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Old 03-02-2009, 11:01 AM   #1
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Orthorexia

Another form of overbearing anxiety inducing parenting..some balance and moderation is in order, I think

NY Times

February 26, 2009

What’s Eating Our Kids? Fears About ‘Bad’ Foods

By ABBY ELLIN

SODIUM — that’s what worries Greye Dunn. He thinks about calories, too, and whether he’s getting enough vitamins. But it’s the sodium that really scares him.

“Sodium makes your heart beat faster, so it can create something really serious,” said Greye, who is 8 years old and lives in Mays Landing, N.J.

Greye’s mother, Beth Dunn, the president of a multimedia company, is proud of her son’s nutritional awareness and encourages it by serving organic food and helping Greye read labels on cereal boxes and cans.

“He wants to be healthy,” she says.

Ms. Dunn is among the legions of parents who are vigilant about their children’s consumption of sugar, processed foods and trans fats. Many try to stick to an organic diet. In general, their concern does not stem from a fear of obesity — although that may figure into the equation — but from a desire to protect their families from conditions like hyperactivity, diabetes and heart disease, which they believe can be avoided, or at least managed, by careful eating.

While scarcely any expert would criticize parents for paying attention to children’s diets, many doctors, dietitians and eating disorder specialists worry that some parents are becoming overzealous, even obsessive, in efforts to engender good eating habits in children. With the best of intentions, these parents may be creating an unhealthy aura around food.

“We’re seeing a lot of anxiety in these kids,” said Cynthia Bulik, the director of the eating disorders program at the University of North Carolina at Chapel Hill. “They go to birthday parties, and if it’s not a granola cake they feel like they can’t eat it. The culture has led both them and their parents to take the public health messages to an extreme.”

Tiffany Rush-Wilson, an eating disorder counselor in Pepper Pike, Ohio, has seen the same thing. “I have lots of children or adolescent clients or young adults who complain about how their parents micromanage their eating based on their own health standards and beliefs,” she said. “The kids’ eating became very restrictive, and that’s how they came to me.”

Certainly, not all parents who enforce rules about healthy food — or any dietary plan — are setting their children up for an eating disorder. Clinical disorders like anorexia nervosa and bulimia, which have been diagnosed in increasing numbers of adolescents and young people in the last two decades, are thought by researchers to have a variety of causes — including genetics, the influence of mass media and social pressure.

To date, there have been no formal studies on whether parents’ obsession with health food can lead to eating disorders. Some experts say an extreme obsession with health food is merely a symptom, not a cause, of an eating disorder.

But even without firm numbers, anecdotal reports from specialists suggest that a preoccupation with avoiding “bad” foods is an issue for many young people who seek help.

Dr. James Greenblatt, the chief medical officer at Walden Behavioral Care, a hospital specializing in child and adult eating disorders in Waltham, Mass., estimates that he has recently seen about a 15 percent rise in the number of his young patients who eat only organic foods to avoid pesticides.

“A lot of the patients we have seen over the last six years limited refined sugar and high fat foods because of concerns about gaining weight,” he said. “But now, these worries are often expressed in terms of health concerns.”

Lisa Dorfman, a registered dietitian and the director of sports nutrition and performance at the University of Miami, says that she often sees children who are terrified of foods that are deemed “bad” by parents. “It’s almost a fear of dying, a fear of illness, like a delusional view of foods in general,” she said. “I see kids whose parents have hypnotized them. I have 5-year-olds that speak like 40-year-olds. They can’t eat an Oreo cookie without being concerned about trans fats.”

Dr. Steven Bratman of Denver has come up with a term to describe people obsessed with health food: orthorexia. Orthorexic patients, he says, are fixated on “righteous eating” (the word stems from the Greek word ortho, meaning straight and correct).

“I would tell them, ‘You’re addicted to health food.’ It was my way of having them not take themselves so seriously,” said Dr. Bratman, who published a book on the subject, “Health Food Junkies,” in 2001.

The condition, he says, may begin in homes where there is a preoccupation with “health foods.”

Many eating disorder experts dispute the concept. They say that orthorexia, which is not considered a clinical diagnosis, is merely a form of anorexia nervosa or obsessive compulsive disorder.

Angelique A. Sallas, a clinical psychologist in Chicago, says the idea of a “health food disorder” is practically meaningless. “I don’t think the symptoms are significantly different enough from bulimia or anorexia that it deserves a special diagnostic category,” Dr. Sallas said. “It’s an obsessive-compulsive problem. The object of the obsession is less relevant than the fact that they are engaging in obsessive behavior.”

Dr. David Hahn, the assistant medical director at the Renfrew Center, an eating disorders clinic in Philadelphia, also thinks that orthorexics are anorexics in disguise. “I see many patients that are overly concerned with the quality of their food, and that’s the way they express their eating disorder,” he said.

But whatever the behavior is called, those who have lived through a disorder fueled by an obsession with healthful eating say that the experience can be agonizing. Kristie Rutzel, a 26-year-old marketing coordinator in Richmond, Va., began eliminating carbohydrates, meats, refined sugars and processed foods from her diet at 18. She became so fixated on eating only “pure” foods, she said, that she slashed her daily calorie intake to 500. Eventually, her weight fell to 68 pounds and she was repeatedly hospitalized for anorexia.

Today Ms. Rutzel, who said she is normal weight, often talks to young girls in schools and churches about the perils of becoming health-food obsessed.

Laura Collins, a writer who lives in Virginia, was once a parent who was always “moralizing about good and bad foods,” she said. “We didn’t serve candy, my kids didn’t have soda.” Ms. Collins’s daughter, Olympia, became rigid in her eating, fearing food that she worried would make her unhealthy. By age 14, Olympia developed anorexia, her mother said. To help her recover, the family had to rethink its entire approach to food.

Some experts are quick to point out that it is not only parents who may contribute to children’s food anxieties. They cite nutritional programs in schools that may go overboard. “I see younger kids who have an eating disorder precipitated by a nutrition lesson in school,” said Dr. Leslie Sanders, medical director of the eating disorders program at Atlantic Health Overlook Hospital in Summit, N.J.

Over the last five years, Dr. Sanders said, she has seen a rise in the number of children who are fixated on the way they eat: “Some educators categorize food into ‘good’ and ‘bad.’ The kids come home and say ‘Don’t eat French fries’ instead of talking about moderation.”

The problem, according to some nutritional experts, is that many teachers don’t understand nutrition well. “We’re driving our kids absolutely crazy,” said Katie Wilson, president of the School Nutrition Association. “All the stuff about preservatives and pesticides. All an 8-year-old kid should know is that he or she should eat a variety of colors, and don’t supersize anything but your water jug.”

Nina Planck, author of “Real Food: What to Eat and Why,” said that it’s a “total cop out” to lay blame on schools and parents for children’s eating disorders. “The eating disorder comes out of a disordered psyche,” she said. “You can’t blame the information for causing the eating disorders.”

But Jessica Setnick, a dietitian in Dallas and author of “The Eating Disorders Clinical Pocket Guide,” tells a story that suggests parents’ attitudes can affect children. She recalled a mother who brought in her preteen, apparently bulimic daughter. As Ms. Setnick discovered, the girl was not trying to lose weight. “Her mother only served brown rice, but she didn’t like it,” Ms. Setnick said. “She did like white rice. And while I’m not going to tell anyone what they can bring into their own home, we discussed that when the family went out, it would be O.K. to get white rice.”

When the girl told her mother what Ms. Setnick said, the mother was furious, according to Ms. Setnick. “She said, ‘Don’t you know white rice is just like sugar?’ ”

“My heart broke for that girl,” Ms. Setnick said. “She was telling her mother what she needed, and the mother wasn’t listening.”

Ms. Collins, the author of “Eating with Your Anorexic,” a book about her daughter’s struggle with anorexia, and director of the nonprofit organization Feast (Families Empowered and Supporting Treatment of Eating Disorders), offers some perspective.

“It’s a tragedy that we’ve developed this moralistic, restrictive and unhappy relationship” with eating, she said. “I think it is making kids nutty, it’s sucking the life out of our relationship with food.”
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Old 03-02-2009, 02:17 PM   #2
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I don't believe the hype about food nazis. We live in a country where obesity, and all the health related problems associated with it are at the top of the list of our health problems.

The vast majority of kids eat way too much crap when they are young and this carries over into the rest of their lives.
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Old 03-02-2009, 03:04 PM   #3
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Oh dear. While its obviously good that these kids are mindfull of what theyre eating, it shouldnt get to the point where they worry over it. Kids can take things quite seriously, we wouldnt want them to go too far and develop eating disorders.
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Old 03-02-2009, 04:10 PM   #4
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I'm a firm believer in balance and moderation. When I felt that I was bordering on being heavy and unhealthy, I didn't obsess about every calorie or count carbs, fats sugars....I just focused on eating things that were more fresh, eating a wider variety, and eating less overall. My latest bloodwork shows everything in the optimal range and my BMI right where I want it. I think that most people who eat poor diets already know it. I know I did, I just had to choose to actually do something about it.

Based on what I've seen, many parents need to worry more about their kids' sedentary lifestyles then nitpicking their diet.
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Old 03-02-2009, 04:20 PM   #5
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What's saddest to me is I think some of the parents (and let's face it: it's probably mostly the moms ) that are obsessing over the "good foods" / "bad foods" aren't doing it just because it's a healthier option. I think for some of these folks, it's because it gives them a sense of superiority - 'Look at how much more I care about my family because I put so much effort into selecting the best/purest/safest/healthiest foods. I'm obviously a superior parent to you, with your non-organic peanut butter and mass-produced jam on (horrors!!!) refined flour white bread. Gasp!!!'

Take a child who wants to be just like Mom or Dad, add the constant reinforcement that certain food is bad and other food is good, and it's no surprise that eating disorders are now showing up in children (both girls and boys) as young as 8 or 9. I mean, really - "Don't you know white rice is just like sugar!" - huh?

Moderation folks.... in all things, moderation.

ETA: Liesje typed her reply much faster than mine - but she summed up pretty succinctly what I rambled about: moderation.
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Old 03-02-2009, 04:20 PM   #6
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There is some truth to the stereotype that children are particularly prone to extremely moralistic (overblown sense of justice) and/or 'taboo'-driven (neurotic obsessions with purity/impurity) type thinking. Not all of them certainly, and obviously many adults have such hangups too, but I think most parents would readily agree that for whatever reason this tendency just is more prevalent in children. Our oldest son is a bit like this, not with food but with various other things, and sometimes when I hear myself saying "Akiva, relax--let them find their own way to do this, that's OK" or the like, it cracks me up because I remember my own parents constantly saying the same thing to my little sister, who had (and still has) a similar personality. It's probably impossible to completely avoid triggering it if your child inclines towards it, but certainly presentation matters; for instance if you wish to share with your child some dietary custom or restriction that you as an adult recognize to be a matter of personal choice, then it's best not to frame it to them in terms of wholly Good or Bad, Pure or Impure. And a five-year-old doesn't need to be regaled with litanies about trans-fats and glycemic index values to eat healthily--simply getting across that Oreos or whatever are a special treat to be enjoyed on special occasions, not an everyday snack, is plenty adequate.

I think it's also important to recognize that the more extremist-sounding parents cited in the article are probably acting as much if not more out of exaggerated fears of "poisoning" their children, becoming a Bad Mom who failed to save their kids from developing the kinds of unhealthy eating habits that can lead to bad teeth, excessive weight gain or hyperactivity, as they are out of some draconian determination to engineer the "perfect," dutifully nutritionally exemplary child.

I do agree with Lies and deep though that parents who don't even try to cultivate healthy diet and exercise habits (in themselves or their children) and let their kids take in far too many of their calories in the form of pastries, soda, chips and pizza, while seldom getting any exercise, are a far more widespread problem.
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Old 03-02-2009, 04:27 PM   #7
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In addition to what I said earlier, I think parents these days give their kids too much choice, and they offer explanations when none are deserved. Now I never thought of my parents as mean, but when they put food down, we ate that or nothing. If we wanted a snack, we asked for one and if we got one it was whatever my mom decided. We did not ask "whyyyyyyyy can't I have a fruit snack?" and if we had, I know the answer would be "Because I am your mother and I say no." I used to babysit and nanny, and it was so much easier with kids who were trained to eat what was put in front of them than kids who were allowed to make requests and challenge every little thing. Now my family members who are teachers talk about the ridiculous things kids have in their lunches and how their parents are bending over backward every morning just putting their lunch together....for crap's sakes just shove an apple and a sandwich in the sack and if they don't want it they can "starve" until dinner time! Often Phil and I eat dinner with some friends who have two kids, and I know I've said to them before it's sad that I'm surprised when I see kids who simply eat what's set in front of them without a fit or an interrogation!
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Old 03-02-2009, 04:30 PM   #8
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....for crap's sakes just shove an apple and a sandwich in the sack and if they don't want it they can "starve" until dinner time!
QFT But that old devil "Guilt" is a great motivator in this.
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Old 03-02-2009, 04:53 PM   #9
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Getting kids involved in food prep can help with that...they're often more enthusiastic about the meal if they helped prepare it. Not that 'enthusiasm' ought to be a requirement, but it's nice when it happens. Generally we don't ask ours to help with weekday breakfasts (unless it's just cereal, which any schoolkid can do) or packed lunches though.
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Old 03-02-2009, 06:09 PM   #10
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I was an extremely picky eater. I honestly didn't even like eating at all, much less eating what was put in front of me. The thing is, I never really liked candy much so it wasn't that I was picky because I wanted to eat crap (I love pretty much every veggie, for example). But I had lactose intolerance and a number of other food allergies that made eating simply unpleasant.

My Mom grew up in a household where she was told to either eat what's on her plate or go hungry and that if she was "really" hungry, she'd eat. She said she spent years being miserable because she too was a picky eater and when she had her kids she vowed not to treat us that way. Therefore I never had to eat something I didn't like, I never had to finish my plate, and I freely informed her what I did and didn't like to eat. I guess I was an "easy" child in the sense that I didn't request unhealthy things so she got a break, but I have to say I loved growing up this way, in a sort of hippy-household where we were given a lot of latitude in many other respects as well (no bedtime, we could make choices about our religion, etc). And today, I love going out to restaurants, it's a big passion of mine, I really love baking, and I have no problem eating most things.

Just thought I'd offer a bit of a different POV.
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Old 03-02-2009, 06:22 PM   #11
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Food allergies is one thing....you don't strike me as the type of person who would ask for donut holes for breakfast (as in 10 of them) b/c "mom doesn't care", like the kids I used to nanny for. I think a grilled cheese is the healthiest thing I could even *find* in that house. I don't like tuna and I pick the crust off my wheat bread, but I remember one day I made a tuna sandwich for the little one b/c she liked it and I was so hungry from barely eating all day b/c all they had was junk food so sick not even I liked it, I was eating her rejected tuna sandwich crusts.
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Old 03-02-2009, 06:32 PM   #12
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Yeah, food intolerances and allergies are a whole separate issue I think. And I don't agree with forcing children to 'clean their plate no matter what,' but that's different from generally expecting them to make do with what's offered. It's a balance thing really; omitting a couple ingredients from your cooking in deference to a child's strong distastes isn't innately bad, but if you let it get much beyond that it often goes poorly. Our daughter absolutely loathes raisins, so we don't include them in family meals, which works out fine; on the other hand, a colleague of mine catered to her very strong-willed toddler's food preferences so much that for maybe a year he would ONLY eat fish sticks, French fries, Cheerios, and PB&J sandwiches (which had to be made with creamy peanut butter, grape jelly, and white bread, or else he'd throw a huge tantrum). Obviously at that point you have a case of letting the desire to please your child through food go too far; it just becomes a control battle, with the controller being the child which isn't how it's supposed to be.
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Old 03-02-2009, 06:45 PM   #13
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Yeah there's a difference between having choices and letting the kids control what the choices are. If I said "mom can I have a snack?" and I was old enough to get it myself, I'd probably end up with some strawberries or saltine crackers with cheese. Frozen meals, sweets, fried foods....we just didn't even have that around, too expensive.

I think it also depends on how the family as a whole treats food. For us it was just a necessary evil. My mom hates cooking and her cooking sucks monkey balls. My dad enjoys it more but because of his job he can be gone for a week or more at a time. I'm a picky eater as well but there was usually at least 1-2 things in the meal I could/would eat. For example, I don't ever make myself green beans but if the meal is pork and green beans, I'll eat the green beans. When I did gymnastics, I had to eat on my own b/c I needed to be out the door before dinner. Ironically, I ate the worst stuff at that time (though it had no effect since I was working out several hours a day).
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Old 03-02-2009, 10:22 PM   #14
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Yeah, food intolerances and allergies are a whole separate issue I think.
You'd be surprised at how many of my relatives would say things like "oh she's too spoiled" when I refused to drink milk or eat cream cheese or eat wholegrain bread (I really like it but I'm allergic to oats which are often in grain breads). Nevermind the teachers at school who would pontificate on how I'd have crumbly bones.

Truth be told I honestly don't even remember having snacks as a child. I think if we were hungry between meals, we would have some fruit or sometimes I remember making a piece of toast and spreading some peanut butter on it, or my brother really liked those Baby Bel cheese wheels so he'd have those. But I seriously don't remember us buying pre-packaged sugary snacks or anything of the sort.
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Old 03-02-2009, 10:58 PM   #15
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You'd be surprised at how many of my relatives would say things like "oh she's too spoiled" when I refused to drink milk or eat cream cheese or eat wholegrain bread (I really like it but I'm allergic to oats which are often in grain breads).
Quite different from these days where we have "peanut free" schools and churches to accommodate peanut allergies.
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