Orthorexia: When Eating Healthy is Unhealthy: 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 necessarilydisordered but can cross the border into Orthorexia when; 1) Fixation on food becomes allconsuming. 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 tobe 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

To Blog Or Not To Blog ...

I went on a blogging hiatus while I tried to figure out the delicate balance between recovering from an eating disorder and being a kidney patient. Most of the time I end up shutting it all out by compartmentalizing, putting it away in my head and just going through the motions, staying in this weird limbo. How can I honestly say that I'm doing everything I can to save my kidney when I still suffer from eating disorder? Am I recovering? You bet your ass I am. But it isn't possible to just get over an eating disorder, simply because I now have a new diagnosis. If I could just get over it, I wouldn't actually have an eating disorder and we'd be discussing a problem that doesn't actually exist. 

I'm not perfect and I'll call you a liar and tell you that you don't actually know me if you think I am. But I'll do the same if you don't actually think that I'm giving it my all and doing the best that I can. If it were as simple as picking up a hamburger and going to town on a plate of french fries then by all means, fire up the grill and pass the ketchup ... but I think we all know it doesn't work that way. 

Today I met with my nephrologist (kidney doc) and received my referral to the vascular surgeon for a preoperative vascular access/dialysis evaluation. I was also officially referred for transplant. Transplant. AYFKM? I've been an eating disorder patient my whole life (well 2/3rds of my life) and these are words that I feel should not be in my vocabulary. I don't know how to be a kidney patient. 

Scarlett says I have to separate the two, so I'm going to work on doing that. Maybe the key to getting through this is realizing that I can be an eating disorder patient working on my recovery AND a kidney patient starting the road to recovery via dialysis and/or (hopefully or) transplant. It'll be kind of like ... multi-tasking. Anyway, I think I'll stick to blogging during this process because I do not want to lose ground in my eating disorder recovery. I need to make sure I don't let my eating disorder become the way I cope with my kidney and I also need to make sure that my eating disorder recovery does not get lost to my kidney recovery. Let the multi-tasking begin.

What I do not miss about my eating disorder at this point in my recovery: Not having control over my thoughts. I love that I can break away from the eating disorder chaos in my brain and think about other things, future plans. I like that I can have day dreams about something other than an eating disorder related issue or thought. And I love that it happens naturally and I can experience what it feels like to have moments of freedom.

What I am not going to miss about my eating disorder once I'm recover(ed): Being denied a fun afternoon jogging around Greenlake with my friends and then going to eat frozen yogurt afterwards. When I'm recovered, I'm going to go to run  Greenlake every day, and I'm going to run with a handful of crab cakes from Tom Douglas' restaurants, and I'm going to do it in neon green shoes, because I can.

Realities of Bulimia: Between Life and Death Part 4

Realities of Bulimia: Between Life and Death Part 4

Eye opening reality of what Bulimia is truly like, when it takes someone's life.
Eating disorders are a very harsh reality of our culture and here at Ramey Nutrition, it is important that we are doing everything we can to bring awareness to this life threat, prevent all development of eating disorders that we are able to access, support those in treatment, and love them into recovery, supporting their recover(ed).
http://youtu.be/OybG3m92Rt8

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Patient Interview: Recovered from Anorexia and What it Means

Recovered at Ramey Nutrition! Alice inspires patients to keep recovering with each step no matter how small!

Caffeine and Fibromyalgia

Caffeine, I must admit, is a uniquely cultural and ever increasing part of our lives. From the 30 oz. Trenta size that Starbucks is now offering to the increased 20 oz. Red Bulls, we are faced with more caffeinated options than ever before. Currently, having to restrict my own caffeine intake due to stress issues has been enormously upsetting to my soul; and no one understands the love and passion around this sweet molecule than yours truly.

Research done on the health benefits of coming off caffeine, done in a stupor of de-caffeinated exhaustion, has led me to some interesting findings that I'd invite you to consider, as you sip your quad/short/soy/extra foam/latte. Doing this research was purely an effort to find any benefit remotely close to the benefit I feel when blissfully caffeinated. Just so we are clear, this research NEVER would have been entertained had I been able to have the substance my soul so tragically misses. Fibromyalgia, however, is a condition that has provided many, here at Ramey Nutrition, with unexplained pain and discomfort that seems to top charts on pain scales everywhere, and keeps me in a constant state of research for relief options.

Fibromyalgia, a relatively new discovery in the medical world, is a condition where patients have reported symptoms of chronic widespread pain, intolerance to pressure, debilitating fatigue, sleep disturbances, bowel and bladder abnormalities, numbness and tingling, depression, anxiety and stress-related disorders such as posttraumatic stress disorder. A Ramey Nutrition patient recently reported, “…the pain is so intolerable, I don’t want to take a bath, because the water pressure hurts. I hate this!”

How does caffeine enter the equation, you ask? Fibromyalgia is believed to be medically linked to brain chemical imbalances that control mood, and is often accompanied by chronic fatigue. Obviously, you can see how a patient with fibromyalgia would migrate toward anything with a stimulant-like effect, and the stimulant most widely used, legal and available, is caffeine.

Without fibromyalgia, the normal mechanism of caffeine works by increasing the density of serotonin receptors, giving us a sense of euphoric energy. A 1993 study on mice published in "Cellular and Molecular Neurobiology" notes that density of certain serotonin receptors in the brain, including 5 HT1 and 5 HT2 serotonergic receptors, increase by 26 to 30 percent when mice take in an equivalent dose of 100 mg caffeine per 2.2 lbs. body weight a day.

Right about now you're probably midway through that quad/short/extra foam/soy latte thinking, "Well that sounds like a cure to me!" As it was mine, if this is your thought, please continue reading with caution...

When there is a serotonin deficiency, which is likely in fibromyalgia, the use of caffeine starts to require ever increasing amounts in order to produce the same effect. Patients often find themselves with depression if not adequately caffeinated, and as the need for the drug increases, the signs and symptoms of depression present themselves in greater intensity. This increased need tends to spiral downward into a cycle of over-stimulation of the nervous system, and exacerbation of chronic fatigue syndrome.

Either insomnia ensues, when caffeine's half-life lasts through what should be REM sleep, or unending fatigue sets in when the nervous system crashes without its beloved drug. As the nervous system, which is stimulated to feel more pain than normal, is over-stimulated by caffeine, pain tends to become exorbitantly unbearable.

“Caffeine is a loan shark for energy. We recommend not using a lot,” says Kent Holtorf, MD, founding medical director of the Fibromyalgia and Fatigue Centers, located across the country.
Getting on this roller coaster of increased pain, fatigue, and depression, just to get a short, false sense of euphoria, which quickly tends to turn its ugly head toward barely awake, might not be worth it.

Again, I write this from a catatonic state of sober melancholy, wishing I had a quad/short/soy/extra foam/latte in my hot little hands. This should assure you that this is not written from a "natural healing perspective," or that I am someone who believes caffeine to be anything but beautiful, and lifesaving. Those with fibromyalgia, however, might entertain the idea that getting off of it (God forbid), might alleviate pain, fatigue, and depression, so prevalent in this disorder.

-Scarlett Ramey, MS, RD, CD
President and CEO of Ramey Nutrition