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

Weight Stigma Awareness Week

Ramey Nutrition is honoring Binge Eating Disorder Association's National "Weight Stigma Awareness Week" September 23-27, 2013 by sharing some of our intimate weight stigma experiences.  We would love your participation with any submitted stories, experiences, poetry, art or videos.  Please send all submissions to my direct email at: scarlett@rameynutrition.com

Just to show how weight stigma is all around us, one of Ramey Nutrition’s employees, Rachel was willing to share about when she went to Albania with a group from her church. Rachel’s friend, Haley, and her husband were also on this trip. When the group was in Albania, they befriended many of the people living in the area. Rachel overheard a conversation that Haley had with one of the Albanian men. Haley was explaining to him which man was her husband. She said, “My husband is the guy over there with the white t-shirt on.” The Albanian friend responded by saying, “Oh, the fat one!”

                Later on, Haley and her husband were approached by another Albanian who had also overheard the conversation. He told them that they shouldn't be offended by the description of “fat”. He went on to explain how calling somebody fat in Albania is very similar to calling someone tall, short, blonde, or brunette.

Isn't it interesting how many connotations we have for the word "Fat" and how it has become such an emotional trigger for us, where in other countries, it is just a simple descriptor.

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.

Night Baker finds strength, healing in blog readers By Candice Madsen March 11th, 2013

 The Night Baker Video

 

OREM — For a Utah woman battling anorexia, sharing her story with the world ultimately helped save her life.

It's been five months since KSL met Camilla Kuhns — known in the blogosphere as the Night Baker. Camilla bakes and blogs in hopes of raising enough money to overcome her anorexia for good.
Camilla checked into the Center for Change in Orem, not knowing how long she'd be able to afford to stay. Treatment costs $900 a day.
But Camilla said the generosity of family, friends and strangers who follow her blog kept the money and support coming, giving her the funds and the strength to fight for her life.

I'm so much more fun and I enjoy things more. I am excited about my life and that is so much better than being skinny.

–Camilla Kuhns, Night Baker

Five months ago, doctors told Camilla she could have a heart attack at any moment. Her eating disorder has controlled her life for 18 long years.

"This has been a crutch for me for so long," she said. "I just feel like I'm losing my crutch."
Camilla entered treatment terrified to let go of the habits that were killing her. But now, five months later, she has a new take on life.
"I feel so much better," she said. "I'm so much more fun and I enjoy things more. I am excited about my life and that is so much better than being skinny."
Her family is grateful to have this Camilla back.
"I have my daughter back," said David Kuhns, Camilla's father. "She is fun. She's energetic. She's all the things that I knew she was."
Camilla said treatment wasn't easy. She wanted to quit many times, but she knew people all over the world were praying for her.

My dream as a child was to grow up and not be an anorexic woman. I'm getting back to that person who has other dreams, better dreams, and it is just a really good feeling.

–Camilla

"They really saved my life by following the blog and reminding me that I had an audience and that it wasn't just about me," she said.

Camilla didn't realize the full impact she'd had on others until she met a woman who went into treatment because of Camilla's story.
"It's so humbling because this woman is so incredible and she has a family and she is so successful," she said. "I though that if this is the only person who saw my story and got anything out of it then it was so worth any ridicule I've gotten from sharing my blog."
Camilla hasn't completely conquered her eating disorder.
"It's still there and it yells at me sometimes, but I feel like my voice is louder now," she said.
For the first time in almost twenty years, Camilla said she finally feels in control of her future.
"My dream as a child was to grow up and not be an anorexic woman," she said. "I'm getting back to that person who has other dreams, better dreams, and it is just a really good feeling."
Camilla will receive a few more weeks of outpatient treatment at a center in Arizona as she makes the transition back into the real world.

 

From 58 pounds to thriving By Chelsea Roff

How yoga helped an anorexic recover

STORY HIGHLIGHTS

• Chelsea Roff nearly died from severe anorexia and its complications
• She spent 16 months in Children's Medical Center Dallas
• She says she was lucky to get enough resources to put her life back together
• Now, Roff wants her story to be a "beacon of hope" for others who might be suffering

Editor's note: In the Human Factor, we profile survivors who have overcome the odds. Confronting a life obstacle -- injury, illness or other hardship -- they tapped their inner strength and found resilience they didn't know they possessed. This week we introduce you to Chelsea Roff, who had a stroke at 15 brought on by her severe anorexia. At the time she arrived at Children's Medical Center Dallas, she weighed 58 pounds. Now 23, Roff is a writer, speaker and yoga instructor.

(CNN) -- The first emotion I remember is rage. It was a violent, fire-in-your-veins, so angry-you-could-kill-someone kind of rage.

I wanted out. I wanted the pain to be over. I wanted to die. I was mad at myself for not having the courage to just do it quickly, angry at the hospital staff for thwarting my masked attempt.

I was convinced that I was "meant to" endure this, that my long, drawn-out starving to death would prove my willpower to God. In the days prior to my stroke, I'd had vivid hallucinations -- of Jesus on a wooden cross outside my bedroom window and a satanic figure sneaking up under my bedroom covers to suffocate me at night. I thought I was meant to be a martyr. I thought God wanted me to die.

As the fury subsided, delirium set in. I became confused, defiant and completely irrational. I told the doctors that they couldn't possibly keep me overnight, because my family didn't have insurance or money to pay. When a cardiologist responded that she wasn't sure if I'd live another week, I told her she was full of s---.

I hid the food they were trying to make me eat in my underwear, in flowerpots, even in my cheeks like a chipmunk -- certain no one would notice. I didn't want to get better. I was convinced nothing was wrong.

I remember having nurses turn me over in the middle of the night to tend to the bed sores on my behind, places where the skin was so thin that my tailbone was starting to protrude through the flesh.

I remember waking up to discover I'd wet the bed nearly every morning for the first three months I was hospitalized. I was ashamed, disgusted. I'd lost control of the muscles in my bladder; I was like an infant all over again. I remember shooting a nurse the bird when she told me I couldn't walk, only to crumble to the floor when I angrily pushed the wheelchair away to give it a try.

Unbeknownst to me at the time, my arrival at the hospital had launched an investigation by Child Protective Services back at my home in Austin. The caseworkers deemed my mother an "unfit parent" and my sister and I were placed under custodianship of the state. My care was left to the doctors and nurses at Children's, while my sister was sent to live with our godparents. My mother, herself an alcoholic and anorexic, had literally drunk herself into oblivion (she was later diagnosed with Wernicke's Syndrome, a form of alcohol-induced dementia).

I spent the next 16 months of my life in that hospital. I completed my junior and senior years of high school through a distance education program, talked my way through hundreds of hours of individual and group therapy and slowly, painfully worked to bring my body and mind back to life.

When Medicaid finally pulled the plug on funding for my treatment, I was unrecognizable from the day I'd walked in. I'd gained nearly 40 pounds, and the feisty, fiercely independent spirit I'd been known for as a child was on her way back in (close to) full force.

Although I was still significantly underweight and terrified to leave the security of the hospital, my medical team managed to convince the caseworkers to grant me emancipation. At 17, I re-entered the "real world" as a legally recognized adult.

My doctor at Children's helped me make arrangements to move into a garage apartment with a close family friend near the hospital. I got a job at a local Starbucks, started applying for college, and, by the grace of who-knows-what, was offered almost free weekly therapy by a psychologist who'd treated me at Children's.

Three months later, I took my first yoga class. I was lucky. I was blessed. I was given enough resources to put the fragments of my broken life back together.

My hope is that my story might serve as a beacon of hope for people grappling with their own inner demons in silence and isolation. Whether it's an eating disorder, abandonment, depression or addiction, please know:

There is a way out. You don't have to suffer alone. There are people out there who want to love you, who would be honored to bear witness to your pain. Healing doesn't happen in a vacuum. We are human and we have an inherent need to see and be seen, to touch and be touched. No one heals heartbreak alone.

For the broader community, I hope this story will diminish some of the stigma and misperceptions about eating disorders. Many of us have been taught that people with eating disorders simply want to be skinny, feel like they have to look like supermodels to be worth anything, or just have an unhealthy "need for control." Those are all symptoms of an eating disorder, not the cause.

I realized that I feel like a child who was once desperately thirsty, who was given enough water to survive and shake her thirst, and now feels compelled to go out and give water to anyone who's parched. "Look! Water! I know, isn't it good?! Drink up!!" When I see people drink the water, I can't even describe the feeling -- it's as if I'm experiencing the first sip all over again. It brings me incredible joy, even healing. It's an act of alchemy. It allows me to make light of some of the darkest days of my life.

I once had a therapist who, when asked how I could ever repay her for all she'd given me, told me: "Your life will be all the thanks I need." This is how I thank her. This is how I thank all those who helped me find my way out of the darkness. Share the water.

Destination Recover(ed): Day 677

Thanksgiving was pretty awesome this year. In the past it has always been a chaotic time. Ever year I intend on arriving at my Dad's early in the morning so I can feel like I got to spend enough time over there before having to leave to go to my Mom's for second Thanksgiving (which is a fucking nightmare if you have an eating disorder. As if ONE Thanksgiving dinner isn't traumatizing enough). I never want to leave my Dad's house when it comes time to go and I always wish I had gotten there earlier so it could feel like I stayed longer. So far this has never happened. I'm always running late. If I want to be at Dad's by 9am it's almost guaranteed that I will actually make it there around noon. We do a pot luck Thanksgiving at my Dad's. Dad and Mom always do the turkey (this year they deep fried it. *Awesome* fun times not blowing the house up!) and stuffing and then everyone else brings a side dish. We sign up on the list. It's fun. I made fresh from scratch (NOT from a can) green bean casserole and also fresh homemade cranberry sauce (plus I brought the kind in a can for my sister, who loves it). This year I was ready! This year I was on schedule! Car loaded Thanksgiving Eve, ready to roll out of my driveway at 7am to drive from Stanwood to Shoreline to pick up my friend Natalie by 8am and then make the 1.5 hour drive to my Dad's arriving around 9:30am! No muss, no fuss, no chaos, no anxiety. 
Per usual I was late this year ... BUT not as late as the previous years, so we're making progress already! Last minute I decided to  prepare everything for my Mom that she wasn't able to get done because she was working back to back to back to back schedules at work. I think it's awesome that my Mom is the big head honcho where she works but it requires an obscene amount of her life, especially during the holidays where she is on blackout and isn't allowed to take days off and her company requires that she work until midnight on the eve of eves, and eves of holidays, and then turn around and be there at 4:00am the following mornings. So I felt bad this year and prepped all her food and recipes. I got in my car by 9:00am to go get Natalie. 2 hours late. DEAD FUCKING CAR BATTERY. Apparently when I loaded my car up before I went to go to bed (aka watch a movie because I actually didn't sleep for one second that night) I left the light on above the console. Awww MAN! Are you effing kidding me?! Unfucking believable! :::*pouty face*::: Mom to the rescue (which is completely out of character and uncommon for my Mom). She hands me her keys and says, just replace the gas so I can drive to work in the morning. OMG, am I actually going to be THANKFUL for my MOM this year?! Keys in hand, food and supplies transferred, on the road. I picked up Natalie, and after making a few stops (Walgreens and QFC for the alcohol my Mom called to see if I could pick up) We were at my Dad's house 11:45am. Record Time. I may or may not have sped, but the fact that there was absolutely NO TRAFFIC may have also contributed. And the best part? We were the first to arrive! Everything else basically went off without a hitch, not exactly on schedule, but whatever, family was together, we food was eventually cooked and everyone was set at the table. We started a new Thanks Giving tradition, too. Normally we would go around the table and each give thanks for what we were thankful for that year, but this year was different. This is the first Thanksgiving since my grandpa passed away on December 1st last year. Last year he wasn't present at the table because hew as in the hospital, but we were all kind of in an emotional cocoon last year, everything was awkward without grandpa who was the always the Turkey Carver and giver of thanks and Grace sayer. This year, without grandpa, we started new traditions in his memory and it was beautiful and sad and I cried at the table. Mom carved the Turkey this year (because my DAD doesn't know how to carve a turkey and pulled out the power tools, so Mom took over). My sister Rashel was home this year after a very long year of her taking off to find herself. Dad & Mom weren't wrought with the pain of dealing with Rashel's absence and grandpa's last few days. My Sister Crystal is pregnant with my nephew, Jonah, and she is so beautiful at 8.5 months pregnant (and always) and her and her husband are so happy. My other sister, Shannon wasn't going through (and as everything panned out, never went through) a divorce. We weren't in the emotional turmoil of being at the hospital every single day for a month to be with grandpa and see him so ill. I wasn't just discharged from the hospital, the same hospital and subsequently the exact same room as my grandpa. Grandma wasn't crazy, or withdrawn from the grief. We were OK. We made it through the year. We survived. We had an abundance of love and reasons to be thankful this year. We do every year. I have an amazing family, and not just at holidays. I gave thanks for that this year. I gave thanks that I know we are not "normal" in the way that my siblings talk to each other every day and my sisters are my best friends. I gave thanks that we say I Love You when we see each other on holidays as well as Tuesdays or because it's a Saturday. I gave thanks that I can send my Dad a text at 4am on Monday morning because I just felt like telling him I was thinking about him and he'll text me back and say he loves me and thanks for making his day. I gave thanks that I can open my email and see a random message from my grandma that she loves me and "That Is All". I gave thanks for Scarlett and Sandy for their patience, unconditional love and belief in me. And I gave thanks that for this day, I was able to be present in my life and not worry about the food I was giving thanks for. I was able to engage in conversation and comprehend when people talked to me. I gave thanks that I wasn't bundled up in blankets, looking gaunt and dead, just trying to make it through sitting at the table because I didn't have the strength to hold myself up and the chair was so painful to sit on because my bones protruded and there was nothing to protect them. I gave thanks that my mind wasn't cluttered with my eating disorder, although it was still present it wasn't loud, and it wasn't in charge. Another day with my eating disorder so present is what I strive for. It's my proof of my recovery. It's the bounty of all the hard work and the painful days. It's something tangible that I can say OK, so this is what it's like. Now I know. It's not just like working your ass off doing the the fucking impossible without a clue of what you're actually working towards ... you can't miss what you don't know, and I feel like sometimes I'm just working blindly, not knowing what exactly the payoff really is going to be, other than this "word" recovery ... which means "not dying" "healthy" "not sick" but you don't know what the FEELS like, you just know that you don't want to die, that you don't want "this" anymore, that you're tired of fighting, that "something" has to change. Recovery. You just want recovery. So you do the work. You cry the tears and you scream because it's hard. Some days it's impossible. And you fight, anyway. But you don't know what it's going to be like. You're taking a giant fucking leap of fate, feet first without knowing where you're going to end up ...  I suppose it's like a blind person trying to imagine color. How do you do that? Where would your brain go to know what the color RED is if you've never seen it before? I decided to blog about this because for one day, for one meal, I was free. Whether or not I decided to eat or try food, it didn't matter. I was thinking about my family, present, engaged in conversation, laughing, crying, being alive. This is what it's going to be like to be recover(ed), and while I may be a long long ways from recovery, I am recovering.

World Diabetes Day, We're Celebrating with a New Location!

19940 Ballinger Way
Shoreline, WA 98155

Exercise May Delay Early Aging of People With Diabetes

Fitness training improves their cardiovascular health, preliminary study finds


FRIDAY, Oct. 19 (HealthDay News) -- Regular exercise may slow the premature aging of the cardiovascular system that occurs in people with type 2 diabetes, according to new research.

A healthy adult loses about 10 percent of fitness with each decade of life after age 40 or 50, but research shows that fitness levels in people with type 2 diabetes are about 20 percent lower than in healthy adults.

This accelerated loss of fitness increases the risk of early disability and death, said Amy Huebschmann, of the University of Colorado School of Medicine, and colleagues.

"Not only do these patients have more trouble with exercise ... but also with activities of daily living, such as a simple stroll to the corner store," the researchers said in an American Physiological Society news release.

The investigators confirmed other research, however, that has found that regular exercise can slow premature cardiovascular aging in diabetes patients. The findings suggest that their fitness levels can improve by as much as 40 percent after 12 to 20 weeks of exercise training.

"In other words, these defects are not necessarily permanent," Huebschmann said. "They can be improved, which is great news."

Regular exercise, however, does not restore diabetes patients' fitness levels to those of healthy adults, according to the findings. The research was presented last week at an exercise conference in Colorado sponsored by the American Physiological Society, the American College of Sports Medicine and the Canadian Society for Exercise Physiology. Data and conclusions presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal

Although exercise can benefit diabetes patients, it may be difficult for them to achieve the recommended 150 minutes per week of moderate exercise. Huebschmann and her colleagues are working on ways to help diabetes patients reach their exercise goals.

"Type 2 diabetes has a significant negative impact on health, but that impact can be improved with as simple an intervention as regular brisk walking or other physical activity that most people with diabetes can do," Huebschmann said.

More than 8 percent of the U.S. population has diabetes, mostly type 2, according to the U.S. Centers for Disease Control and Prevention. With type 2 diabetes, the body can't properly process glucose, the main type of sugar in the blood.

The U.S. Centers for Disease Control and Prevention explains how to stay healthy with diabetes.

New Day Northwest Features Ramey Nutrition!

Ramey Nutririton is on New Day Northwest!

Get Ready for Beyond Type 2!

Get Ready for Beyond Type 2!
Starts January 2013 with Kaitlin Todd, RD, CD!
http://www.rameynutrition.com/beyond-type-2-diabetes-program

First Rule of Fight Club....

Welcome to Fight Club – with Ramey Nutrition!
Fight Club is an 8-week program for men designed to tackle the toughest obstacles on the road to wellness. Facilitating a community of support, Fight Club directs members to honestly identify what they are fighting for (or against) and confront their current strategies and tactics for achieving victory.
Kaitlin Todd, RD, CD will lead group talk time on Mondays from 5:00 to 6:30PM followed by Boxing to release issues and regain power physically and emotionally, which will be led by Jason Steele from 6:45 to 7:30PM.
What’s been holding you back from the passions in your life?
Maybe you’ve had a heart attack, stroke, knee replacement or back surgery and have been challenged by unexpected physical limitations?
Maybe your daughter has been restricting her food intake for years and struggling to recover from Anorexia?
Maybe you consider yourself incredibly disciplined with your food and exercise plan Monday through Friday, only to find yourself binging on “forbidden” foods on the weekend?
Perhaps you go out of the way to avoid the mirror because you are disgusted by what you see in the reflection?
Maybe you openly joke about your shape or size only to beat others to the punch line?
Kaitlin Todd, RD, CD will lead group talk time on Mondays from 5:00 to 6:30PM followed by Boxing to release issues and regain power physically and emotionally, which will be led by Jason Steele from 6:45 to 7:30PM.