“When Healthy Eating Becomes Unhealthy”

 

WHAT IS ORTHOREXIA?

Orthorexia is an unhealthy focus on eating in a healthy way. Eating nutritious food is good, but if you have orthorexia, you obsess about it to a degree that can damage your overall well-being. Steven Bratman, MD, a California doctor, coined the term in 1996. It means “fixation on righteous eating.” Since then, many medical professionals have accepted the concept. It isn’t an official diagnosis. But the basic idea is that it includes eating habits that reject a variety of foods for not being “pure” enough. Eventually, people with orthorexia begin to avoid whole meals that don’t meet their standards or that they don’t make themselves. Some experts think there are similarities in orthorexia and in eating disorders like bulimia and anorexia nervosa. All are about food and control. 

ORTHOREXIA SYMPTOMS:

If you have orthorexia, you might:

• Worry about food quality. High levels of concern about the quality and source of foods you eat could lead to anxiety.
• Avoid going out to eat or avoid eating food prepared by others out of fear that foods you don’t prepare yourself won’t meet your standards.
• Fear sickness. You worry about how “clean” food is or if it’s “bad” for your health.
• Show physical signs of malnutrition. When you limit the variety of foods you eat, you may not get all the nourishment you need. You could lose weight as a result.
• Bury yourself in food research. It’s one thing to spend a few minutes scanning a product label or surfing the web for more information on ingredients. But with orthorexia, you may spend hours thinking about food and planning meals.
• Refuse to eat a broad range of foods. It’s normal to avoid some foods because you don’t like the way they taste or the way they make you feel. But with orthorexia, you might decide to drop whole categories of foods from your diet. For example, you might stop eating grains; or any foods with preservatives, gluten, or sugar; or all foods that just don’t seem “healthy."
• Fear losing control. You feel that you’re doing the right thing by eating healthy. But you may also be afraid that eating even one meal you didn’t prepare -- including dinner at a restaurant -- can be disastrous.
• Be overly critical of your friends’ food choices. At the same time, you may have no rational explanation for your own.
• Find yourself in a vicious circle. Your preoccupation with food causes you to bounce between self-love and guilt as you change and restrict your diet.

ORTHOREXIA CAUSES AND RISK FACTORS:

Anyone can get an eating disorder. Though the causes and risk factors vary from person to person, they fall into three main groups:

• BIOLOGICAL: Having a close relative with an eating disorder, a history of dieting, or type 1 diabetes.
• PSYCHOLOGICAL: Perfectionism, dissatisfaction with your body, or a history of anxiety.
• SOCIAL/CULTURAL: Being teased or bullied about your weight, having had family trauma that spans generations, or buying into the idea of an “ideal” body.

ORTHOREXIA DIAGNOSIS:

As with bulimia and anorexia, your doctor or nutritionist may be able to help with orthorexia. Because of the emotional parts of the condition, they may ask you to see a mental health professional. Right now, there are no official criteria for making a diagnosis because orthorexia isn’t included in the DSM-5, the guidelines doctors use to diagnose mental health conditions.

In 2016, Bratman and Thomas M. Dunn, PhD, a professor at the University of Northern Colorado, proposed a two-part diagnostic criterion for the condition:

CRITERION A says the person will have an obsessive focus on healthy eating and get distressed over food choices they feel are unhealthy. They’ll lose weight as a result of food choices, but not because they’re trying to. In addition:

• They’ll compulsively follow and be obsessed with rules about food that they believe will promote health.
• Breaking the rules will create fear of disease along with anxiety and shame over their food choices.
• The rules will get harsher over time. The person may do cleanses.

CRITERION B says the person may notice mental health and physical problems:

• The restricted diet can lead to malnutrition, severe weight loss, or other medical problems.
• Their rigid beliefs and rules can cause problems with social relationships, or at work or school.
• Their body image and sense of self-worth could depend on how well they follow their healthy eating rules.

ORTHOREXIA TREATMENT:

The key is to recognize that even though eating healthy food is good for you, the way you’re going about it is causing harm. You’ll need to train yourself to think differently about it.

If you think you have an unhealthy relationship with eating, your doctor may suggest mindful eating strategies. Common treatments include:

• Exposure and response prevention: The more you’re exposed to the situation that causes you anxiety, the less it’ll upset you.
• Behavior modification: Understanding the negative effects of your actions so you can change what you’re doing
• Cognitive restructuring or cognitive reframing, which helps you identify habits and beliefs that cause stress and replace them with less rigid thoughts and actions
• Various forms of relaxation training, like breathing exercises, guided imagery, mindfulness meditation, yoga, and tai chi.

 

SOURCES:

National Eating Disorders Association: “Orthorexia Nervosa.”

Academy of Nutrition and Dietetics: “Orthorexia: An Obsession with Eating Pure.”

Palo Alto Medical Foundation: “Orthorexia Nervosa.”

Zeratsky, Katherine, RD, LD: “Orthorexia: When healthy eating becomes extreme,” Mayo Clinic Nutrition-Wise Blog, Nov. 15, 2016.

American Psychiatric Association: “Orthorexia: Can Healthy Eating Become Unhealthy?”

National Eating Disorders Association: “Orthorexia,” “Risk Factors.”

Neuropsychiatric Disease and Treatment: “The clinical basis of orthorexia nervosa: emerging perspectives.”

Bradley University: “Orthorexia.”

University of Northern Colorado: “Thom Dunn.”

Foundations Recovery Network: “Exposure and Response Prevention Therapy (ERP).”

StatPearls: “Behavior Modification.”

American Addiction Centers: “Cognitive Restructuring.”

Harvard Health Publishing: “Six relaxation techniques to reduce stress.”

MEDICALLY REVIEWED BY: Brunilda Nazario, MD, WebMD on September 09, 2020

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.  

“How Much Sleep You Need, According to Experts”

Sleep is essential for optimal safety, mood, performance, and health. As one of the three pillars of a healthy lifestyle (the other two being diet and exercise), the amount of sleep you get can dramatically improve or hinder your quality of life in various ways. 

HOW MANY HOURS OF SLEEP DO YOU NEED? The amount of sleep a person needs each day varies with age, according to the National Sleep Foundation. 

• Newborns (0-3 months) need 14-17 hours  
• Infants (4-11 months) need 12-15 hours
• Toddlers (1-2 years) need 11-14 hours
• Preschoolers (3-5) need 10-13 hours
• Children (6-13) need 9-11 hours
• Teenagers (14-17) need 8-10 hours
• Adults (18-64) need 7-9 hours
• Older adults (65+) need 7-8 hours

Pregnancy, sleep deprivation, and poor sleep quality can also affect how much sleep you need, according to the Mayo Clinic. 

WHO’S AT RISK OF SLEEP DEPRIVATION? In short, almost everyone is at risk of catching fewer zzz’s than they really need. Whether you’re a shift worker who sleeps at odd or varying hours, a new parent attending to a waking baby, or someone who is ill or stressed, you’re bound to experience periods when you log fewer hours of sleep than you need. Children, and especially adolescents, who often keep late hours during the school week, are particularly vulnerable. According to research presented at the American Academy of Pediatrics 2019 national conference, fewer than half of all 6- to 17-year-olds are getting 9 hours of sleep on most nights.

WHY DO OLDER ADULTS SLEEP LESS? Older adults need about that same amount of slumber as other adults, but they tend to sleep more lightly and for shorter time spans than younger adults. They have less “deep slow-wave sleep”—the most restorative stage of sleep—“and their sleep is more fragmented, meaning that they're going to wake up more frequently,” Kenneth P. Wright Jr., PhD, assistant professor of integrative physiology and director of the Sleep and Chronobiology Lab at the University of Colorado at Boulder, tells Health. “And when they do wake up,” adds Wright, “they tend to be awake for a longer period of time than young adults.” To put it simply, older adults’ sleep difficulties are often related to the natural aging process, explains Wright. He says another reason could be that many sleep disorders increase with age.

WHAT HEALTH RISKS ARE ASSOCIATTED WITH SLEEP DEPRIVATION? Inadequate sleep negatively affects health in a number of ways, says the American Academy of Sleep Medicine. Sleep deprivation can really do a number on your mood and performance. It can make you feel irritable, anxious, or depressed. It can make it difficult to concentrate on everyday tasks. Lack of sleep can become a safety hazard when it results in drowsy driving and workplace injuries, says the sleep organization. Digestive problems are very common in individuals who have poor sleep quality and probably account for the most common reason why people miss work, Christopher Winter, MD, owner of Charlottesville Neurology and Sleep Medicine in Virginia and medical director of the Martha Jefferson Hospital Sleep Medicine Center, tells Health. “Cancer is another disorder that's been linked to poor quality sleep,” notes Dr. Winter. “Individuals who work unusual schedules and have unpredictable sleep timing over time may show an increased risk for certain types of cancers, particularly women and breast cancer.” Sometimes sleep deprivation is a consequence of a sleep disorder. People with sleep apnea experience brief and repeated pauses in breathing during sleep, making it difficult to slumber soundly. Research suggests those who suffer from this sleep disorder are more likely to experience irregular heartbeats, heart failure, heart attacks, and strokes. Regular lack of sleep can make symptoms of an existing chronic condition seem worse and may even increase the risk of developing certain conditions—high blood pressure, obesity, diabetes, and heart attack, to name a few. It becomes a vicious cycle. People end up reaching for medicines to treat their symptoms, which only worsens the quality of their sleep, says Dr. Winter. And that, in turn, can negatively impact existing medical conditions. He explains that individuals who are not getting enough sleep also are more susceptible to illnesses, as poor quality sleep weakens the immune system. “It’s pretty difficult to figure out systems within the body that are not affected,” observes Dr. Winter. 

HOW DO YOU BUILD GOOD SLEEPING HABITS? Consistency is important. Dr. Winter recommends trying to build in a little bit more consistency and not having such a wide span of sleep timing. He also recommends going to bed and waking up around the same time every day. “If you have the opportunity to sleep in until two in the afternoon on the weekend that might not be the smartest thing to do from a sleep perspective,” says Dr. Winter. Sleep Education recommends limiting exposure to bright light in the evening, turning off electronic devices at least 30 minutes before bedtime, not eating a large meal before bedtime, avoiding consuming caffeine or alcohol before bedtime, and reducing your fluid intake before bedtime. 

ISSUES RELATED TO HEALTHY SLEEP: In our current culture, someone who falls asleep immediately is viewed as a good sleeper. In reality, it’s quite the opposite. “I'm much more concerned about the patient who can fall asleep in any situation than I am an individual who might take 30 or 45 minutes to fall asleep every now and then,” says Dr. Winter. The reason? People who can fall asleep quickly at any time and anywhere may have narcolepsy, a chronic sleep disorder characterized by excessive daytime sleepiness and sudden sleep attacks. That said, people who consistently have difficulty falling asleep may have insomnia. Some other common symptoms of this sleep disorder include frequent waking during the night and having trouble going back to sleep, waking up too early in the morning, not feeling well-rested after a night’s sleep, and problems with concentration, according to the Cleveland Clinic. This, among other reasons, is why many sleep disorders go unrecognized and untreated in clinical practice. Historically, doctors didn't get much training on recognizing sleep disorders. In recent years, there's been a push to bring doctors up to speed on the potential health risks of sleep disorders, and so now more people with sleep disorders are being properly diagnosed and treated, says Wright. If you think you have a sleep issue, voice your concerns to your doctor, says Dr. Winter. “Sleep disorders are often difficult to diagnose because patients don't talk about sleep with their doctors, and doctors are not great about asking patients about their sleep.” 

By: Jenna Wirith

The contents of the Health Magazine and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the Health Magazine and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Health Magazine and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. Health Magazine and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by Health Magazine, Health Magazine employees, others appearing on the Site at the invitation of Health Magazine, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk. 

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

 

 

“Dealing With Sleeping Disorders”

What Are Sleep Disorders? Sleep disorders are conditions that affect how much and how well you sleep. The causes range from poor habits that keep you awake to medical problems that disrupt your sleep cycle. If you don't feel rested in the mornings, see your doctor. Insufficient sleep is a serious problem that poses a threat to your health and safety.

The Dangers of Poor Sleep? Lack of sleep can take a toll on nearly every aspect of daily life. Research has linked sleep deprivation to car accidents, relationship troubles, poor job performance, job-related injuries, memory problems, and mood disorders. Recent studies also suggest sleep disorders may contribute to heart disease, obesity, and diabetes.

Symptoms of Sleep Disorders: Symptoms vary depending on the type of sleep disorder but may include:

• Excessive sleepiness during the day
• Trouble falling asleep or staying asleep
• Snoring or brief pauses in breathing during sleep
• Urge to move your legs at rest or an uncomfortable feeling in the legs at night

The Sleep Cycle: There are two forms of sleep: REM sleep and non-REM sleep. REM stands for rapid eye movement and is associated with dreaming. It accounts for 25% of normal sleep, coming in longer periods toward morning. The rest of our sleep time is spent in NREM, which consists of four stages from light sleep (stage 1) to deep sleep (stage 4). Sleep disorders interfere with normal sleep cycles, preventing a good night's rest.

How Much Sleep Is Enough? Sleep needs vary widely from person to person, but general guidelines are:

• 16 hours for infants
• 9 hours for teenagers
• 7-8 hours for adults

Keep in mind that some adults do fine with 5 hours of sleep and others need as many as 10 hours per night.

Insomnia: Most people have trouble sleeping once in a while, but when the problem lingers night after night you may have insomnia. People with insomnia may lie awake for hours before falling asleep. They may wake up too early and be unable to drift off again. Or they may wake up repeatedly throughout the night. Insomnia is the most common sleep disorder in the U.S.

Insomnia and Sleep Hygiene: In many cases, insomnia is related to poor sleep hygiene. This refers to bad habits that interfere with sleep. Examples include drinking coffee in the afternoon or evening, smoking or eating heavy foods before bed, going to bed at a different time each night, or falling asleep with the television or lights on.

Insomnia and Mental Health: Mental health problems can lead to insomnia. These include depression, anxiety, and post-traumatic stress disorder. Unfortunately, some of the medications used to treat these conditions may also cause sleep problems. If you suspect your medication is disrupting your sleep, talk to your doctor about adjusting your treatment.

Insomnia and Medical Conditions: Insomnia is often related to medical problems, including:

• Arthritis
• Heartburn
• Chronic pain
• Asthma
• COPD
• Heart failure (due to breathing problems)
• Thyroid problems
• Neurological disorders, such as stroke, Alzheimer's or Parkinson's

Other Causes of Insomnia: Insomnia can occur during pregnancy, especially in the first and third trimesters. The problem may return during menopause, when hot flashes can interrupt a good night's sleep. Both men and women tend to have more sleep problems over age 65. And shift workers and frequent fliers can develop a circadian rhythm disorder. In this case, a sort of "internal body clock" that controls sleep, hormone production, and other body functions is disturbed.

Sleep Apnea: People with this sleep disorder have episodes when they stop breathing many times while they sleep. The breathing pauses last several seconds and trigger a switch from deep sleep to light sleep. These interruptions can lead to daytime sleepiness. Many people with sleep apnea don't know they have it. Snoring is a common warning sign, and a spouse may notice breathing pauses followed by a snort or gasp.

Risk Factors for Sleep Apnea: Sleep apnea is most common in people who are male, overweight, and over age 65. Hispanics, African-Americans, and Pacific Islanders also have a higher risk of developing the condition. While it is more common in adults, sleep apnea sometimes occurs in young children who have enlarged tonsils.

Restless Legs Syndrome: People with restless legs syndrome experience discomfort and the urge to move the legs at rest. The problem is usually at its worst during the evening and night. This can make it tough to fall asleep. Others experience twitching motions during sleep that may cause brief awakenings.

Narcolepsy: Narcolepsy causes extreme sleepiness during the day. People may find it hard to function without naps, despite spending enough time in bed at night. Other warning signs include:

• Being unable to move when you first wake
• Losing muscle control with strong emotions
• Dreaming during naps
• Dream-like hallucinations as you fall asleep or wake up

People with narcolepsy enter REM sleep almost immediately, without the NREM sleep stages that normally lead up to dream sleep.

Sleepwalking: People with this sleep problem can literally get up and walk while they are sleeping. The episodes occur during the deeper stages of NREM sleep, and the person may do a variety of activities without waking up. Sleepwalkers typically don't respond to questions and won't remember what they did once they wake up. Sleepwalking is most common in children but can last into adulthood.

When to Call the Doctor: There are steps you can take to fight sleep disorders on your own, but some situations require medical attention. Call your doctor if you snore loudly or gasp during sleep, if you think a medical condition or medication is keeping you up at night, if you're tired all the time or if you fall asleep during daytime activities.

Sleep Diary: Charting your habits for 1-2 weeks can provide valuable information. Include:

• When you go to bed, fall asleep, and wake
• How long and well you slept
• Time awake during the night
• Caffeine or alcohol consumed and when
• What/when you ate and drank
• Emotion or stress
• Drugs or medications

Diagnosing Sleep Disorders: To diagnose a sleep disorder, your doctor will ask about your sleep habits and medical conditions. Next, you may be referred to a sleep clinic for testing. A polysomnogram, also called a sleep study, records brain activity, eye movements, and breathing while you sleep. These patterns can indicate a disorder like sleep apnea or a less common type. Research has identified more than 85 sleep problems, including sleep terrors, REM sleep behavior disorder, and sleep starts.

Treating Sleep Disorders: For sleep apnea, a CPAP device increases air pressure to keep airways open so you can rest more soundly without the breathing pauses that interrupt sleep. Narcolepsy and restless legs syndrome can be treated with lifestyle changes and prescription medication. There are also effective medications for insomnia. However, many people can beat insomnia without medication by changing poor sleep habits and taking care of related conditions.

Cognitive-Behavioral Therapy: Several methods can ease sleep anxiety, which makes insomnia worse. Relaxation training and biofeedback help to calm your breathing, heart rate, muscles, and mood. Talk therapy can help replace bedtime worries with positive thinking, so your mind can settle down at night. Cognitive behavioral therapy (CBT) works as well as prescription drugs for many people with chronic insomnia.

Sleep Hygiene: Exercise - Adopting habits that promote sleep is known as good sleep hygiene. Regular exercise should be part of the plan, but the timing is important. Exercise in the late afternoon can make it easier to fall and stay asleep – just don't let it get too late. Exercise within a couple hours of bedtime can make it harder to fall asleep.

Sleep Hygiene: Problem Foods - Certain foods and drinks should be avoided in the 4-6 hours before bed:

• Caffeine, including coffee, tea, and soda
• Heavy or spicy foods
• Alcohol (While alcohol helps some people fall asleep, it leads to nighttime awakenings.)

Sleep Hygiene: Helpful Foods - A light evening snack of complex carbs and protein can lead to better sleep. Cereal with milk or crackers and cheese fit the bill, but they should be eaten at least an hour before bed. Warm milk and chamomile tea raise body temperature and make many people feel sleepy.

Sleep Hygiene: Television - Late-night television may be part of your routine, but chances are it is not helping you sleep. Television engages the mind and can increase alertness, keeping you awake. Playing video games before bed or surfing the Internet may have the same effect. The National Sleep Foundation recommends removing televisions and computers from your bedroom altogether.

Sleep Hygiene: Bedtime Rituals - You can signal your mind and body that it's time for sleep by creating a bedtime ritual. This may include a warm bath, reading a chapter of a book, or practicing relaxation techniques, such as deep breathing. It's also important to stick to a firm bedtime and wake-up time, even on the weekends. If you still have trouble sleeping despite improving your sleep hygiene, check with your doctor.

Reviewed by David T. Derrer, MD on February 27, 2014

SOURCES:

National Institutes of Health.
National Sleep Foundation.
University of Maryland Medical Center.

Much Love, Dr.Shermaine #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2Live

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.