When Jenna Strong started eating healthier, she did it for her future. She and her wife, Kate, wanted to start thinking about having a family, but the two were self-admittedly not able to take that step without evaluating their eating habits.
"We could easily split a large stuffed crust pepperoni pizza, a two-liter Coke, and a bag of store-brand cookies for dinner," Strong said. "Actually, that was kind of our favorite."
She said she capped off at 300 pounds on her 5' 6" frame before determining to make a change. "I started off with super basic stuff. I switched to fat free, sugar free, you know, all the traditional diet stuff. It worked for a kick start. I just kept trying to make healthier and healthier changes."
Strong began to exercise as well, watching The Biggest Loser as her motivation. With this new lifestyle, the weight dropped off. Within two years, she'd lost 125 pounds, using what she calls intuitive choices about food, exercise and portion control.
She started school to become a personal trainer to help others achieve what she'd been able to do, and the pounds kept melting away. She lost another 50 that year, and at one of her lowest points, weight-wise, came in at about 115 pounds.
"I got comments about how great I looked," she said. "I started fitting into clothes I was never able to wear before. I could shop anywhere. I loved seeing myself in photos. It was such a new experience."
But somewhere during all of this, her healthy choices had taken a sharp turn without her consciously knowing. Small physical and mental changes started concerning Strong's loved ones: Her hair started falling out in small patches, her breasts shrunk to below an A cup, and she hadn't gotten her period in months—symptoms caused by a severe or abrupt lack of protein, iron, or Vitamin A. Strong shrugged these things off.
"I was shaking and crying, just panicked. That was the moment I realized there was a problem. I was terrified of food."
For Strong, it took a panic attack in a public space for the things to start adding up. "Kate and I were spending the night shopping, and I pretty much would only eat my own food at that point, and I didn't have any of my snacks on me. I just started freaking out. Even at a salad bar, I said, 'but it's not organic!' I was shaking and crying, just panicked. That was the moment I realized there was a problem. I was terrified of food."
Fear of food is not a new problem, but it's recently been studied as a form of eating disorder, and is being considered by the American Psychiatric Association for inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM), during its next edits. It's called orthorexia, a term coined in 1997 by Dr. Steven Bratman.
Bratman explains that it's not eating healthy food that is the disease, but the vice-like grip of the mind on the idea of only eating healthy food—it becomes an obsession. He coined the term as a way to strip the virtue from healthy foods from his patients who couldn't understand how something good for you could ultimately be bad for you, psychologically. By labelling it a disease, his patients were able to separate themselves from the belief that what they were doing must be good for them.
Fear of food is becoming widespread, says Jim White, a registered dietician, nutritionist, and spokesperson for the Academy of Nutrition and Dietetics. They can get addicted to the high of weight loss, White said, but there's also another component at work. "People start to control their diet in ways that are not sustainable. We're crossing off entire food groups now, as a society. Don't eat dairy, don't eat carbs. How realistic is that in our society?"
While extreme diets work well for a week or two, cutting out entire food groups like gluten content or lactose content, can cause deficiency of important vitamins and minerals, said White, making the body more susceptible to illness. "Gluten is nothing to joke with," he said. "Food or lack of it can be majorly detrimental to your body."
This type of anxiety with regard to foods is what leads to disordered eating, according to Marcia Herrin, founder of the Dartmouth College Eating Disorders Prevention, Education and Treatment Program. In an interview with PsychCentral, she said, "It seems rational to think that certain foods are so unhealthy they should be avoided, but it isn't. If truly a food was bad, it would be banned from the food supply. Any food in 'bad' amounts can be dangerous. Even too much water can kill you."
Herrin mentioned that seemingly innocuous life limitations can be vital clues to discovering crippling food anxiety before it irrevocably impacts health, either physically or mentally. These are some warning signs, she said: "If it matters what the menu is before you can accept a dinner invitation; if you can't travel because you will be faced with unfamiliar food; if you can't eat wedding cake at a wedding."
If you exhibit any of these signs, Mirasol Eating Disorder Recovery Center has a list of questions that could help you determine if you are suffering from orthorexia. If you are, the center recommends finding a therapist who specializes in Cognitive Behavioral Therapy and looking for signs of underlying anxiety as a root cause.
Illnesses like cancer, diabetes and heart disease can also lead to orthorexia. Danielle Adams' relationship with food was healthy until she was diagnosed with breast cancer in her early 30s. "My friends started telling me that sugar feeds cancer, and if I didn't stop eating it, the cancer would come back no matter how much chemo I went through," she said. "And I was so scared already, I started to believe them."
Adams went through her rounds of chemotherapy while also starving herself. "I was hungry, and doctors were telling me to eat, but I would get so scared of everything," she said. "My husband would make me drink a smoothie in the morning, and that's all I'd eat all day."
"It feels like my brain is basically broken"
It's now been more than two years since Adams was diagnosed with cancer, and while her food fears are being controlled, she still deals with them every day. "I still check labels, wondering if I eat this is the cancer going come back. There are still days I skip breakfast, lunch or dinner. It feels like my brain is basically broken, but I know, at this point, those thoughts are wrong."
During Strong's recovery from her fear of food, she switched from personal trainer education to preparing food for cancer patients in their homes, to combat this very phenomenon. "My love of cooking combined with still wanting to be healthy led to me becoming a personal chef, in this way," she said.
But being around those fighting for their lives did strain Strong's own relationship with food again. "I suddenly felt like everything was going to give me cancer," she said. "I thought, if you want to actually be healthy, you should be eating like these people [cancer patients] eat."
Strong is holding the line between healthy eating and her fears. "There is no denying in my head the powers that food have. Food is a hugely emotional factor in our lives. It has to do with our cultures, our socioeconomics, our childhoods, how we raise our own children," she said. "There are so many factors, and it is so deeply personal. We cannot leave it up to ad campaigns and social media to tell us how to eat."