Podcaster Farah Eltohamy interviews Megan Kniskern, a lecturer at ASU's College of Health Solutions, to discuss orthorexia, also referred to as the "healthy eating disorder." The two also discuss how to better one's relationship with food, their body and overall health without sacrificing anything in return.
Disclaimer: This podcast contains sensitive topics including multiple forms of eating disorders.
Farah Eltohamy: The standard American diet is notorious for being far from healthy. As Americans, we are exceeding the recommended calorie intake from things such as solid fats, sodium and added sugars. There is this ongoing concern to better our diets which many have taken to social media. Many of those who do so are "social media stars" — people who have very large followings on these platforms. As a result, there has been this heavy push of "clean eating" onto easily impressionable audiences. While essentially there is nothing wrong with encouraging healthy lifestyles, the danger in social media is a pursuit of perfection. This can lead to obsessive behaviors and eating disorders. One example is orthorexia, when trying to become healthy becomes too unhealthy.
Megan Kniskern: My name's Megan Kniskern, I am a registered dietitian at Arizona State University. I've been a lecturer here for about four years, and I've actually done the majority of my career in the realm of working with eating disorders, addictions and mental health as it relates to nutrition issues.
Farah Eltohamy: What exactly is orthorexia?
Megan Kniskern: Orthorexia is not a diagnosable eating disorder. It's not in the same realm as anorexia nervosa, bulimia nervosa or binge-eating disorder. It is an increasing trend that we see in having disordered eating patterns that resemble similar characteristics as diagnosable eating disorders. When it comes to orthorexia, there's this fixation on this perfect, clean, righteous eating, which is really kind of the literal translation of orthorexia.
We become hyper-focused on doing and eating and acting and caring for our bodies in this perfect way, which does interfere with your ability to live a normal life. That sense of being healthy becomes essentially unhealthy through the extreme measures that people begin taking. It also mirrors the way an eating disorder consumes someone's life but instead as the want to eat perfectly can consume your life. We want food and health to take a certain amount of our life and our energy and our focus, but we don't want it to take all of our life and our energy and our focus.
Farah Eltohamy: Why is orthorexia not talked about like other eating disorders?
Megan Kniskern: One, because you can't diagnose it. It's really in its infancy and it's being researched pretty heavily right now in order to identify what are the predispositions or the factors that contribute to someone having the acquired behaviors of orthorexia nervosa.
Then also, how would we diagnose it if it did become an actual mental health diagnostic term? We're not there yet. It's really more of a conceptual idea although it has a lot of great concepts already in place. I think that we kind of look to the things that we know more about and we tend to shy away from things that we don't.
Social media is really tending to force our hand in this avenue because we didn't in the past see a number of people having these growing platforms and these growing knowledge based pieces of information that are thrown out there to the ether and having people respond to them. But it's a personal belief system in lot of ways.
It's more of a focus on how can you define who you are through how you look externally, and that's done through prioritizing your health in a way that becomes a full time job. Nobody has that kind of time and those resources to do those things realistically. But we make it seem very easy, and we create all these tips in these different ways of doing it that don't really promote the accurateness of what they're actually doing behind the scenes, which is this is all-consuming for most of them. And I'm saying them in relation to people who make it seem really easy to make it so that you are the best, healthiest version of yourself.
That's privilege-based, it's time-based, it's money-based, it's skill-based. If you don't know how to cook or prepare or shop or plan, there's a lot of things that can go wrong. Therefore the rest of us all just continue to feel like we're not that healthy, or we're not that determined or we're not that driven. In some way it translates into insecurities and inadequacies in how we view ourselves. So it kind of sells itself, right?
"I want to be better, I want to look better, so I'm going to follow along with these different extreme eating patterns," and then that doesn't really play itself out. We find another extreme way of eating and we normalize it through our culture because we see it everywhere we go.
Farah Eltohamy: How can one prioritize their physical health and their overall diet without sacrificing their mental health and spiraling into an obsession with food?
Megan Kniskern: It comes with identifying that there is a lot of different purposes that food serves. Food serves a sense of fuel. If we don't eat we die. Food also serves a sense of nourishment and pleasure. You can't just look at food from a sole perspective of fueling your body. We have innate drives, we have hunger, we have appetite. There's a reason there is an infinite number of food choices and combinations out there. This is a privilege that we all have. We get to fuel our bodies with something that we can also enjoy.
Not all the time, we're not always going to love our lunch. Today I didn't love my lunch but I had fuel and I ate it and I'll do better the next meal.
We have to look at it from multiple perspectives. We also socially engage around food a lot. It takes away some of the fun aspects and some of those social aspects when we don't look at food from a number of different perspectives. Finding a better balance with how you view food can be really helpful.
We also know that if we tend to tell ourselves we can't have something it tends to be the first thing that we kind of want to have. When we put ourselves in these uber-restrictive places, where we're not allowed to have certain things, it again creates a sense of heightening. We become more and more and more fixated. No one eats perfectly, even anyone that you follow that looks perfect or says that they eat perfectly, there just isn't such a thing, perfect is different for each of us.
Instead we compare. We are comparing apples to steaks. We are comparing oranges to broccoli. We are comparing ourselves in a way that just isn't really useful when looking at bodies and lifestyles and experiences and access. All of that is a lot more complicated.
Farah Eltohamy: One proposed method by dietitians to combat eating disorders is something called intuitive eating. Could you elaborate what that is?
Megan Kniskern: Yes so intuitive eating is a 10 step approach to really get to the core of how you take care of yourself through food. It's identifying that food is fuel and that we have to have balance in all things.
I would drink soy lattes all day long if I could, but I know that that's just not the best option for me. We find different ways that we have a little regulatory agencies that we put on ourselves, but not in a way that eliminates entire food groups or that reduces our food pleasure or that doesn't take into consideration that our body will send us signs and signals for things that we need.
Sometimes you'll have a meal and an hour later you're like, "why am I hungry I had a big meal?" Well you don't get to decide that, your body is deciding that. It's about how do you reconnect to your body, to the signs that your body sends, to what your body needs, and also stop making your body and food the enemy and start to make it really one comprehensive way to move through life with ease and with pleasure and with balance.
Farah Eltohamy: What are your final words of advice to college students who feel like they're lacking an overall sense of balance because of hectic schedules or financial status?
Megan Kniskern: Throughout our entire life cycle, things are going to change and how much we are able to prioritize cooking at home or getting to the gym or having outdoor activities in Arizona. There's different times where we have different priorities, and as a student if you're working a job, if you're going to all your classes, if you're studying, if you're involved in organizations and you can't prioritize cooking your food, getting tons of fruits and vegetables getting to the gym regularly, that's OK.
When you get to a time in your life for you do have more of an opportunity to do that then start fitting it back in. Check in with yourself every once in a while see, "Am I sleeping okay? Am I hydrating myself effectively?" There's a lot of other ways that we also prioritize our overall health not just through how we eat and how much we exercise.
You'll also start to notice sometimes maybe you're getting tired more frequently or you feel a little more lethargic, maybe that's a sign. "Okay, you know what a couple of times this week I'm going to get up I'm just going to do a little 20 minute walk around wherever I live." It doesn't have to be, "I'm going to the gym, and I'm getting my two hour workout on." Sometimes it's just finding these moments to fit in times for yourself and maybe that involves moving your body, maybe that involves having dinner at a friend's house. I know living in the dorm can be really difficult when it comes to food prep, but maybe it's going to a friend's house and having a meal that you make together there and taking some leftovers back with you.
It's about finding little moments where you can make decisions that you know are good for you but not making it so that you feel terrible or guilty when you're not prioritizing that at every corner or every turn in your education process.
You'll get out of school, you'll maybe only have your job, you won't have to worry about all these other things. Then you refit it back in, and you find communities at a yoga studio or a spin studio or hiking clubs. There's other ways that you can incorporate taking care of yourself through activities and actions that matter and that you enjoy, not as a burden, not as a requirement necessarily.
Farah Eltohamy: For the State Press, I'm Farah Eltohamy.
If you or someone you know is struggling with an eating disorder and is in need of support, please call the National Eating Disorders Association Helpline at 1-800-931-2237. For a 24-hour crisis line, text “NEDA” to 741741.