Let’s Talk About Orthorexia: Interview with Author Renee McGregor

by Mental Movement Magazine

Orthorexia Definition: an obsession with eating foods that one considers healthy; a medical condition in which the sufferer systematically avoids specific foods that they believe to be harmful.

Have you stopped to notice that it’s actually become somewhat socially acceptable to obsess over the food we eat? If we haven’t followed every clean eating/meal prep account on Instagram or replaced all perceived “bad foods” with the “good foods” then we are certainly hyper-aware of the food choices we make every single day.

Although this doesn’t place every food conscious person with Orthorexia, there are certain red flag traits that could mean our perceived healthy food choices are in fact, a guise for this serious eating disorder.

This is the premise for exploration and understanding in Renee McGregor’s latest book Orthorexia: When Healthy Eating Goes Bad. One of the UK’s top sports nutritionists, Renee advises athletes from amateur to Olympic level and holds the position for Nutrition Lead at the charity, Anorexia & Bulimia Care.

We caught up with her to talk about some of the topics raised in the book and to gain some much-needed insight into this often masked modern day epidemic.

First of all, we are really pleased to see your book in our ‘shelf-help’ bookcase. Not only an easy to pick up, easy to read kind of book but one that is pretty jam packed with everything we needed to know about the impact, signs and symptoms of Orthorexia. With the rise of trends in lifestyle choices such as veganism, gluten-free, paleo and other plant-based diets – would you say there is a certain unawareness attached to people suffering symptoms of mental ill health because Orthorexia seems so successful in hiding beneath the guise of being ‘healthy’?

Renee McGregor: Absolutely, today’s society seems to have made it very easy for any new food fad or trend to be labelled “healthy”. This is also indeed why  Orthorexia is presently not a diagnosable eating disorder within the DSM-5, Diagnostic and statistical manual of mental disorders. Not everyone embarking on a plant-based or gluten-free diet is necessarily going to develop Orthorexia, but those that are susceptible can definitely hide behind it as it provides a perfect smoke screen for the real issues that are going on- it looks plausible that they are following a new way of eating to improve their overall health.

What are some of the physical implications to Orthorexia? How dangerous is this for our overall health?

Renee McGregor: It’s important to highlight that not everyone who embarks on a new eating fad or food restriction is going to put their body under stress. However, the key issue with Orthorexia is that it is the pursuit of being “pure or clean”. So what may start out as deciding to become vegan for health and ethical implications, when this doesn’t provide the “comfort” or the outcome the individual is searching for, this can soon turn into further restrictions. So for example, they may also become sugar-free and then gluten-free and so on and so on. This of course then becomes a very restrictive diet that is deficient in vital nutrients for all the processes that are going on in the body.

In a similar way, individuals that follow a very low carbohydrate diet will suffer from physical manifestations such as headaches, low energy, constipation and also bad breath. While many advocates of a low carb diet will report that these early symptoms will pass, the long-term effects to their digestive, hormonal and bone health are often ignored.

One of the fundamental pre-occupations for people suffering from Orthorexia comes from a need to implement the ultimate healthy-eating lifestyle. Oftentimes, this laser-focus on achieving supreme optimum health is supported by the companies, brands, bloggers and social media influencers fuelling these trends; normalising what is actually a rather unhealthy response to food. It feels like a complete minefield out there, so how do we separate ourselves from all of this when we are so deeply invested and can’t differentiate between what’s good for us and what isn’t? Where do we begin?

Renee McGregor: That’s such a good question and actually a very valid point. It is really important to highlight here that those susceptible to Orthorexia, searching for a way of self-improvement and becoming more “comfortable” with themselves through food choice, are more likely to believe these influencers fuelling pseudoscience and fads. This is because once you are in that mindset, you are continually looking for validation that the food rules you have adopted are true; individuals with eating disorders work very hard at maintaining it, as this is what keeps them “safe” from the disharmony and negative emotions that really need addressing but feel too uncomfortable.

Those that are more balanced with their approach are more likely to decipher between what if fact and what is fiction; anything that is too extreme and removes whole food groups should be questioned. Any new way of eating that claims a particular collection of weird and wonderful food ingredients that will lead to everlasting health, youth and energy is unlikely to be supported by the necessary evidence. Look at where the information is coming from –if it’s a food or health blogger, check their credentials –should they really be giving out nutritional advice if their background is history of art?

The last thing to be wary about is that the term “nutritionist” is not regulated here. Many individuals who do not have a degree level qualification in nutrition are able to call themselves nutrition experts, without having the necessary biochemistry and physiological knowledge to provide accurate advice. Always look for individuals who are either Registered Nutritionists or Registered Dietitians.

Self-awareness and becoming mindful about the over-information we consume every day via social media channels, blog and vlogs is evidently a huge part of recovery. As a nation, we are addicted, over bombarded by misinformation masquerading as fact and at an all-time low with self-esteem and confidence. Although most of us are aware of this, we have serious FOMO (fear of missing out) which prevents us from implementing positive changes. What positive steps could you recommend to anyone overindulging and trapped in a loop of looking at all things healthy, clean, fitness-related and obsessing over unrealistic in terms of body and health goals?

Renee McGregor: Firstly remember that what we see on social media is just a snapshot of time; we have absolutely no idea if it is actually the truth.

Secondly, you should never compare yourself to anyone else but yourself –no two people are the same and so drawing comparisons is futile. Instead celebrate your successes no matter how small and focus on what you offer others. Remember that friendships and relationships are a two-way street so if you are gaining something from being connected to an individual, then it is likely you equally offer them something in order for them to be part of your life.

There is no such thing as perfect – it’s unrealistic to pursue this path as it will never bring you happiness; there is only good enough and it is your choice to accept this.

While you may have many thoughts, remember that you don’t have to act on any of them; for example, if you are someone who is always critical of yourself, remember that this is just a thought –you do not have to believe this is true. You can actually choose to leave that thought and go through your memory bank to remind yourself of what you are capable of.

Finally remind yourself that no matter what you do, you can never change someone’s perspective of you but you can change your perspective on the given situation.

In your book, you talk about how all foods are your friends and highlight how we often tend to categorise foods as “good” or “bad”, which you make a habit of not doing. This really helped me to recognise how detrimental my own actions with food are and the negative self-talk that comes with that when I decide to eat or drink something that I believe to be bad for me (because Vogue told me last month). You explain how this impacts our responses and how breaking our ‘belief systems’ often evoke feelings of guilt and shame. For people really struggling to alter these thought processes but not quite ready to take the leap of working on it in a therapeutic setting, are there any other ways we can combat the negative self-talk associated with how we interact with food?

Renee McGregor: I don’t believe in demonizing any food as there is no one food that I going to cause you to become unhealthy, put on weight or make you ill. One big step you can take to change your relationship with food is to remind yourself that a healthy diet is actually about the nutritional balance we achieve over a period of time of time; it is not specific to each day. This means that if we have a few days where things don’t quite go to “plan” it’s not the end of the world, nothing awful is going to happen because as long as we achieve balance overall, then no harm is done. This can be difficult for those stuck in a negative mindset about food –one of the only ways to overcome this is to challenge behaviour with a new behaviour. The more you make this your “deliberate practice” the more this becomes the new “normal”.

Finally, many of us set ourselves up to fail as we over-restrict or deprive ourselves of foods that our bodies actually need; this creates a need and at some point, we may find that we succumb to our “cravings” resulting in a negative narrative and a sense of failing. When you don’t restrict then your body is satisfied and you rarely find that you “overindulge” or “break rules”.

Let’s talk about that really bland word ‘moderation’. I was so happy to see you had picked up on this in your book and felt relieved that someone was finally exploring this. We know that all things in moderation are better for us when achieving balance but, it’s never ‘on trend’. Do you think this is likely to change? Is this something you’d like to see or do you think that could create new problems?

Renee McGregor: I think the main issue with “moderation” is that nobody actually knows what it means as in reality one size does not fit all. If you are someone who is highly active then “moderation” will mean something completely different to an individual who is more sedentary. In a similar way, the term moderation implies time and everyone wants a quick fix. As a population we are impatient and often don’t want to put the hard work in; it is much easier to follow a “rule” which often does result in an outcome but usually comes at the cost of your health.

I would love people to start working out what nutrition means for them; individuals need to relearn the ability to listen to their bodies as 99% of the time, it knows exactly what we need and when.

Talking about the language we use to describe certain foods, do you think to describe foods as ‘clean’ and ‘dirty’ are actually really dangerous in terms of how we perceive ourselves in relation to them? What would be better alternatives that we could adapt and encourage instead?

Renee McGregor: This is my biggest concern about the increasing use of #clean as it does imply that if you don’t eat in this way then somehow you are eating dirty. Even for the most emotionally robust individual, this can cause concern. Personally, I prefer the terms nutrient dense and non-nutrient dense –I feel this helps to describe the food and then also provides an element of choice. I’m not saying that you should never eat non-nutrient dense foods but it does provide you with some guidance that these should not be included every time you eat. I think people will also be surprised as to what foods would be listed under which category. So from my point of view shop-bought, almond milk would be non-nutrient dense as when you look at the majority of brands in the supermarket, from an energy, protein, vitamin and mineral point of view this product is devoid. A food that I would consider nutrient dense would be whole grain bread as it provides energy, fibre and B vitamins.

Through our work with Mental Movement Magazine, we have often noticed that those in recovery of eating disorders such as anorexia and bulimia are now completely obsessed with health and fitness to the point that it does appear to be, unhealthy. Would you agree this is ‘a thing’ and if so, how would loved ones go about responding and helping those who may be unaware of the transition from one eating disorder to another?

Renee McGregor: Unfortunately, this is a big problem. While individuals in recovery want to “recover” they still have huge fears around food and in particular those foods they deem unhealthy. Again, social media influencers provide ammunition for this and so many recovering become stuck in a new method of control. And this is the bigger picture – remember that eating disorders are mental health illnesses and are really not about food or body image. They are about deep emotionally rooted issues that the individual is not prepared or ready to address as it feels too uncomfortable. Fixating on food restriction, weight or quality of food is much easier, even though it creates just another problem to cope with. Those in recovery often have to restore weight and maintain this for a good period of time before the real work on their mindset and behaviours can be tackled. For this reason, they will often move from one method of coping to another. Just being aware that this can be an issue makes it a little easier to deal with, It takes a long time to recover from an ED and involves a multi-factorial approach where behaviours are challenged.

In terms of educating the younger generation about the impact of Orthorexia, what do you think schools, places of study, shops or gyms could do to ensure we are opening important conversations in helpful ways? What needs to be changed and addressed to ensure we are aware of unhealthy obsessions before it becomes a part of the way we live our lives?

Renee McGregor: I think there needs to be more work done in schools and places of study around social media –the positives and the negatives –helping students to appreciate that not everything they see is truth. Similarly, gyms and shops need to create a space that is inclusive of all –I feel images should be diverse from physiques to ethnic origin and we should be celebrating how wonderful our bodies are regardless if what they look like.

I also think that more needs to be done around education so that schools and the fitness industry have an increased awareness of how to spot the signs but also how to approach the subject and communicate. (Anorexia and Bulimia Care, the National Eating Disorder Charity have developed online courses for this exact purpose).

I also would like to see more legislation around food marketing and promotion. As soon as a trend hits, it is not long before food brands seem to be cashing in which suggests that indeed these trends such as high protein, gluten-free and sugar-free are what we should all be striving for.

If you are interested in reading Renee’s latest book and want to learn more about, Orthorexia, Orthorexia: When Healthy Eating Goes Bad, by Renee McGregor, Nourish 2017 is available to buy for £8.99.

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