How dieting or over-emphasising ‘healthy eating’ leads to eating disorders

Taking care of our physical health is important, and there is no doubt that the food we eat has an important influence on our physical and mental wellbeing. I have a very holistic approach to mental health, and often talk to my clients experiencing depression and anxiety about adding foods in to their diet that are shown to boost positive mood. It has saddened me however that as science has discovered more ways that food influences our health, the marketing machine behind the diet industry has jumped on board. We are bombarded with ‘better’ ways to eat, are witness to sensationalist headlines about foods that are dangerous, and are sold ‘life changing ‘ diets that will, well, change our lives. Add these messages to a society that idealises a thin body image, use words like “guilt free” when selling a product, and we have the starting ingredients for the perfect storm.

As a psychologist who specialises in eating disorders I often hear my clients say, “I just started by trying to eat a bit more healthily…” They have often turned to the diet industry, and followed a particular movement such as “going paleo”, “cutting out sugar”, or “low carbs”. From early on certain foods are ascribed moral value, there are rules abound, and the health conscious individuals find themselves anxious when faced with “bad” food, a sense of shame if they dare to ‘indulge’, and pride when they resist. Even early on the shift towards healthy eating can see people shift from elation following a “good day” and high levels of self-criticism when they perceived they have failed.

So why does this happen, and why can being ‘healthy’ have such horrific consequences? Research shows that individuals who have internalized the “thin ideal” are more vulnerable to eating disorders. Sadly here in Australia up to 75 % of high school girls believe they are fat. Sadly most adult women I know also express at least a moderate level of body dissatisfaction. Most of these people will turn to the health and diet industry to ‘fix’ this ‘problem’. Add psychological factors such as perfectionism, anxiety, low self-esteem, or obsessiveness and it is likely that once dieting or healthy eating starts, the dieter will aim to perfectly follow the ridged set of rules their chosen plan prescribes. Sadly this often results in declining social events, eating alone, spending much of the day preoccupied with food, and feeling anxious when there is no “safe” or “clean” food available. These diets usually prescribe a calorie count that is well under what an average adult needs to survive, or cut out food groups that are essential for the body.

Unfortunately once on this path, there is often a combination of energy deficit and emotional deprivation due to the joy of food and eating being taken away. Our bodies are amazing machines which will fight to keep us alive, hence people who are not fueling their body adequately will find themselves constantly preoccupied with food. The starving brain sadly becomes less able to think flexibly, and this preoccupation often leads to further rules and attempts to be in control. Ultimately, in most cases, the body wins, and people find themselves binging on forbidden food. What follows can be anything from purging, excessive compensatory exercise, guilt, shame, and self-loathing. Almost inevitably, full of self-criticism and a sense of failure an even stricter attempt to diet resumes the next day. Once in this cycle people find it very hard to break out. The young women I work with often tell me that reaching their goal weight if they are able to do so is bitter sweets, and often accompanied with a realization that the sadness they were trying to fix is still with them, or that they are constantly anxious that they may not be able to maintain this weight. New, more extreme goals are often set, and the disorder takes a stronger hold.

So how do you know if your healthy eating or dieting is becoming disordered?

  • You say no to social invitations because you don’t know what food will be there

  • You find yourself unable to concentrate because you are distracted by thoughts of food

  • Food groups are banned without medical reason, or moral/religious beliefs

  • You experience shame or guilt when eating certain foods that you enjoy

  • The food you eat is consistently strongly influenced by the influence you believe it will have on your shape or weight

  • You find yourself caught up in a diet/binge cycle and don’t know how to get yourself out.

If you have answered yes to some of these it may be valuable for you to seek professional support. Here in Melbourne we are blessed to have many dietitians who promote a non-diet approach to healthy eating. This breaks down the rules helps people to relearn how to eat intuitively again. Further a psychologist who specialises in eating disorders may be useful in helping you manage the emotional and psychological factors getting in the way of a healthy relationship with food and your body.

Tom Morley