreated. Behavioral weight reduction programs can be helpful both with weight loss and with controlling the urge to binge eat. Because depression often goes hand in hand with binge eating disorder, antidepressants and psychotherapy may also help.

Recognizing the signs and symptoms of an eating disorder is the first step toward getting help for it. Eating disorders are treatable, and with the right treatment and support, most people with an eating disorder can learn healthy eating habits and get their lives back on track.

Ramey Nutrition Statement: Promoting Positive Body Image through Public Policy

In order to understand the role of policy in promoting positive body image, a broad perspective must be kept as one’s struggle is multi-factorial and not identical to another. We must look past the physical “body” to the deeper struggles – struggles that ignite 10 foot flames to an already burning fire. Although the influence of media cannot be ignored, we can as providers support individuals to a place of empowerment over the messages and images that are before them. Instead of expending efforts to alter advertising companies’ course of action, we can discuss the underlying messages and beliefs being portrayed -- and explore how these align with what is actually true. Policy efforts focused on communicating this message will exert twofold influence: supporting individuals through the healing process and removing attention from the media “culprits” that secondarily influence one’s view of body.
-Rachel Myhre, MS, RD, CD

Between a Kidney and a Sick Place

Sometimes I feel like the only reason I get back on track is so that I can get derailed. I'm starting to think that I secretly enjoy it in some sick twisted way. I mean, after all  I *am sick. I even have the T-Shirt. It says right on it: S I C K. 
The kidney shit has got me bummed out but I try not to think about it. I'm not ready to fully embrace the reality surrounding this whole dilemma ... And for now that's cool with me. Long story short, I have exactly 1 kidney kidney and it doesn't want to work anymore. I think it's retiring. I think I've pretty much beat the shit out of it and so now it's decided to beat the shit out of me. For the moment I'm living in a state of kind of denial. I understand what's going on but I'm exercising my right to compartmentalize and avoid emotional tags. 
I don't think I'm mentally prepared to handle the road this is going to take me on yet. All the terminology makes the whole thing sound so much more dramatic than it really is ... and I don't mean to minimize here, but you kind of have to. If I walked up to you and said I had Stage 4 Kidney Disease and have just completed a series of Venofer infusions you would think I was going to die tomorrow. It sounds like Cancer, Stage 4. You'd have no idea that what that means is my kidney has a GFR of 22, which you could potentially live with for the rest of your life with minimal life style changes and that Venofer is a fancy word for Iron. Or that I'm waiting for EPO injections so that my bone marrow will produce more red blood cells and my hemoglobin will get out of the range of needing a blood transfusion simply means my thigh is going to be in pain after the needle goes into my muscle for the shot. 
And ALL of this is just fireworks and smoke and illusions to cover up the other reality that I am also in the midst of recovering from a raging eating disorder. I'm still trying to figure it out in my head. Am I a kidney patient or am I an eating disorder patient? I don't even fucking know how to merge the two. Can I honestly do everything I can to save my kidney and still have an eating disorder? Can I just "get over" my eating disorder to save my kidney? No, I can't. I don't know how to. If it were that easy, if it were as simple as trading one for the other I think I would have found something positive to substitute it by now. I can't just stop being sick because now my kidney is sick. I wish I could just turn it off like that. I wish it were that simple. 
And so the guilt is horrendous. Why can't I just do what I'm supposed to do and stop these crazy thoughts? Why aren't the eating disorder thoughts and distortions stopping? Why can't I say 8 Ensures? Why not 9 or 10, let's just drink em until I'm at a healthy weight? Dive into this head first? Because it's a disease, that's why. Because it's not a fucking choice, that's why.

B is for Boring

I need a hobby. I have decided that I'm unusually boring these days. Sitting in my bed feeling sorry for myself makes me feel icky, like I'm wasting space. I feel like I was more of a human when I was active in my eating disorder. I need to figure out how to get that person back ... sans eating disorder, of course.
I had this project once, that I worked on every night when I didn't sleep. Instead of laying lame in my bed staring at the ceiling I sat on my floor, spread out all my art supplies, turned on my music and went to town. It was meditative for me, calming. A way to express what I was feeling without having to speak. I had it for at least 10 years and then one day I just stopped. I don't even know where it is. Tonight I'm going to start my project over. I'm going to start being more interesting in my life.
Kidney update: Barf, I don't even want to talk about it.
What I don't miss about my eating disorder this far in my recovery today: Not sure. I'm kind of a Negative Nancy today so I'm drawing a blank on the positives.
What I'm not going to miss about my eating disorder when I'm recovered: Obviously the boring me. I need more substance, so I'm going to create it. And Ensures, I'm still sick of Ensures.

Still, Stuck, and Paralyzed

I'm sitting in my bed at 3:40am experiencing the biggest Ambien FAIL known to man and I realize that I don't know how to feel what I'm feeling right now and it's pouring out my eyeballs. I'm overwhelmed. I think I'm having a normal "healthy" reaction to what's happening in my life. I feel a little withdrawn because I'm afraid that if I put myself in a social situation right now, I'm going to burst into tears in the middle of a conversation that I wouldn't even be paying attention to and wouldn't be able to explain why.  I'm not sad, although I can't seem to stop crying. I'm exhausted, although I can't seem to sleep. I should be focusing on my intake and my recovery and not falling in to my eating disorder, although I don't feel like consuming anything. I believe this to be normal but it feels so foreign to me. With my eating disorder, whether or not I starved myself or ate, there was a desire either way. A desire to refuse the food or a desire to eat it. A desire to fight it or give in. There was something there, some kind of feeling. Right now, I don't feel anything either way, except that I don't like it and have no desire to change it right now. I expect this will change after I finally get sleep, and then a hundred times over again. 

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ADHD Teens at Risk of Eating Disorders By Chris Iliades, MD Medically reviewed by Pat F. Bass III, MD, MPH

Teen eating disorders are on the rise — and they're becoming more prevalent in kids with ADHD. Experts explain why.

ADHD: My Son Nathan
One to 2 percent of students in America struggle with an eating disorder — and according to studies, eating disorders are significantly more common in teenage girls with ADHD than in girls without ADHD.

A possible explanation: Eating disorder behaviors like binge eating may be a way of self-medicating for ADHD teens. "The key link between eating disorders and ADHD is the impulsive need for stimulation,” explains Eric Hollander, MD, professor of psychiatry and behavioral medicine and director of the Compulsive, Impulsive, and Autism Spectrum Disorders Program at Albert Einstein College of Medicine and Montefiore Medical Center in Bronx, New York.

“ADHD in teens may cause symptoms of boredom and restlessness that are temporarily relieved by compulsive or addictive eating behaviors. Overeating or binge eating may stimulate the dopamine reward system and dopamine pathways in the brain.”

Dopamine is a brain chemical that tends to be low in people with ADHD. Dopamine is also important in appetite regulation and some compulsive eating behaviors have been shown to activate dopamine pathways.

Adolescent girls with ADHD also frequently develop dissatisfaction with their body image, which can lead to repeated bouts of binge eating and bulimia, notes Hollander.

ADHD usually begins in childhood, but girls are more likely to reach their teens being undiagnosed and untreated for their ADHD. Untreated teen ADHD increases the risk for compulsive eating and other eating disorders like bulimia or binge eating.”

Here are some ADHD symptoms kids and parents should be aware of:

Difficulty paying attention and staying focused
Problems at school
Constantly losing things or making careless mistakes
Restlessness and impatience
Parents who know or suspect that their teen has ADHD should also be aware of the warning signs of a possible eating disorder:

Dramatic change in weight
Excessive concern over diet
Being depressed about body image
Use of laxatives, diuretics, or enemas
Avoidance of family meals
ADHD in Teens and Eating Disorder Treatment

Parents and teens need to learn as much as they can about these disorders and take an active role in treatment. ADHD and eating disorders are both treatable. Teen ADHD can be controlled through a combination of medication and behavioral therapy. Teen eating disorder treatment often involves both individual and family therapy and education about healthful eating. Treatment of ADHD symptoms may also help symptoms of eating disorders.

The key is to recognize the problem and take action. Teen ADHD and eating disorders that go unrecognized and untreated can cause lasting damage to both mind and body.

Ramey Nutrition Taking New Day Program Patients!

Providing eating disorder treatment that leads efficiently to full recovery was the guiding principal on which Ramey Nutrition was founded. Eating disorders are frequently “treated” in the field of nutrition counseling; however we focus on empowering our patients to be recovered in order to move on with lives that are meaningful to them. By avoiding a focus on education and meal plans, we are able to respect the knowledge our patients already have. As they feel safe in knowing this, we are in a better position to simply remind them of the power they have to heal their issues; the nutrition naturally follows their healing.
Www.rameynutrition.com

"A mother who radiates self-love and self-acceptance vaccinates her daughter against low self-esteem." -Naomi Wolf

Ramey Nutrition's First Referring Doctor Killed in an Avalanche

The woman who died after she was buried in an avalanche near Snoqualmie Pass has been identified as Bellevue naturopathic physician Dr. Joy Yu. The search for a man caught in a second slide has been suspended.

The woman who died after she was buried in an avalanche Saturday on Red Mountain has been identified as Dr. Joy Yu, a naturopathic physician.
Yu worked at the Creekside Center for Integrative Medicine in Bellevue, according to a billing receptionist at the office who was too upset to provide additional details. She said Yu’s relatives were on their way to town after learning of the accident.
Yu has a blog that identifies her as an active Northwest hiker and dog lover.
Yu was one of two people hit by an avalanche in separate incidents Saturday near Snoqualmie Pass. A man who’s been missing in an avalanche on Granite Mountain has been identified as 61-year-old Mitch Hungate, a Renton dentist, according to KING 5 news, a Seattle Times news partner.
The search for Hungate has been suspended indefinitely, as rescuers believe the conditions on Granite Mountain nare too dangerous.
Two other men were carried along with Hungate in the Granite Mountain avalanche, but they have been located. A GPS device worn by one of the men showed they tumbled down the slope more than 1,200 feet in less than one minute, according to the King County Sheriff’s Office.
Hungate did not emerge from the snow slide. Described as an experienced outdoorsman, Hungate was “always out hiking and climbing,” according to Bruce Kolpack, who has climbed with him. “He stays in really good shape.”
Hungate’s wife and sister are on the mountain awaiting news.
“All of us stayed up here in the hope against hope that there would be a rescue,” Hungate’s wife, Marilynn, told KING 5. “I really didn’t want to leave him. I want to be with him until he can be here with us.”
Yu was pronounced dead after rescuers transported her down from Red Mountain at about midnight . The Sheriff’s Office said she had a pulse when she was dug from the snow. Rescuers, who hiked nearly three hours to reach her, spent six hours carrying her on a sled off the mountain, but she did not survive.
Other snowshoers located Yu about 45 minutes after an avalanche hit and found her face down in about 5 feet of snow. Her dog, a black-and-white border collie/sheltie mix named Blue, showed up unaccompanied, alerting them that the woman was missing.
The search for Hungate was suspended about 8 p.m. Saturday and did not resume Sunday.
“It’s so unstable, we don’t want to risk our search-and-rescue members’ lives,” said Cindi West, of the Sheriff’s Office.
The Sheriff’s Office is warning the public to stay away from the area, she added.
About 50 rescuers with dog teams searched for Hungate on Saturday but battled “horrible” conditions, according to Katie Larson, of the Sheriff’s Office. Overnight, the mountain got another “big dump of snow,” making the conditions too dangerous to send in searchers, she said.
His two companions suffered non-life-threatening shoulder and hamstring injuries, the Sheriff’s Office said.
The Granite Mountain avalanche occurred first, at about noon Saturday, near Interstate 90s exit 47. The Red Mountain slide hit about a half-hour later, a few miles east near the Alpental ski area.
In all, more than 100 members of search-and-rescue teams from Seattle, Everett, Pierce County and Yakima participated in searches at the two avalanche scenes.
At the Red Mountain site, Yu had been snowshoeing with her dog behind a group of 12 other snowshoers when the avalanche struck.
The group of 12 was split up by the avalanche, with four making it off the mountain on their own by 5 p.m.
The remaining eight snowshoers, who were at about 4,800 feet, realized Yu was missing when the dog came up to them afterward. They were able to find Yu and dig her out. They tried to keep her warm as they waited about 2½ hours for rescuers to reach them. The rescue party did not reach the parking lot until about midnight Saturday, and by that time Yu had died.
The last avalanche fatalities in this area occurred in February 2012 when four people were killed at Stevens Pass and near the Summit at Snoqualmie, Larson said.
She said avalanches can be common this time of year.
“Whenever you have warm weather and then cold weather and snow, it can be bad,” she said.
Paul Baugher, director of the Northwest Avalanche Institute, which offers avalanche consulting and safety training, said the forecast for avalanches at Snoqualmie was “high” on Saturday.
“Because of the cold temperatures, the snow underneath is relatively well frozen and stable,” he said. “But there’s a poor bond between the new snow coming down and old snow, which is very hard and slippery. That produces soft slabs of very sensitive snow.”

Our hearts and prayers go out to Texas today. @rameynutrition

Talking About Old Age Or Being Fat Linked To Physical And Mental Health Problems by Joseph Nordqvist

Talking about being old is an important indicator of body dissatisfaction, in the same way that talking about being fat is, according to a recent study published in the Journal of Eating Disorders.

Body dissatisfaction is associated with a number of physical and mental health problems, such as depression, low self-esteem, and stress. So-called "fat talk" and "old talk" have been found to contribute towards feelings of body dissatisfaction. It occurs when women express distaste about the appearance of their body and wish they were either better looking, thinner, or younger.

Researchers from the University of West England and Trinity University investigated the impact of "fat-talk" and "old-talk" throughout women's lives. They surveyed a total of 1,000 women aged 18 to 87 from various parts of the world; they assessed their fat talk, old talk, body image disturbance and eating disorder pathology.

Interestingly, a previous study published in Psychology of Women Quarterly identified that it's worrying how some women believe "fat talk" to be a helpful coping mechanism when in fact it actually exacerbates body image disturbance. In addition, those who engage in fat talk on a frequent basis are more likely to have an ultra-thin body ideal than those who don't.

They found that "fat talk" and "old talk" occur throughout the majority of women's lives. In general women talk more about their weight and appearance than they do about their age. However, as they get older they tend to talk less about their weight and more about their age.

Those who reported talking about being old or fat were more likely to have a negative body image than those who didn't.

As with fat talk, old talk is associated with body image disturbance as well as eating disorder pathology.

According to Dr. Carolyn Black Becker, who led this study:

"Until now, most research has focused on the negative effects of the thin-ideal and speech, such as 'fat talk', in younger women, but we need to remember that the thin-ideal is also a young-ideal which, as our results show, becomes increasingly important to negative body image as women age."


Written by Joseph Nordqvist
Copyright: Medical News Today

Where in the World is Ramey Nutrition??

Paris…California….or your house?! We want to see where Ramey Nutrition travels to. So next time you are sporting any Ramey Nutrition apparel (t-shirt, water bottle, etc.) tag Ramey Nutrition on Facebook or Instagram. For each picture you tag, you will be entered to win a free Ramey Nutrition fitness class, of your choice. Drawings will be done weekly!

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NEDA Burger? Ramey Nutrition's Open House BBQ!

Ramey Nutrition NEDA Events

Open House BBQ 

Friday May 17^th 5:00pm Ramey Nutrition Headquarters

NEDA great way to start off summer? NEDA burger?   

Comejoin the Ramey Nutrition Team for our Open House BBQ.

We will have fun, food, fitness and information all for agreat cause.  Make a $15 donation to NEDA(national eating disorder association) and enjoy soda and BBQ. Otherrefreshments will be available for a small donation.

Meet the Ramey Nutrition Team of Excellence, and get information on Eating DisorderRecovery Programs, Diabetes, Weight Management, and Medical Nutrition Therapy along with our Fitness and Yoga classes.

Take a free fitness class with Jason Steele at 5:30 in the Grauer Gym

Learnall the ways that Ramey Nutrition can help in your life or that of loved ones.

Sign up for the 2013 NEDA walk on Saturday June the 1^stat Seward Park or stop by Ramey Nutrition and signup or use the link to sign upfor the Ramey Nutrition Team at http://neda.nationaleatingdisorders.org/site/TR/NEDAWalk/General?team_id=10330&pg=team&fr_id=2220. The password is: Honey22

Thank You for all of your support!