When Health Becomes Unhealthy

Originally published in LawTalk Magazine July 2017


As a health and wellbeing professional I spend a lot of time advising, encouraging and inspiring people to do more ‘healthy’ things.  We all understand that we need to look after ourselves to perform at our best, whether that’s physically, mentally or emotionally.

In New Zealand health is becoming a bigger issue than ever before.  The latest NZ Health Survey in 2015/16 found that 34% of adults 15 and over were obese and a further 35% of adults were overweight (but not obese).  From 2006/7 to 2015/16, the adult obesity rate increased from 27% to 32%.

These days, its seems that health is complicated – the information out there is overwhelming and often conflicting.  Everyone seems to be gluten-free, dairy-free, sugar free, organic, paleo or vegan, advocating for high intensity exercise or high volume endurance.  As a society, we also appear to have a tendency towards the extreme – if a little of something is good, then more must be better.

What can start out as a healthy interest in healthy food, exercise and lifestyle can quickly spiral out of control into a case of ‘orthorexia’. And it’s happening more and more often.

Orthorexia is a term first coined by Dr Steven Bratman in 1997 to describe how some people’s dietary restrictions in pursuit of health perfection leads to unhealthy consequences like social isolation, anxiety, loss of ability to eat naturally and intuitively, reduced interest in other human activities and in some cases malnutrition.  The focus is less on losing weight (such as in anorexia or bulimia) and more on achieving perfection in the form of a flawless diet and lifestyle.

Since looking after your health is considered socially acceptable (as it should be), and making sacrifices for your health, exercising extreme self-control, ‘eating clean’, and being ‘good’ are generally admirable qualities, this makes orthorexia complicated and the line between interest and obsession becomes blurred.

The increased trend towards orthorexia can be partly attributed to the images of perfection we’re continuously exposed to in social media and mainstream advertising, feeding our propensity to be critical of ourselves, our bodies and our eating patterns and pushing us towards more extreme behaviours in a bid to attain perfection.

So how do we know if we’re simply healthily health conscious or unhealthily health obsessed?

Some common signs of health obsession are:

Feelings of guilt after ‘unhealthy’ behaviours.  Most of us can handle an occasional treat without beating ourselves up – we understand that having some birthday cake or taking a day off from the gym every now and then isn’t going to undermine our health too much and is a part of life.  But if this idea is difficult for you, if it makes you anxious, angry or depressed when you start thinking about being out of routine, it’s time to examine this more closely.

Health as morality. Yes, some foods are ‘better for you’ than others but when you start to think of your food as ‘good’ and ‘bad’ it’s easy to get caught up in thinking about yourself as ‘good’ and ‘bad’.

This kind of thinking sets you up for failure, cultivates feelings of guilt and a need to punish yourself after you’ve been ‘bad’.  Before long, you’re thinking about how far you should run to ‘burn off’ that dessert or how many squats make up for that after work drink.  Having that occasional chocolate bar or burger may take you further away from your health goal, but it does not make you a ‘bad’ person and you do not have to ‘make up’ for it.

If you’re feeling excessively righteous and worthy for eating foods that you consider ‘good’ or ‘safe’, if you’re exercising because you think you ‘have to’ even when you don’t feel like it and if you feel anxious or self-loathing when you have ‘bad’ food or give yourself a day off from the gym, have a think about your values and the place of food and health within your world view.

Your world becomes smaller to fit your health requirements.  If you’re saying no to social engagements because you would rather go to the gym, if meals out stress you out because you don’t know if the food on offer fits your food rules then your life is being governed by your health and exercise practices.

You may find you get apprehensive and worried thinking about what you’re going to eat or how you’re going to get your exercise in when your routine is disrupted and out of your control, for example during a work trip.  There’s a difference between being organised and making the best choices for the situation you’re in and being dictated by your beliefs around healthy perfection.

When sticking to your health rules starts to affect other parts of your life to a large degree, and restricts what feel you can do, you’re becoming health obsessed.

A large part of your day is consumed with thinking about food and exercise.  We should definitely plan and be organised when it comes to what we’re eating during the week and when we’re going to get our exercise in, but if you find you spend most of your day thinking about what you’re going to eat, and stressing about what’s in it, or worried that an hour at the gym is not going to be long enough, consider if you have your priorities right.

When we’re preoccupied by thoughts of how to make healthiest choices it doesn’t leave much room to think about other aspects of our lives.

You over-exercise.  When you’re ‘pushing through’ your exercise and your body tells you it’s just too much but you have a ‘no excuses’ mentality. When it’s hard to get out of bed in the morning, you’re sore and achy all the time, you have continuous niggling injuries or you’re getting sick more often and your muscle mass is decreasing despite increased weight training your body is telling you it needs to rest and recover. If you’re carrying on regardless and you’re just not listening to your body, perhaps your ideas about health are getting too inflexible.

If any of these resonate with you, it’s time to take a step back and re-examine what being ‘healthy’ means to you.  Ask if your world is being limited by your beliefs about health and if your ideas of how you’re supposed to eat, exercise and live encroach on your behaviour or causes you guilt or anxiety.  Are you spending more and more time thinking about what you can and can’t eat or how much exercise will equate to your calorie intake?

Consider how the obsession with health started and whether it developed as a coping mechanism, for example as a means to control your life when things were out of control or distract you from something else that was happening at the time.  If you need help working through eating and health behaviours consider contacting a nutritionist, dietitian, counsellor, psychologist or health coach.

Reducing or eliminating junk food and getting regular exercise is by all means a good idea but becoming obsessive or compulsive about it all will impact on your mental, physical and emotional health.  Food serves a larger purpose for us than just providing nutrients.  Food is social and central to relationships and connection with family and friends.  It also becomes a political act when you take into account how where and what you buy.

A health-conscious person cares about their body; a health obsessed person freaks out over it.