Ask Dr. Mike: When Healthy Eating Goes Too Far

Ask Dr. Mike: When Healthy Eating Goes Too Far

You don’t seem to get a lot of letters from guys, but my wife and I have read your column in the past and we like it.  I was hoping you will answer this letter so that I can show my wife and get her to see that her problem is real and that she needs help.  My wife and I have always been healthy when it comes to food, but over the past year or so her healthy eating has gone to a crazy, crazy place.  She only eats organic foods that she buys at Whole Foods now, and she will only eat at Whole Foods if we eat out as a couple or family.  Last week she ate at Whole Foods while me and the kids went to Chipotle next door, which was weird.  She’s also super on edge about water now, and she only washes off lettuce at home with bottled water and brushes her teeth with bottled water.  We can no longer eat at anyone’s house, and when we went to her parents for the holidays this past Christmas, she brought her own food.  She’s also a huge Dr. Oz fan and buys every food and supplement or vitamin he recommends.  Our kids used to joke about how weird their mom and me were with our healthy eating, but it’s no laughing moment anymore for them.  Our youngest daughter actually cried about it the other day when we ate at Chipotle and my wife at Whole Foods.  Every time I’ve tried to talk to my wife about her problem, she becomes upset and just walks away tearful.  Not sure what to do.  Help!

Struggling in Ashburn

Dear Struggling in Ashburn,

Based on what you’ve written, your wife may be suffering from Orthorexia Nervosa, which is an eating disorder that involves health-focused obsessions and fixations with food and restrictive eating.  Individuals in the throes of Orthorexia are compelled to only consume foods that they view as being healthy or pure or clean.  Unlike Anorexia where thinness is the goal, for those with Orthorexia, the goal is the perfect diet; eating foods that provide one with a sense of eating exclusively to feel healthy.

Individuals with eating disorders of any kind are typically difficult to treat because they often possess little to know insight or self-awareness regarding their problems with food, and the disorders are largely driven by anxiety and distorted self-image.  The comorbidity (i.e. the occurrence of two or more conditions) between eating disorders and other psychiatric conditions (e.g., Obsessive Compulsive Disorder) is high, so your wife’s struggles with healthy eating may or may not be her primary problem.

I recommend that you talk with your wife about your concerns again.  This time instead of focusing on her eating as “her problem,” I would focus instead on the negative impact her behaviors with food is having on the children and you.  For example, you could let her know about your daughter’s upset and tears the evening your wife’s restrictive eating needs led to you separating as a family for dinner.  Anything you say to your wife should be asserted from a place of love and concern, and you should avoid arguing at all costs.  If she becomes defensive with you during the conversation, be empathic and reiterate your concern for your children as well as for her and you both as a couple.

You’ve written that your wife’s problem with healthy eating worsened within the past year, so perhaps the two of you could also discuss what this past year has been like for her; were there any negative or upsetting changes or events in her life during that time period?  Hopefully, she will feel supported and loved by your conversation, and more open then to the idea of getting help.

Not having formally evaluated your wife, I cannot diagnosis her.  And I will add that while Orthorexia is recognized and treated worldwide as an eating disorder by therapists, it hasn’t been accepted by the American Psychiatric Association.  It’s also not included as a diagnosis in the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM).  Based on what you’ve written, your wife’s struggles do seem to be negatively impacting the quality of her life and her relationships.  Thus, I recommend that she consider scheduling a consultation with a psychiatrist or psychologist to determine what exactly is going on for her and to get her the help she may need.  I hope showing your wife my response here is helpful.

Dr. Michael Oberschneider is a highly accredited clinical psychologist and the founder of Ashburn Psychological Services. Dr. Oberschneider has spent over a dozen years working as a psychologist in a variety of capacities with children, adolescents and adults. Dr. Oberschneider has practiced as a staff psychologist at an inpatient hospital unit, the United States Justice Department, the City of Alexandria (Youth and Family Services) and in private practice.