Grandma Gertie always said there's not a savory dish that can't be made tastier by just a touch of tarragon.

Tsunami and Me

Tsunami and Me
too big to escape now....

Sunday, October 20, 2019

Pure as the Driven Snow

When I was a Peace Corps Volunteer in the Dominican Republic I befriended a young vegan woman from Colorado. We both lived near the Haitian border where fresh vegetables rarely could be found. We'd go to the local open air market and she'd snag what few gnarled carrots and shriveled green beans she could find.

"I just make do with bananas and peanut butter and I'm grateful that rice and beans together make a complete protein," she explained.

I admired her fortitude. A lifelong vegan, raised by vegan parents, she didn't make a fetish of her eating nor did she sneer at me when I stopped at the local ice cream store for a chocolate chip cone.

She'd just have a glass of fresh guanabana juice and keep me company. I never heard her comment on her purity or the impurity of others. She simply didn't eat meat or dairy products. 

Yesterday, at the Orange County fairgrounds, I overheard some conversations and saw some displays that reminded me of why eating disorder treatment clinics are burgeoning in the United States. 

I enjoyed the fresh pineapple juice I ordered to accompany my vegan tacos, but found it overly sugary. I don't have any food allergies or taboos, but keep sugar to a minimum. Nonetheless, I didn't feel that I'd ruined my efforts to lose the weight I gained during my Grand Jury duty by sipping about a quarter of the huge cup I'd bought. It only had been offered in one size: gargantuan. 

That wasn't the case of the three people I overheard standing by the coconut vegan ice cream booth. They were nattering about sugar, fats, sodium, GMOs, and complaining about not seeing all the ingredients listed on some of the booths featuring so-called healthy foods. 

"Well, at least we're better than those fools who buy funnel cakes and those slider towers at the Orange County Fair," one said.

It was the word "better" that made my ears prick up like my late, great Akita, Tsunami's, when I mentioned treats. I surveyed the booths and the displays. Mentally,  I pictured a 1940s flashing neon sign,"orthorexia, orthorexia, orthorexia"  
Certainly a desire to improve one's health by a vegetarian or vegan diet is not a mental health disorder.  But feeling purer or better than those who do not follow similar diets might well be a sign of obsessive thoughts that can lead to an eating disorder. 

Back in the 1980s when I worked as a supervising psychotherapist at a Southern California HMO, I had many patients who were anorexic or bulimic. It wasn't until around 2005 I first heard of orthorexia nervosa. No, that particularly eating disorder cannot yet be found per se in the DSM5. But it well falls under Avoidant/Restrictive Food Intake Disorder (ARFID) which is.  
The doctor in NE WA who first discussed orthorexia with me had a daughter who was severely malnourished because of it. When her application to join the Peace Corps had been rejected, she had become both severely depressed and obsessed with pure eating. She'd systematically eliminated so many foods from her diet that she practically subsisted on celery and bottled water, which she consumed by the liter. 

"She claims it flushes the poisons from her body," the physician said. "She's having kidney issues and the renal specialist has warned her that she is dangerously close to  hyponatremia."
"Hypo what?" I asked.
"Hyponatremia. It's overhydration. Your kidneys can't flush out all the water you've consumed."
Now I looked around the VegFest and noted that nearly everybody was toting a plastic bottled water in addition to whatever vegan or vegetarian dish they were consuming. I thought about Orange County's landfills and the floating plastic islands in the ocean.
This morning I Googled "Orange County treatment centers orthorexia nervosa." Twenty-six names of clinics came up. It's quite an industry. So how do you find a happy medium? What is the Golden Mean? It's the obsessive thinking and the sense of being purer than others that's the tipoff.

I consulted the National Eating Disorders website for these warning signs and symptoms of orthorexia. 
  • Compulsive checking of ingredient lists and nutritional labels
  • An increase in concern about the health of ingredients
  • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
  • An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
  • Unusual interest in the health of what others are eating
  • Spending hours per day thinking about what food might be served at upcoming events
  • Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
  • Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
  • Body image concerns may or may not be present

Basically, it's good to maintain good health. But to feel superior to others because of our exercise program or food choices may be a mistake. We need to ask our guardian angels to not let us become so pure that we mistake ourselves to be angels in a world full of sinners.

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