Orthorexia

A controversial condition that walks the line between healthy eating and so-called “perfect eating” / healthism. Sometimes, in a quest to nourish our bodies in the most beneficial way, nourishment become so restrictive that every meal becomes compulsively calculated, or worse, a person may stop eating altogether as there is a supposed flaw with nearly every food. We may starve our bodies as a result.

Wikipedia notes that the term orthorexia comes from the Greek words “orthos” and “orexis”, meaning “right diet.” This condition is not to be confused with anorexia, where the underlying drive is thinness. In orthorexia, the motivation is one of eating as healthily as possible. Sometimes, however, those with orthorexic symptoms become confused with those with anorexic symptoms, as the result of orthorexia can be extreme weight loss. Orthorexia symptoms are also sometimes seen as a form of Obsessive Compulsive Disorder due to the extreme anxiety and corresponding rituals that can be formed around food consumption.

Wikipedia quotes the man who coined the term orthorexia, Dr. Steven Bratman as suggesting two screening questions for orthorexia:

• “Do you care more about the virtue of what you eat than the pleasure you receive from eating it?”
• “Does your diet socially isolate you?”

Other self-test questions may serve as a useful starting point.

If you think that orthorexia may be an issue for you, I invite you to contact me today. Cognitive behavioural therapy or other therapeutic approaches may be helpful. To me, the important thing is not to make judgements about patterns of eating or particular types of foods, debating whether they are healthy or not, good or bad, but rather, to look at those points where your eating choices are interfering with your ability to live normally.

Body Dysmorphic Disorder

People suffering from body dysmorphia believe that one part, or several parts of their body is abnormal and develop tremendous anxiety around this perception. Large parts of the day may be spent obsessing about the perceived physical flaw. When symptoms are more severe, delusional thinking may result.

With body dysmorphia, symptoms of depression, anxiety and withdrawal from social situations may occur. Suicidal thoughts may also be present. Other signs and symptoms of body dysmorphic disorder include:

• Frequent self-examination in the mirror or refusal to look in mirrors, have photographs taken etc.
• Believing that others can notice the so-called physical flaw or refusal to believe others’ perception that the “flaw” is not serious
• Skin picking, particularly as the skin is a common target of dysmorphic thinking
• Compulsive hair plucking (trichotillomania), another common body target
• Use of make-up to cover the perceived physical flaw, or in some cases, plastic surgery

Treatment may include psychotherapy, medication or a combination of the two. Feel free to contact me if you would like to get started.

Emetophobia

In my Vancouver counselling and therapy office, I have met with numerous people with what are known diagnostically as “simple phobias“. Emetophobia, or the fear of vomiting, is a potentially serious condition as it can cause people to severely restrict their food intake out of fear of becoming sick. This is not to be confused with anorexia, where the motivation is thinness, although the physical consequences for both conditions may be similar. In an effort to avoid vomiting, people suffering from emetophobia may force their bodies never to throw up, even when this is naturally a symptom of other conditions, such as gastroenteritis. Fears of getting sick may also prompt some people to misuse medications such as Gravol.

Historically, I have often used cognitive behavioural therapy (CBT) to treat emetophobia, which includes graduated exposure. Rest assured that this therapy is done gently and collaboratively. The goal is to quell the anxiety and panic associated with the fear of vomiting, NOT to force you to vomit and be okay with this. More recently, I have been drawing from internal family systems therapy, mindfulness and relational psychotherapy.

To learn more about this condition, local Registered Clinical Counsellor, Anna S. Christie has written an excellent and very comprehensive article on the topic, the best I’ve seen.