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Who’s at risk for obsessive healthy eating? Toronto research sheds light (ctvnews.ca)
74 points by okket 4 days ago | hide | past | web | favorite | 57 comments





It's chilling when you see a description of what you are doing, online, in a random click that you just made.

I have OCD, and hide it well. Looks like I have ON and have not hid it well at all. I run obsessively, eat extremely clean and have been struggling to even eat things that are outside my "normal" diet ever since the stress at work and relationships have increased.

I figured it was something I needed to research when I felt _bad_ for eating a sandwich after a 56 mile bike ride. But I never did, maybe because I didn't want to know the answer.

Oh well, the more you know...

My OCD has increased as well. They're definitely connected.

Edit: grammar and some spaces.


Anorexia nervosa and excessive exercise seem to be causally linked.¹

If you want to cure someone of anorexia, you will usually have more success if you both eliminate the excessive exercise and address the eating behaviour at the same time.

For some reason, it seems as if each behaviour somehow supports the other, and to break the cycle, you have to address both.

Also if you or anyone has an eating disorder, take it seriously and seek treatment. Eating disorders have the highest death rate of any mental disorder.

1: When researchers restrict rats’ food intake while giving them unlimited access to a wheel, the rats start running excessively. Paradoxically, these rats opt to continue running rather than eat during the short intervals of time food is made available to them. If allowed, they will literally run themselves to death. (https://www.verywellmind.com/excessive-exercise-eating-disor...)


I wonder why its unethical to test such things on human beings. I'm assuming it's unethical, because there rarely seems to be any damn work on this using humans.

Those rats ran themselves to death, will we humans? We share about 92% of the genes[0] (on the first google attempt), what changes does that giant 8% contain?

Just pick up people like me, and make us run and give us food.

I doubt we will object if it means there's a possibility that we might help ourselves.

Are they afraid they'll make it worse? Sure that's a possibility, but that's the price to pay. I'm willing to pay that price if it means people after me, who have this wire crossed in their brains will be served better healthcare in the future.

Some experiments might not work, but we've just discovered another way to _not_ make the lightbulb, but the good news is that the lightbulb _will_ be made if we try n times.

[0] https://blog.23andme.com/23andme-and-you/genetics-101/geneti...


Philosophers can have a long discussion on ethics. There is no universal truth to the subject. You can turn God, the gods, and many other philosophers. Take your pick who you follow, there is no universal law saying you are right or wrong.

The average person in our society has decided that killing other humans is generally unethical, so it is. Most people have some sort of exception to that rule. Some people allow the death penalty for various crimes against their ethics (no universal truth of what is a crime exists). Some people allow for some area on the scale of where someone needs medical care for their cells to live. Some people allow killing before birth. Most people allow war in some part. I have my own opinions on the above, you do as well, but they are not the point. I'm sure we disagree on something.


You don't need to try to induce it in humans, you want to create treatments that work.

In this case the study in rats provides an interesting hunch, that food restriction and excessive exercise seem linked.

Then you can certainly run a trial where you either eliminate exercise or not, and see if it makes a difference.


It's far cheaper to run an experiment on 100 rats than 100 people, and it's unethical to let people run themselves to death obviously.

It's not unethical to watch people run and eat -- Gatorade/UF exercise lab does this stuff all day long. Obviously it's unethical to let you continue to do so if adverse health effects are observed.


> it's unethical to let people run themselves to death obviously.

It's also unethical to let rats run themselves to death, and it wouldn't pass an ethics review board if you suggested an experiment like that these days.


So the truth is that rats could run themselves to death (seems unlikely) or maybe could stop at some point before, when some metabolite reachs some level or falls under some level. Impossible to know it because... taboo.

Even if this information could help to understand better anorexia nervosa in humans.

Maybe we should do the experiment with running thumbleweed instead.


Actually it isn't obvious. It only seems like it is obvious because most of us share some values.

It actually has been tested on humans: the Minnesota Semi Starvation Experiment. The experiment involved starving 36 people for a year. It was really designed to look at the physical impact of starvation and refeeding, so they used only the most psychologically healthy people they could find. Still, several developed anxiety reactions to food and continued not to eat after they were allowed. Many others developed food obsessions - several went on to become chefs.

The goal of the experiment was to figure out what to feed holocaust survivors.

https://en.m.wikipedia.org/wiki/Minnesota_Starvation_Experim...


Anorexia and bulimia are both OCD spectrum disorders. It's not remotely surprising that they're linked, but, as parent comment suggests, please help those who need it get treatment, even (especially) if it's yourself.

I was in the same place until recently. I put together a list of things [1] that helped me get a handle on this stuff. There does seem to be a way out; this is the first time in my life where I've been able to focus on non-food and exercise things.

[1] https://sites.google.com/view/the-no-nonsense-guide/guide#h....


Thank you, I just read through that and it's all very anxiety inducing. Probably because it's true.

I'll give it a try. I realise I need to.


Just as a data-point when my wife treated her orthorexia her OCD got much better.

I'm glad there's a label for this that's not attached to the previous connotations of "anorexia." I'm a guy who struggled with eating disorder symptoms for most of my life, and hid them for fear of attaching AN stigma to myself.

Last year I got serious about researching the biology of eating disorders, and I'm convinced now that in 40 years we'll think of anorexia and its cousins more like type I diabetes than a mental disorder.

For example: did you know that it's possible to induce self-starvation and hyperactivity (hallmarks of eating disorders) in mice [1]? It's been known to science since the 1950s, but this fact is curiously absent in popular understanding of eating disorders.

This new understanding led me to start a recovery project, and happily it's working out: I've finally got relief from the awful mental fixations (like those described in this article).

[1] https://relative-energy.tumblr.com/post/183390573416/activit...


Oh this is interesting. This behavior is fairly common knowledge among cat people: if you have an adult cat that's being persistently hyperactive and displaying increased hunting/pouncing in a manner that's out of character for your cat, you need to take your cat to the vet for a checkup, your cat probably has dental problems and isn't eating.

What I'd like to know is why this reaction isn't more common among humans. I'm a fat person who's tried calorie restriction and all it does is make me tired and depressed. I suspect there's a good reason for that, and it has a lot to do with why I'm a fat person in the first place.


> What I'd like to know is why this reaction isn't more common among humans. I'm a fat person who's tried calorie restriction and all it does is make me tired and depressed. I suspect there's a good reason for that, and it has a lot to do with why I'm a fat person in the first place.

There're interesting stories about people changing their weight after a stool transplantation, without changing their diet.

The bacteria in the gut seems to have a deep impact how food is utilized, even which kind of food is preferred and how you feel eating it, but it also seems to work the other way around, that the food effects the kind of bacteria in the gut.

It makes perfect sense to work this way, on one side you prefer food you can better utilize, on the other your body is able to adapt to the available food.

So changing the bacteria eating different food should also be possible, but the change might be quite unpleasant, you certainly won't feel that well, it might take some time and you need quite a bit of will power to get through.


Unfortunately the studies on stool transplants didn't replicate.

There's a great book about this called "The Diet Myth" by Tim Specter. IIRC he's a Professor of Genetics and specialized in twin studies and sort of stumbled into researching gut bacteria because he was fascinated by identical twins were one was obese and other was a healthy weight. It's mindblowing how little we know and understand about such an important topic.

Edit: If you're interested, this talk[1] he gave at the Boston Science Museum is what made me read his book.

[1] https://www.youtube.com/watch?v=PEAdtGa549I


Calorie restriction is different to starvation (at least as usually used). When I'm actually starving, I do feel strangely energetic. Your body takes time to switch into starvation mode and during that time you do feel lethargic. IIRC it takes about 6-8 hours of not eating to enter starvation mode.

When I'm actually starving, I do feel strangely energetic.

You get the same effect without starving, just restricting carbs:

https://en.wikipedia.org/wiki/Ketosis


This is a very strange way of using the word starvation. You're more closely describing ketosis, but even that tends to take quite a bit longer than 6-8 hours to be significant.

If you feed your cat, shouldn't it be obvious how much of it's food it is eating? Unless it's hiding the food somewhere.

> Last year I got serious about researching the biology of eating disorders, and I'm convinced now that in 40 years we'll think of anorexia and its cousins more like type I diabetes than a mental disorder.

I needed an absurd long time to realize how food intolerances are increasing my anxiety and obsessiveness. I never had strong physical reactions shortly after the eating, but very subtile and delayed - sometimes even days later - reactions mostly on the mental level, which made it very hard to connect the food with the reactions.

That changed my thinking about certain kinds of mental disorders quite a bit.


I'm in the process of identifying various foods that have negative effects on my health. It's frustrating, because there is absolutely no research or literature out there that validates or corroborates my findings. Send me an email (listed in my profile) if you want to compare notes.

I can only say that it is pretty hard identifying the food if you still eat somehow normally.

It is easier to make hard restrictions for some time - one to two weeks - until all your symptoms are gone and than add one food after another to see if they introduce the symptoms.


Additionally, anorexia manifests in equal rates between societies which have almost nothing in common culturally, falsifying the hypothesis that it is caused by cultural factors.

Regarding "orthorexia nervosa", on the other hand, there is a perverse incentive in psychology to define everything under the sun as a disorder. I do not see right off the bat why this should not be thought of as being different from a specific manifestation of OCD.


Where do you have it from? Anorexia rates change even within the same society.

"An analysis of many studies from Europe and North America revealed that rates of anorexia increased sharply until the 1970s, when they stabilized.Rates of bulimia increased during the 1980s and early 1990s, and they have since remained the same or decreased slightly."

https://www.nationaleatingdisorders.org/toolkit/parent-toolk...

The same page show differences in anorexia rates between countries too.


OCD is already heavily mis-used. Attaching more meaning to it isn't likely to improve anything.

> but this fact is curiously absent in popular understanding of eating disorders.

No it isn't, the "Minnie Maud" model is dominant. (Minnesota, the soldier starvation experiment, and Maudsley, a protocol developed by a specialist London hospital).


? Google for one doesn't think "Minnie Maud" is dominant outside of non-scientific fad blogs and one trademarked business offering.

https://www.google.com/search?q=%22Minnie+Maud%22

https://edinstitute.org/homeodynamic


Minnesota Stavation Experiment: https://www.google.co.uk/search?source=hp&ei=3E7cXIXhF9HxkwX...

Eating Disorder Maudsley Model: https://www.google.co.uk/search?ei=5k7cXIPmF9eO1fAPjZu_0AI&q...

Wikipedia has this for the Maudsley model: https://en.wikipedia.org/wiki/Maudsley_family_therapy

These are the main two prongs of anorexia treatment: feed people (by force if necessary) but be careful to avoid re-feeding syndrome; provide family based therapy.

More recently there are moves to early intervention, which is safer, more effective, longer lasting, and cheaper. One model might be FREED. https://www.health.org.uk/improvement-projects/first-episode...


What is the difference between diabetes and a mental illness, and why would eating disorders be less mental than other disorders? In other words, why wouldn't all mental disorders be more like diabetes?

> They also discovered that vegetarians and vegans were at higher risk.

Surely it's far more likely that the causation goes the other way? Or is there a hypothesis that trying vegetarianism promoted overthinking / overcaring about diet?

I suspect this isn't very specifically an eating disorder, but that it's an obsessive compulsive or zealotry disorder where food just happens to be a target.


Sounds like something that requires further research, however, I do see how vegetarians / vegans (or anyone following a specific diet for that matter) become a lot more mindful of what they eat, or what they "are allowed to" eat.

Questions I had after reading the article:

1. Is there any reason why these researchers are focusing on an unhealthy obsession with healthy eating, instead of an unhealthy obsession with [x: x ∈ anything], or just unhealthy obsessions in general?

2. Are there enough people with this disorder to classify it as a disorder?

3. Why are "Lacto-vegetarians" at the highest risk? What is it about drinking milk that makes people want to be extremely healthy?

----

Answers I received after reading the link to the University Press Release:

1. It's basically a disorder for people whom are relapsing from a previous eating disorder. Although it's gender-neutral for some reason.


You could classify lots of things as 'unhealthy obsessions' but then you'd just have a group of disorders, it wouldn't help you treat them. Clearly even two kinds of obsessive eating patterns are different enough to warrant different analysis. For example, there are a great many more practical ways you can act on ON than AN, and being health-obsessed might have less social stigma so the patterns leading to it might be harder to pick out as problems. If you want to treat these people on their terms and in ways that make sense, you have to drill down and deconstruct the specific phenomena.

There is a place for general obsession research, of course, but examining why people congregate around this one is obviously helpful to that goal anyway. What exactly about healthy eating makes it attractive to obsessive tendencies? The commonalities and differences compared to AN are surely going to be valuable.

We programmers like to abstract over things, but tons of good work in science involves just having a go at at one thing until it is better understood.


I think the answer you got is correct: this is what a lot of people who are semi-recovered from an eating disorder wind up with. That aspect is what distinguishes it from other obsessions.

Interestingly, eating disorders and chronic semi-starvation lead to rigid, OCD-like behaviors. For me it was rituals around walking and movement - they have faded away during eating disorder recovery.


Is there any reason the astronomers choose to focus on Wolf-Rayet star evolution and not stars in general?

Science starts with data. If you want to prove a general theory, you show that it fits the simply-collected facts. You don't cook your experiment to prove your pet hypothesis.


This is tricky. If you believe that glycemic variability (or avoiding insulin spikes) is a major factor in longevity, or if you believe the same for periodic or intermittent fasting, it will in fact "interfere with your normal life" or "make it hard to go out eating with others" as the researchers described. But those challenges are still the right thing to do if you subscribe to that science.

I think the researchers are imaging hardline discipline and re-structuring of normal dining affairs without any element of "obsession", even though the latter is probably required at some dosage to be effective, in the same way you obsess over, say, technology X when you need to be good at it.


Even if you do accept that disordered eating behavior leads to a longer life, that doesn’t mean that it’s the right thing to do. If someone is spending years of their life with increased social isolation, decreased free time, and decreased enjoyment of food, just to live marginally longer, is that a rational choice?

For me, it wasn’t a rational choice at all - it was an anxiety response to food with a good justification (health) that people around me were willing to accept. In retrospect, I realize how much I was missing out on. Life’s much better now that foods something I can enjoy and now that eating can be a social experience.


I can't accept the label “disordered eating”, given it's based on how people ate for millennia and the underlying mechanisms therein.

There's of course room for middle ground. For example, I had a dinner I cared about, the host cooked lasagna, and I didn’t want to reject the host’s cooking or draw that kind of attention to myself. I know you can render your body in an insulin sensitive state if you do a muscle-glycogen depleting workout before, so I just did some weights after work and could enjoy the gathering guilt free.

Definitely about health span too, not just lifespan. Ie invest now so at 60 you feel like 40, and can pick up (great)grandkids let alone be able to tie your shoes in your 90s.


Disordered eating isn't about the eating. It's about the thought process and obsession behind it.

So the thought process you described is similar to orthorexia except the feeling of guilt is more powerful so it has a more powerful effect on behavior. For instance missing loved ones birthday's and avoiding go outing much at all in order to make sure you only eat the healthy food.


There is no need to obsess over anything when you better your habits. You will eat good, because that'll be your "standard", your habit, your go-to mode, your default.

If you only eat good/clean when you are pushing yourself to eat clean, you are doing it wrong and eventually you'll give up and gain back all the weight. Inevitable.

Also, as someone that has very low bodyfat (6/8 pack for years), there is absolutely no need to eat clean 100% of the time.

I'd say that if you eat 90% cleanly of the time, you are golden.

There are ways to make your food delicious without adding huge amounts of calories (think of spices, etc.)

All it takes is some common sense, and some (very little) knowledge of nutrition to eat healthy. I would say that anyone can learn this, in less than a month.

Also, I suggest anyone (that hasn't done this) to count their calories for a month, and be meticulous about it - you will learn a lot. Afterwards, you will not have to count calories - your estimation will be good enough.

About the habits and "converting" to a better lifestyle? That I don't know. I don't understand why is it so hard for people. It seems like it is, even for people that know everything about it. That I can't explain.


> There is no need to obsess over anything when you better your habits.

That's not how orthorexia nervosa works. It's not an "obsession" in the colloquial way you're using the term but an actual pathological obsession. A diagnosable mental health condition. Your comment is incredibly insensitive (I hope because you only bothered to read the title) and is the equivalent of telling someone with a cold that there's no need to cough.


I stand behind what I wrote, cause that's the truth. I can't understand anyone being offended by it.

Not a fan of the way we are blowing things out of proportion so much these days.

Eating right is not that difficult. It's not difficult AT ALL. The mere fact that we are discussing this is insane, to me.

There was a point of time in history where civilizations routinely starved to death - THAT was difficult.

Having the most abundant choice, and voluntarily picking the wrong one, all the time, all day every day - I just can't sympathize with that and call it "difficult".

Especially if you know what you are doing. And you must know, cause you'd figure it out by the results pretty quickly. (Not you in particular, it's a general statement)


I don't understand why the general tone of this article is "Did you know disordered healthy eating is possible" but the review of literature found that most of the studies are of poor quality, and furthermore the DSM does not recognize this condition as an eating disorder.

Am I missing something or isn't this putting the cart before the horse?


If you were trying to turn your scientific community around and make them pay attention to an issue when they hadn't been, isn't "Guys this thing is real" the tone you would take? The lit review is used to show that not enough research $ are being poured to get good science, but you can't convince the $ to flow if people don't think it exists. You don't have to prove the disorder exists to a peer-reviewed standard before they let you try to do exactly that. You can start with anecdotes if you want. These folks started with a meta-analysis of risk factors, which looks fine to me.

I became obsessed with label-reading and healthy foods because I had a serious problem with feeling ill from food. It turned out it had nothing to do with organicness, preservatives, additives or much else besides that I had undiagnosed celiac disease and a couple food allergies.

I was a vegetarian for a while because I found I felt better. This was probably a coincidence related to the meals I prepared being gluten-free.

“They also discovered that vegetarians and vegans were at higher risk.“ seems backwards - isn’t it more that hypertrexia makes one more likely to become a vegan or vegetarian?


There is a question as to whether this is a real disorder. Eating healthy and convincing others to do so isn't a sin.

https://nutritionfacts.org/video/is-orthorexia-a-real-eating...


Whenever researchers talk about any mental disorders you need to add the phrase "...which interferes with their day to day life, and causes harm or distress".

These people are not eating healthily, they have an obsession with "healthy" food that interfere with their day to day life and causes harm or distress.

That harm may be from something like REDS (Anna Boniface has written useful stuff about that), or it may be over-training or food restrictions.


Sometimes 'disorder' means "behaving in a way that annoys other people".

https://www.mayoclinic.org/diseases-conditions/personality-d...


For information about the label of PD I like Meeting the Challenge, Making a Difference, because it was coproduced by people with the label.

https://www.crisiscareconcordat.org.uk/inspiration/meeting-t...

I think you've been unfairly downvoted. I don't think you're saying "people who have this label are annoying", I think you're saying "health care professionals who struggle with a patient are likely to say it's the patient's fault, because that patient has a PD".


Isn't talking about downvotes prohibited on here?

> they have an obsession with "healthy" food that interfere with their day to day life and causes harm or distress.

Ah, so they would be better off eating junk food? That's actually what the authors of the studies suggest.


My lay impression is it’s a form of OCD

It's possible it interferes with day to day life but extends life as a whole considering the typical diet in America.



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