Orthorexia is an unhealthy obsession with so-called healthy eating. Athletes are particularly susceptible to this pattern of disordered eating, because there are so many considerations around fuelling for training and performance. Orthorexia may accompany or be a precursor to other forms of disordered eating, such as anorexia nervosa (leading them to restrict permissible foods to green vegetables, for example, or fruit). It may also be linked to obsessive-compulsive disorder (OCD).
Appetite Journal recently published a literature review which suggests that an extreme focus on healthy eating can be a sign of mental health struggles, despite it not being in the DSM. Authors suggest that people with a history of perfectionism, dieting, a drive for thinness and fear of losing control are particularly susceptible to developing orthorexia.
Trent Stellingwerff is a physiologist and the Athletics Canada IST (integrated support team) lead. He says that his non-scientific definition of orthorexia is, “Someone who can’t eat apple pie at Grandma’s at Christmas time because it isn’t a clean food. The actual definition is really, really grey. There’s such a huge contextual element to orthorexia.” Stellingwerff says, “To win an Olympic medal or make national team it can take some nutrition interventions. But this doesn’t mean that you become a slave to it–nutrition can’t become compulsive or all about control.”
Eating a healthy diet is obviously desirable. Figuring out what constitutes a healthy diet can take many athletes (especially younger athletes) down an unhealthy path into orthorexia and other eating disorders if they lack correct information about nutrition. Many athletes can create a list of foods they don’t eat, which can cause big problems. Jennifer Mills, an author on the literature review, told the National Post, “For some, the list of forbidden foods can grow so long that their diet may be lacking in essential nutrients, which in severe cases can lead to health hazards such as anaemia, vitamin deficiencies or excessive weight loss.”
Many athletes and runners have to travel for competition, and those who struggle with control surrounding food can sabotage themselves come race day. If the place they’ve traveled doesn’t have food that they consider ‘healthy enough for consumption,’ then race day fuelling can suffer.
Stellingwerff notes that over the past two decades he’s seen a huge increase in orthorexia, which he believes is due to the prevalence of social media. For example, the hashtag #cleaneats has nearly seven million associated posts on Instagram. Stellingwerff says, “There are many people on social media portraying their diets and there’s a perception that you need to eat in a very specific way to be successful. Part of me would smile when Usain Bolt would talk about winning Olympic medals on Chicken McNuggets.”
It’s not that Stellingwerff recommends a highly processed diet, but runners should strive for emotional and contextual balance. This balance leaves room for a bit of everything and permits an athlete to let go of total control. “You have to have room to live your life and be happy.”