When Eating “Clean” Gets Messy

In today’s world, we are more aware than ever before of what we put in our mouths at mealtime. Whereas once we might have dieted to lose weight, what we consume now has been imbued with new powers. Whether you want to minimize environmental impact and maximize food quality (Whole 30, Eco-Friendly Eating), reconnect with our primal ancestors (Hello, Paleo!), or achieve the “perfect” macronutrient balance (No carbohydrates!  No white flour! Eat this, not that!), there is sure to be a food ethos to meet every taste.

The shift from weight towards wellness – even Weight Watchers is advising that we “move beyond the scale” – is ostensibly a good one. For many people, embracing an approach to eating that includes more fruits and vegetables and sweets in moderation is a win-win that helps with energy, sleep and, in some cases, the prevention or management of chronic health conditions.  Going to the local farmer’s market to buy organic, seasonal produce can feel doubly good because you know you are doing something to care for both your body and the environment.

So what’s my beef with locally sourced, grass-fed beef? As I see it, the trouble is that this shift from “diet culture” to “food culture”, is…well…shifty, and the end result may not always be that different from the diets of yore. In the past, the virtues of eating only grapefruits or drinking chocolate shakes three times per day were espoused. Today, the magazine racks in your local grocery store are full of guidance on the “right” way to achieve optimal health. And thanks to the internet, we are now also armed with a virtual, unlimited fountain of nutritional “know-how” that flows from sources varying widely in their knowledge and experience, including dietitians, wellness bloggers, and beauty editors.  A Google search for “eating clean” promptly provides 125 MILLION hits – with the top result providing detailed instructions such avoiding processed foods, eliminating refined sugar, and eating five or six small meals a day.

Maybe this doesn’t set off the alarm bells that a grapefruit-only diet would, but it should. For most people, rigid diets are simply unsustainable, as is any weight loss that might result from them. Perhaps even more concerning, for other people, trying to limit or eliminate certain foods (or entire food groups) sets into motion a slippery slide on the eating behavior spectrum towards increasingly unhealthy eating behaviors such as fixed rules about what or when to eat, severe calorie restriction, rituals around eating, binge eating and/or purging.

In my experience, it is not always obvious from the outside who is experiencing this slide into an eating disorder. Certainly, these behaviors might lead to dangerously low weight for some people. Many others, however, continue to be at a “normal” weight that is actually underweight for their body’s needs and begin to experience some of the psychological elements of an eating disorder such as intrusive thoughts about food, an intense fear of gaining weight, or feelings of losing control (or being overly controlled) around food. We consider this a type of Other Specified Feeding and Eating Disorder (OSFED) – emphasis on disorder, and de-emphasis on other, please – called atypical anorexia nervosa, and are in the process of trying to learn more about people who may fall into this group.

At the Columbia Center for Eating Disorders, we have worked for years to develop a line of research investigating how people make decisions about food. Using the newest advances from cognitive neuroscience and neuroimaging, we can directly assess the brain circuits that underlie a person’s process of making food choices. In our ongoing study, we are aiming to get a better sense of what (if anything) is different in the brains of people who don’t diet at all, those who do but do not develop an eating disorder, and finally, those who start by trying to “watch what they eat,” but wind up further along that slippery slide on the eating behavior spectrum, regardless of weight. People with eating disorder symptoms who participate in this study have the option to receive treatment at no cost.

We hope, as always, that if you recognized yourself in any of the description provided above that you will join us on our research mission. Regardless, we encourage you to speak with your physician or have a consultation with a mental health provider to assess whether or not your “clean” eating is getting messy.

For information on this study or other current studies (and treatment options) at the Columbia Center for Eating Disorders, please call us at 646-774-8066.

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