When Does a Therapeutic Diet become an Eating Disorder?


Do you know anyone on a very restricted diet? First to go is red meat (because of the cholesterol), then chicken (because of the antibiotics) then it’s anything with eyes.

What follows on the banned list is dairy (because it forms mucus), gluten (because of the bloat), potatoes and rice (because they are starches) and oil (because it’s oil).

Interestingly coffee, alcohol and diet cola are often still included in this healthy diet, which makes me suspicious this is not a health fest but rather disordered eating. It’s not immediately obvious because the person is not starving themselves (as in anorexia) or throwing up or purging (as in bulimia). Nevertheless… Houston – we have a problem.

While some restrictive diets may appear hunky-dory on the surface because there is no junk food and an preponderance of lettuce leaves, the lack of variety and paucity of nutrients may lead to health problems. Some as blatant as protein deficiency, but other common nutrients in low supply may include iron, B12, calcium and essential fatty acids. It can take some time for deficiency signs to emerge, such as weak nails, lacklustre skin, lethargy and slow healing time. In addition, the long-term health problems are significant including osteoporosis, infertility and lowered immunity.

Mea culpa

Naturopaths are partially to blame as we often diagnose food sensitivities, taking people off a particular food to see if their symptoms improve. Eliminating a food e.g. milk products for one or two weeks as a dietary challenge is unlikely to negatively affect your health. If the allergy diet improves your symptoms (e.g. hayfever or sinus), your naturopath may recommend you reduce these foods from your everyday diet. What the naturopath will also do is to ensure that the rest of your diet makes up for the lost nutrients. In the case of dairy you would be considering calcium-rich food like almonds, fish with bones (sardines, canned salmon), soy milk and leafy green vegetables. If the person is at particular risk of calcium deficiency, a supplement might be appropriate. The problem occurs when other nutritious foods are not substituted for the eliminated ones. This often happens for the budding vegetarian, who will simply take the chop off their plate and not replace meat with other protein choices such as legumes, nuts and seeds.

Given the emphasis on the body beautiful (i.e. thin) and all the conflicting ideas about what is good and bad to eat, no wonder there is confusion about what constitutes a good diet. Women in their late teens to late twenties seem to be more inclined to favour super-strict diets. Fear of fatness is a major concern, and if this diet also keeps them slim, it is really hard to convince these women to change.

A restrictive diet makes socialising very difficult. When a diet so severely interferes with someone’s life, without VERY good health reasons, it is time to question the real reasons. These reasons may be similar to why someone chooses other eating disorders including obesity, anorexia and bulimia. There are counsellors who specialise in this area. A healthy diet is a varied diet that adds pleasure to your life, rather than restricts it.