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The number of children fixated on health foods is on the rise, so is this really a problem? Most experts and families alike want children to adopt healthy eating habits in hopes that such behaviors will stem the tide of obesity and nutrition sensitive diseases like diabetes. But sometimes too much of a good thing can create more harm than good.
Yesterday my neighbor came over with her 7 year old grandson. Knowing I'm a dietitian, she said she had concerns about her grandson's diet and growth. I asked her what was going on and she proceeded to tell me that she thought her daughter's extreme health food behaviors might be impacting her grandchild's behavior, growth and development. She noticed that her grandson talked a lot about gluten, salt and vitamins and was anxious about attending a birthday party during coming weekend because he was afraid that he might eat something "bad." His behavior at school has not gone unnoticed either. He often critiques the other children's lunches and once lectured the teacher about the hazards of salt!
What she described to me is a condition called orthorexia nervosa, a disordered eating pattern characterized by a fixation on food quality and purity that results in a preoccupation with diet. The term "orthorexia" is from the Greek words, "ortho" meaning "correct, true or straight" and nervosa meaning "obsession. " In orthorexic children, food anxiety is common, especially around mealtimes or in unfamiliar eating environments like a birthday party. The apprehension of eating something forbidden outweighs the joy of eating, leading to feelings of panic, anger and dread. Orthorexic children often become socially isolated from their peers and there are some reports of depression.
Orthorexia is not a case of "picky eaters;" it is a pattern of behavior that is driven by obsessive thoughts about food quality and virtue. Experts disagree as to whether orthorexia is a real disordered eating pattern or an off shoot of anorexia or obsessive compulsive disorder. Regardless of title, the pattern is real.
Until recently, orthorexic eating patterns were thought to only affect adults, but dietitians and mental health experts alike are starting to see the pattern in kids, a condition I call "orthorexia by proxy." The behavior is usually linked to ultra health food conscious parents whose own dietary behaviors influence their children's choices. Parents intent on using food as a way to prevent or treat hyperactivity, heart disease and diabetes have caused many kids to worry about diet at younger and younger ages.
Parents should be vigilant about what their children eat but in some cases public health messages are taken to the extreme or food selection is based on a widespread nutritional myth. What starts as a good intention, can sometimes lead to unhealthy obsessions and dysfunctional eating behaviors that if persistent, can adversely impact growth, development and well-being of the child.
As a clinician, I have counseled adolescents and young adults with eating disorders or obsessive food behaviors, some of these cases began as orthorexia in childhood. To be clear, not all dietary conscious parents will foster orthorexia, however, some children are susceptible, particularly those with existing obsessive compulsive tendencies or anxiety disorders. Helping these young clients re-learn balanced eating behaviors and choices while addressing obsessive tendencies is the focus of therapy.
Nutritionally sound decision-making skills can be promoted in environments that offer all foods in realistic portion sizes. Providing an array of foods while slimming the serving size teaches children that there are no "good or bad foods." For example, describing foods as "sometimes" foods vs. "always" foods can empower younger children to make more thoughtful food choices when no one is looking. Presenting realistic portion sizes ingrains the child with the ability to recognize when serving sizes are on steroids. Lifelong dietary habits begin early. Parents and caregivers should consider empowering the child with food decision making skills through example and choice, rather than elimination and severe restriction.
When it comes to diet, creating mindful children is a worthy goal. Choosing to surround children with a diverse assortment of food builds self esteem, decision-making skills and can be an opportunity to teach about ethnic culture and creativity. But as with all things, balance is the key to success. So the next time a diet fad, nutrition study or new dietary restriction appears in the news, ask yourself: "Does this new strategy promote balance and choice?"
To learn more about orthorexia, visit www.orthorexia411.com
