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Orthorexia Nervosa

Discussion in 'Personal' started by jubilee, Dec 16, 2018.

  1. jubilee

    jubilee Star commenter

    I have a close relative with bizarre food preparation regimes and a very restricted diet. She is down to about 10 foods and one of those is a particular margarine. She has been cutting out foods for decades. A recent illness has seen her weight drop to 35 kilos (5.5 stones) before improving a little.
    We have tried over the years to persuade her to take in more calories and to re-introduce banned foods but she takes umbrage at us suggesting that she doesn't know what her own body can tolerate. Every single ache and pain, twinge and feelings of unease (shakiness, furry tongue, digestive problem etc) leads to something she has eaten in the previous hour or two being removed from her diet, sometimes for good. She only drinks water heated to a specific temperature and keeps a pan just for that purpose. None of her pans can be used by others in the house.

    She can sound incredibly plausible with her pseudo-science about digestion and nutrition and doesn't like it when you contradict her with the facts.
    She genuinely seems to want to be a healthier weight, so I don't think that it is Anorexia. Does anyone have any experience of Orthorexics and what can be done to treat them? We are fast coming to the conclusion that she really needs to be sectioned for her own good, but that would have to come from her husband and he seems to have decided that it's easier to pander to her eccentricities.
  2. Orkrider2

    Orkrider2 Star commenter

    From my, admittedly fuzzy, memory of eating disorders in my psychopathology course, it sounds more like it’s an OCD spectrum thing. From memory, eating disorders and OCD do tend to be comorbid anyway so it could be a combination of both.
    Usual treatment for both eating disorders and OCD tends to be CBT and anti-depressants and possibly family counselling.
    An alternative therapy for OCD centres around the idea that the intrusive thoughts do not need to go away, but their importance and the time dedicated to them should be decreased through therapy until they no longer cause distress and thus no longer need the compulsive behaviours to cancel them out.
  3. jubilee

    jubilee Star commenter

    Thanks for your reply Orkrider. I do see OCD as being part of the problem with the routines that she has around food preparation and things like personal care and household tasks. However, the main issue is her nutrition (or lack of it) and she eliminates foods based on what she decides are unbearable physical symptoms. She's not allergic to anything but claims to be super sensitive to most foods and tells us that we wouldn't be telling her to re-introduce them if we could feel what she feels.
  4. peakster

    peakster Star commenter

    We had a teacher in our department a few years ago who had a serious eating disorder. She wouldn't eat anything cooked, ate no carbs or proteins and would often go a couple of days without eating at all.

    She was incredibly thin - and then she started to develop stress fractures because her bones started to go brittle.

    She is a bit better these days though.

    ROSIEGIRL Lead commenter

    She needs professional help but of course that is dependent on her admitting that she has a problem and wanting to make it better.
    Has she sought help?
  6. nizebaby

    nizebaby Star commenter

    The encouragement of food hypochondria is big business nowadays. It plays on the susceptibilities of people who have an uneasy relationship with what they eat.
  7. jubilee

    jubilee Star commenter

    She's at the GPs more than the average, I'd say. She has had loads of tests and does have some genuine health issues but they are not things that are related to her 'special' diet.
    She mainly refuses the medication that they offer (innoculations, antibiotics, inhalers) and then complains that the NHS can do nothing for her. Family tell her that the NHS is offering her treatments but that she is rejecting them.
    She comes away from GP/Practice Nurse visits with a decision made that she will need to book a new appointment soon as they haven't understood her case properly. She gets fretful on Fridays as the GP will be closed over the weekend and she might need to see them again.
    One GP, she says, has questioned her aggressively over her eating habits and clearly suspects anorexia. Others, she says, are more sympathetic. How could she possibly be anorexic, she says, when she is constantly flagging up her low body weight. Anorexics don't go to the GP and flash their jutting-out hip bones, she says.
  8. nizebaby

    nizebaby Star commenter

    She is surely delusional.
  9. monicabilongame

    monicabilongame Star commenter

    She needs a referral to the community mental health team
    mothorchid and nizebaby like this.
  10. bonxie

    bonxie Lead commenter

    5.5 stones is awfully light, even for a very petite adult. She must be close to needing to be hospitalised as extremely anorexic at that weight. It does sound like mental health support would be beneficial.
    Would another family member be able to talk to her GP about the family's concerns about her weight, restricted diet and strange food preparation methods? Due to patient confidentiality, the GP would be unlikely to divulge information about the patient but should be willing to listen to your concerns and that would give the GP a better picture of what is going on with your relative.
  11. jubilee

    jubilee Star commenter

    Thank you everyone for your input.
    Bonxie, I have been considering writing a very long letter to the GP and risking being ostracised if she finds out about it. The trouble is that she lives 130 miles away from me and I haven't managed to find out where her GP practise is! I offered to take her to the GP on my last visit but she insisted on her husband taking her. I suspect that he has always stayed in the waiting room and hasn't been able to contradict her assertions about normally eating 4 big meals per day.
  12. frangipani123

    frangipani123 Lead commenter

    A difficult situation and I, like you, thought that writing a letter to the GP may help the next time she goes in. She needs mental health treatment but that is hard to come by. Do you have any idea of her background and what may have possibly triggered this in the first place?
  13. jubilee

    jubilee Star commenter

    She had Glandular Fever and Pleurisy at university and food obsessions seem to date from that time. At least 40 years ago she went through a year of eating a pound weight of raw carrots per day, added to a normal salad at lunchtime. It would take her over an hour to eat the meal. She stopped only because her skin turned bright orange. It looked like she had overdone that awful Tanfastic artificial tanning cream that was popular in the 1970s.
    She spent a lot of money each month on expensive magazines and from those she has built up her anecdotes about food, exclusion diets etc.
    Her background is my background but she was treated as a difficult child who wanted to spend time producing the perfect homework for school. I'd speed through mine to get meals cooked, housework done etc in order to keep my mother's temper in check. She definitely did not feel cherished as a child.
    frangipani123 and nizebaby like this.
  14. Aquamarina1234

    Aquamarina1234 Star commenter

    Neeeeh! She's gorn off er rocker like I did mine. You cope with whatever until some actual proper probs turn up and then to cope with them (usually easily solvable if you weren't already nutty) you "deal with" the imaginary ones.
    monicabilongame and nizebaby like this.
  15. nizebaby

    nizebaby Star commenter

    Those food-faddy magazine nutritionists have a lot to answer for. Their smug and often neurotic successors, food-faddy bloggers, are worse because they reach a wider audiences, and they cost less.
  16. Aquamarina1234

    Aquamarina1234 Star commenter

    GPs have limits on third-party concerns. When my husband was not coping with breavement (putting it mildly), our family practice, who hadn't actually even met him at that point, said if he wasn't prepared to come in and talk, there was nothing they could do.
  17. frangipani123

    frangipani123 Lead commenter

    I realise this but if a letter is sent it would be read and may be considered.
    bonxie likes this.

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