My Battle with Orthorexia

This is the most difficult post that I have written. In fact, it is one of the most difficult things that have ever written, period. 

Has anyone ever told you that you are 'too close to the situation'? I had quite a few people in my life tell me this throughout the past couple of years. I thought: "Nah... look at all of this research I do. Look at all of this information I have found. Look at all the progress I have made. Look at all of these people that have healed themselves this way. Look at all of this groundbreaking literature to back it up. Look at all of this HEALTHY stuff I buy!"  

Since 2010 I have been on an endless search to heal various physical ailments through food elimination and diets. In doing so, I became acutely aware of all the nasty things that get put into packaged and processed foods, the dangers of this food and that food and benefits of this food and that food. And countless diets. Paleo, Primal, Raw, Vegan, Vegetarian, Pescatarian, Anti-inflammatory, Macrobiotic... seeking that perfect combination that would allow me to feel my best. Be the healthiest. The cleanest. The Purest.

During this same time, I continued to suffer from gastrointestinal issues (chronic diarrhea and bloating). So, in my mind, there was still something wrong. There was still something to fix.

The search consumed me.

The search consumed me.

What I have is called, Orthorexia. It is much different than Anorexia though it can have similar side effects. While anorexia typically has a fixation of weight, orthorexia is a fixation on eating healthy. They do overlap. And I believe my struggle with orthorexia, obsession with healthy eating and having a clean body also morphed into anorexia. 

"Orthorexia' is defined as an obsession with 'healthy or righteous eating'. The phrase was first created in 1997 by California doctor Steven Bratman, and refers to people who create severely limited diets in the name of healthy eating. It often begins with someone's simple and genuine desire to live a healthy lifestyle. The person may choose to stop eating red meat, but eventually cuts out all meat; then all processed foods, and will eventually eat only specific foods that are prepared in very specific ways.

As with all eating disorders, the core issue is not about food. My struggle began at a time in my life when I was dealing with massive emotional stress.  In the fall of 2010 I was sexually assaulted and during that same time, had recently left a relationship and entered into another unhealthy relationship (both unrelated to the assault) quickly after. With my life in disarray, and my emotions crying for help, food was something that I could control. 

Or so I thought.

Note: This post is on MY battle. I do not believe that everyone on a restrictive diet has orthorexia.  Though, this post may raise awareness that 'diets' can become an obsession. And can be a 'gateway.' Most of all... listen to your BODY. Always.

It was a slow progression. For much of 2011 I was 'tweaking' if you will, still maintaining a pretty 'healthy' diet and body weight but experimenting with elimination diets. And in 2012, I tweaked a bit more and become increasingly strict with what I allowed into my body. Following my hernia surgery in December of 2012, I became even more fixated on eating healthy, weighing in at 94 pounds at my doctor's appointment just a few weeks ago. 

And then I got sick. Twice. And weighed 'who-knows-what' and then I landed myself in the ER with severe abdominal pain. This pain that I was feeling was on the surface, not dangerous. But the underlying cause - in sum, was that my body just did not have the reserves to sustain me while being sick nor did it have the strength to recover 'like a normal person.' 

A healthy body is a guest-chamber for the soul; a sick body is a prison.
— Francis Bacon – an English philosopher, statesman, scientist, lawyer, jurist and author
 

No doctor has ever told me that I should not eat the foods that I have eliminated from my diet. I truly believed that I was doing the best and healthiest thing for my body. I eliminated entire food groups. No processed foods, no packaged foods aside from bars and sweet potato chips, no refined sugar, no corn, no beans, no grains at all except for oats and brown rice (so no gluten, millet, spelt etc), no yeast, no soy, no dairy, and very limited other starches.

The consequences to this type of restrictive eating are massive.

The side-effects listed below are side-effects that I experienced. These are not researched and therefore I do not know if they apply to others with orthorexia/restrictive dieting. 

Physical Side-Effects:

  • Insufficient nutrients/ malnourished
  • Insufficient calories
  • Dangerous weight-loss / unhealthy BMI
  • Decrease in energy 
  • Dangerously low blood pressure
  • Insomnia
  • Hormone inbalance
  • Loss of appetite

Emotional Side-Effects:

  • Anxiety 
  • Obsessive-Compulsive behavior (measuring food, listing out meals, only eating at certain times)
  • Fear (of food/ingredients)
  • Depression
The spirit cannot endure the body when overfed, but, if underfed, the body cannot endure the spirit.
— St Frances de Sales

There were many signs along the way that I chose to not recognize. For every sign, I had an answer. A rather good one, at that. 

I had one woman I didn't even know straight up ask me: 'Do you eat?' I thought it was the rudest thing I had ever heard. And perhaps it was rude. But maybe it needed to be said.

During this time, I was cooking, baking, blogging about food and my love of food, helping to guide others in their path to a healthy lifestyle and so the thought that I could have a problem was downright absurd to me. Ha! 

I would NEVER EVER advise someone else to do the things that I was doing. I re-read what is on my website after acknowledging that I have a problem and thought "Wow, I'm pretty dang intelligent. Why didn't I just listen to myself?" 

Simply put, I got caught up in my passion. As a friend stated to me: "You know, people take great pride getting taken by their passion. You simply did that."

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I was being dishonest with myself. But most of all, I was not loving myself. I was not nurturing myself and I was not accepting myself. I was loving and accepting myself in ONE condition. I was not loving and accepting myself through thick and thin (pun intended). 

Although, I was doing all of these wonderful things like reading several different self-help books, doing affirmations, connecting with my spirituality and becoming very aware of myself and my surroundings, I was not recognizing the thing that I needed to face the most.

I hit bottom.

Hard.  

Through all of the deaths, break-ups, moves, sicknesses, and surgeries, this struggle, right here, right now, is by the far the hardest that I have fought. And I am honored and humbled to be able to share my experience.

And the work begins...

Some books that I purchased to help me in this journey.

Some books that I purchased to help me in this journey.

An eating disorder can be a dead end or a door opening to a life better than you can imagine.
— Carolyn Jennings

This Wednesday, I start an outpatient program and will be seeing both a nutritionist and psychologist. I am excited for this journey to begin!

Rest assured, I am still very much in love with food, cooking, baking and all that it has to offer. I cannot predict how this will unfold, but I can tell you this: 

My posts will change slightly and my recipes will evolve but I will be here. Learning, pushing forward and sharing my experiences.

And I have an incredible support system. My family and friends have embraced me with loving arms and for that I am immensely grateful. Thank you.

With love,

-AEB 

Listening to your Gut, Mind & Soul

Allow me to tell you a little story.

Over the past two years I have had an intimate relationship with food and yes, at times, a love-hate-relationship with food. Why you ask? In fall of 2010, in the midst of a significantly trying time in my life, I began to experience sudden and intense pain. This initially started as pelvic pain and continued to progress into something that I have now only come to describe as a true conundrum. From pelvic pain, abdominal pain and chronic gastrointestinal issues to joint pain, fatigue, nausea, loss of sleep, weight-loss and nerve pain. That type of pain, combined with emotional distress is downright taxing.

Let me step back for a moment to address a question that may be lurking in the back of your mind. Prior to this, I was easy breezy when it came to health. I rarely got sick, had a pretty rock solid stomach aside from occasional heartburn when I had too much dairy and I maintained a consistent healthy weight and body-mass-index (BMI) for much of my late teens and early 20s. I ate what I considered a well-balanced diet (which did include gluten, some dairy, yeast, soy), indulged in pastries and candy every now-and-then and exercised regularly.

So now I'll jump to fall of 2010, when the flow of my atypical symptoms began.

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Ashley, meet Google.

I had diagnosed myself with numerous conditions including Leukemia, HIV, Ovarian Cancer and Lupus to name a few. 

Mind you, those are all seriously tough diagnosis and while I should have been jumping for joy when I was relieved of those concerns, I slumped into a deeper state of chronic worry. As you could imagine,  emotional distress is the arch nemesis to physical pain and vise-versa.

I was loosely diagnosed with various conditions including Endometriosis, Interstitial cystitis and of course... neurophysological. Neurophysological came with a complex explanation that in summary, the theory was that my nerves were not firing properly and causing both direct and indirect pain. Hm. OK, I could accept that to a certain point. But I couldn't accept that explanation was the end-all-be-all.  

So I dug. I dug and researched. And searched. Most importantly, I searched within myself. I knew that there was something more. So much more. When I laid my head down on my pillow at night and felt my body lie there, I felt what I describe as a heaviness. A pulling. I knew that sensation shouldn't be ignored.

I had this 'gnawing' feeling that what was causing my physical pain was a hernia. I can't quite explain this definitive knowing. All I can say, is that I just new. The thought that it could be a hernia never escaped me and over the years a found several compelling articles that resonated with me.

Hernias in women  often go undiagnosed because they are not only seen as a 'man' issue but they also tend to present themselves differently.  

When a woman lies flat on the examining table, the signs and symptoms of a hernia disappear. And the usual exam, an ultrasound, rarely reveals the real problem. Lacking an accurate diagnosis, doctors often send patients to be drugged up by pain specialists and psychiatrists. 

For many women with these occult, or hidden, hernias, it can take years, if ever, to get the right diagnosis and correct the problem. Women account for only 8 percent of the hernias diagnosed, and doctors simply ‘don’t think hernia’ when women complain of pelvic pain.
— Dr. Metzger

A New York Times article, In Women, Hernias May be a Hidden Source of Agony, was the first one that I came upon. I read it and I grew even more certain that this was what was causing the majority of my pain.

Below are some other articles that I kept with me though the years and showed to various doctors:

As the cliche goes, 'desperate times call for desperate measures.' I had tried every elimination diet that I had researched. Various herbs, medications, supplements, meditation and other self-help techniques. Not to mention thousands of dollars in medical bills and countless tests, procedures, doctor visits, time off of work and I was still symptomatic.

While it's nice to have tests that come back 'normal,' there comes a point where you just want to hear someone say "Aha! We found it! You actually have ____ and that is what is causing your symptoms!" When that time doesn't come, you will do virtually anything to figure it out on your own.

At least, I did.

To me, the only route I saw in relieving symptoms was through food. Based on the triggers that I did find, my diet was already largely paleo/primal (no grains, no legumes, no unnatural sugar, limited carbohydrates), so the next step in my mind was to be even more strict with my sugar intake. I had a couple theories around this, one being that I may have an excess of fructose in the gut. It was just one more thing to rule out (in my mind).

Words of caution: Playing doctor on yourself is risky business.

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So, two years after the onset of my symptoms, in September (2012), I decided to take up the challenge of the 21-Day Sugar Detox. I had high hopes that this would provide some answers. When people hear 'sugar detox,' they tend to think refined sugars, candy, soda etc. Well, I had already cut all of that out long ago. Since I had also already removed grains, legumes, dairy, and unnatural sugars from my diet, the next step and guidelines for the 21-Day Sugar Detox was to remove other sources of carbohydrates (all carbohydrates break down to sugar) so this meant all fruit (fresh, dried or juices) with the exception of one green-tipped banana a day or one green apple. In addition, starchy vegetables were to be removed (so winter squash, sweet potatoes, white potatoes) and alcohol. That my friends, is low-carb.

How low-carb is too low-carb?

Do some people need more carbs than others? Is it safe to take up a low-carb diet? And what can going low-carb do to your body?

Fist and foremost, each meal, snack and trip to the grocery store took that much more planning, that much more research and that much more thought. I recall going out to eat one night while doing the detox. I felt so incredibly hungry before-hand that I ordered a huge burger (sans bun) some mushrooms and vegetables on the side - mind you it originally came with much more including a bun, fries and a chutney. In communicating with my server, I said something along the lines of "Ok, so as long as there are no grains (so, no gluten), dairy, soy, yeast or any sugar then that will be good..."

What?!? Not only did saying that cause me feel like I belonged in the looney bin, I didn't feel like I was being true to myself. We need to eat what makes our bodies feel good (I'll reiterate here, our bodies, not necessarily what our brain or taste buds are telling us makes us feel good ;)), not what a template, website, book or guide says will make us feel good. I was shocked by the words that were coming out of my mouth. And I had gone completely against my own advice that I would coach others.

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At day 13 of the 21-Day Sugar Detox, I made a critical decision to stop. In short, I simply couldn't function. My bouts of hypoglyecemia became extreme despite the amount of food that I was eating to compensate for what wasn't (mainly protein and vegetables), my energy level was non-existent, my weight was dropping too an unhealthy low and I ultimately decided that to continue the duration of the detox could be very dangerous.

So what was next? I was concerned about eating too much sugar too soon so I started rather slowly, adding in fruit little by little. Then starchy vegetables/squashes, then I added in oats and brown rice in very small amounts (this was the first time I had any grains for about 6 months) and then finally limited amounts alcohol (wine or Ciroc vodka) here and there.

I continued to add everything back into my daily diet, with the main reason for the starchy vegetables, oats and brown rice, aside from energy was so that I would stop losing weight and in addition, try to gain some. I had hit the lowest weight in my adult life and not only did I feel uncomfortably thin, friends, co-workers and family expressed concern. Note, I am writing that in past tense though I am still very much in the middle of this path in which you will learn more about shortly.

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And then... things got weird...The 'brain-fog' that I once experienced when I ate gluten, came back with vengeance though I was not consuming any gluten. I became dizzy at unexplainable times and would 'get the shakes,' similar to when I'm hungry except it would occur shortly after eating or when I was not hungry. And my body seemed unable to process alcohol.

I nearly passed out at my sisters after dinner and two glasses of wine (in the span of about 2 hours). I wasn't hungry at all but I was shaking, hot, dizzy etc. and had to eat a bowl of sweet potatoes to recover. That convinced me my body was just not processing alcohol (i.e. sugar) or carbohydrates (also broken down as sugar) properly.

After banning myself from the infamous search engine, I was yet again sucked into the Google. Because what makes any all symptoms worse? Stress. Worry. Anxiety. And with that carries a heavy weight of desperation.

My Keto theory...

My theory is that I unintentionally put myself in a ketosis state. Ketosis is a metabolic state that occurs when your body is not getting enough carbohydrates and sugar and thus your body instead of burning carbohydrates for fuel starts to burn fat and produces a large amount of ketones. Ketones are present in the blood and in the urine. When there are a large amount or too many ketones for your body, a slew of unpleasant and troubling symptoms can occur.

When the ketones are elevated or you are in a ketosis state (a.k.a non-diabetic ketoacidosis), your body can experience (list not exhaustive): 

  • Excessive thirst (check)
  • Increased urination (check)
  • Fruity or metallic taste in mouth (check)
  • General weakness (check)
  • Loss of appetite (check)
  • Abdominal pain (check)
  • Confusion/brain fog (check)
  • Low blood pressure (check)

Because I was exhibiting many of the those symptoms, they tested me for diabetes which was negative.

So, am I 100% certain that this is what happened? No. Am I by definition, a hypochondriac? Perhaps. Though, I'm of the opinion that when someone is in chronic pain without answers, they will go to dire means to seek answers. Is my theory on ketosis just a 'hypochondriatic' conjecture? I don't think so ;) 

But I do know, that while some people can safely go 'low-carb,' for a time most people cannot or should not for a long period of time. 

One thing I know for certain, always consult with a physician before making any significant dietary changes. 

Meanwhile, I had gone back to a trusted doctor, and opted to have an exploratory laparoscopic surgery. He had actually been one of the doctors that was open to the thought that a hernia may be a viable explanation. I knew in my gut, pun intended, that a hernia had been causing my agony for the past two years.

This surgery was performed last month (November 2012). Some endometriosis adhesions were removed, so that theory wasn't invalidated but it wasn't the cause of my pain. During the surgery, two inguinal hernias were discovered. One on the left and one on the right. The one on the left was quite large and likely what has been causing the majority of my pain.

Small inguinal hernia on right side of abdomen

Small inguinal hernia on right side of abdomen

Large inguinal hernia on left pelvis (AKA, The Big Bastard)

Large inguinal hernia on left pelvis (AKA, The Big Bastard)

(Sorry, hope you weren't eating ;)) 

One month later, yesterday (yes, yesterday December 11, 2012),  I had the hernias repaired. They repair the hernias by using what is called mesh and are also performed via a laparoscopic surgery; which is the least invasive option.

Was repairing these hernias the answer I have been searching for? There is no way of knowing that just yet but I will say, that although I am in a significant amount of pain from the surgery itself, I feel I have crossed a momentous chasm. And I am on the road to a beautiful recovery.

I am so very grateful for the unwavering support that I have received from my family and close friends. Truly amazing people in my life. Love to you all.  

My point? ALWAYS listen to your gut, your  mind and your soul. NEVER give up. NEVER accept what you know to be untrue. Trust yourself...

Stay tuned dear friends ;) xo

-AEB