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Orthorexia: Just another buzz word? An eating disorder?

The last 2 years have shown a visible increase in literature on the topic of orthorexia nervosa, despite not actually being in the DSM-5. Does this lack of “true” diagnosis make this condition just another buzz word, or is this the start of a new breed of eating disorders? Furthermore, is the lack of diagnostic criteria ignoring a whole new subset of those with disordered eating under the guise of “health”?

Definitions and Diagnostic Criteria

Orthorexia literally means “proper appetite”, a misleading name given the ramifications of those cited with orthorexia. It was first described in 1997 by Bratman and Knight after Bratman described his own experiences with orthorexia. The symptoms vary from focusing purely on “clean” or “healthy” food to feelings of deep guilt when going “off plan” or eating something “not clean.” Compensatory behaviors that are often found with those who suffer from anorexia nervosa or bulimia are very similar. Orthorexics will exercise compulsively to “make up” for their “mistakes.” They also obsess over nutrition labels and will start to isolate themselves from social events surrounding food for fear of going off their diet. These criteria all shadow behaviors of other eating disorders as well as obsessive compulsive behavior.

Venn Diagram

From “The clinical basis of orthorexia”, a venn diagram showing the overlapping criteria of orthorexia, anorexia and OCD

Orthorexia’s onset can be more insidious than this extreme behavior, though. Often someone starts off wanting to “eat healthier.” They decide to remove a food group from their diet, then another, then another. Before too long they have a very strict set of rules around what they can and cannot eat. These rules and structure make them feel safe and in control, and as long as they abide by them they are eating “healthy”.

One very, very important distinction is that this group has no medical, religious or ethical reason to avoid certain food groups. While those suffering from orthorexia will often claim they are allergic or intolerant to dairy, gluten, etc. they often have never been formally diagnosed. Most of those who suffer from orthorexia have self-diagnosed allergies and intolerances to food groups. Those who do actually suffer from allergies and are intolerant to certain food groups may still fall into other categories of disordered eating, however for the sake of this discussion we will not include them.

One major departure from orthorexia and anorexia (according to research) is the motivation behind the disorder, though I personally disagree. Anorexia’s end motivation may be about weight loss, but there is never “skinny enough” for those with anorexia. They often are unable to see how sick they truly are. I would argue that anorexia is ultimately about control, and here it doesn’t depart too sharply from orthorexia. The suggested criteria for orthorexia points to a need for those to feel “pure” or “clean” by controlling what goes into their body. This mirrors the controlling aspect of anorexia. However, those with orthorexia are quick to flaunt their behaviors, while anorexics are very secretive about theirs. More on this can be read in the paper included at the end of this article.

The Dark Consequences of Orthorexia

Some might argue that orthorexia is a word used by those who “don’t get it” to describe the passionate. Without an official diagnostic criteria this might be true, however it’s impossible to ignore the consequences of unchecked orthorexia. Unchecked orthorexia can mirror a lot of the consequences of anorexia. For example, omitting entire food groups can lead to deficiencies in certain micro and macronutrient groups. Side effects include anemia, osteopenia, bradycardia, hyponatremia, and others.

Other consequences involve the effect it can have on your social life. Food anxiety makes any social outing involving food almost impossible for those with orthorexia. Given the serious overlap between orthorexia and anorexia they’re prone to the same binge-restrict cycles as those with anorexia. Deviations from their diet are met with self loathing and guilt. They spend an inordinate amount of time researching, planning and excluding foods from their diet.


Since this condition is not officially diagnosed, nor is there outstanding data involving its manifestations and treatment, it’s hard to pin point the specific causes of orthorexia. However, there are some places we can look to understand the obsession around health and purity.

  • Fake trainers or nutritionists: Every celebrity is endorsing some diet these days with very little understanding of the consequences of their support. It’s not hard to find a book, website, or blog touting a certain type of diet or food exclusion as THE way to lose weight or become healthy. In fact, there are entire companies built on the insecurity of the average person, creating groups and “coaches” out of everyday, unqualified people. While some of these people may mean well, they ultimately are unqualified to give advice about diets. This creates and endless cycle of misinformation, usually involving statements like “I saw celebrity name gave up gluten, so I did, and now I feel amazing!” or “I recently started pyramid scheme diet here, and I lost 20 lbs!” While these statements may be innocent in the beginning, they can quickly lead to feelings of guilt when strayed from. Since they focus on excluding food groups they may eventually lead to the same social anxiety described by many with orthorexia.
Examples of misinformation found in popular diets, all which have been discredited but are still touted by popular diets.

Examples of misinformation found in popular diets, all which have been discredited but are still touted by popular diets. Source: The clinical basis of orthorexia.

  • Weight loss/health as a social status: We are often to praise people for losing weight or being healthy without truly understanding what it meant to that individual. “Healthy” and “fit” are a social status that are openly praised. Someone who updates social media with their workout or posts about not indulging in the bagels at work are seen as “strong” and someone to look up to. Diets are often associated with strength and willpower to the point where those who don’t adhere to diets 100% are seen as “weak” and “lack willpower.”
  • Good Food/Bad Food Dichotomy: The minute certain food groups are seen as “bad” or “unhealthy” a dichotomy is created. Labeling food as “good” or “bad” without any true understanding of what it means to an individuals diet or health is unrealistic and unhealthy. Research has shown time and time again that if you tell someone they can’t have a certain food type they will crave it. This can contribute to the food binges experienced by orthorexics when they eat one thing off their “meal plan.”
  • Fad Diets: Researchers have noted that orthorexia patterns of food aversion parallel whichever fad diet is currently circulating.

Where To Go From Here

I have stated many times that this condition lacks an official diagnostic criteria, and is not currently recognized by the DSM-5. However, the National Association for Eating Disorders has been compiling data on the topic and has a page devoted to education on orthorexia. This topic has also been explored by a number of popular websites around health and fitness. While it is not currently an eating disorder it IS a type of disordered eating. It is something that interferes with daily life and disallows enjoyment of life. If you feel that you’ve spent an inordinate amount of time worrying about food, or you feel like you might have orthorexia, it is important to seek the health of a trained professional. Disordered eating can lead to eating disorders, and the associated complications from dietary restrictions are severe enough to warrant intervention in some cases.

If you’d like to learn more about the current research of orthorexia, The clinical basis of orthorexia: emerging perspectives is a great paper to help inform you about orthorexia.

What Do You Do? Part 2: Powerlifting

A lot of people hear I’m a powerlifter and think I do what they see on the Olympics. Powerlifting is a competition involving The Big Three – Squat, Bench and Deadlift. Athletes are separated based on weight, age, gender and if they’re using special equipment or not to compete. For the sake of this conversation, I’m only going to talk about “raw” powerlifting. This is what I compete in.

Raw powerlifting involves the use of a weight belt, knee sleeves or knee wraps, and wrist wraps. Some federations have two types of raw powerlifting, which allow or disallow the use of knee wraps. It comes down to the individual lifter as to what equipment they want to use. I compete in knee wraps and with a belt. “Geared” or “equipped” powerlifting involves special suits that help a lifter complete each move.

Before each competition an athlete will weigh in on a scale in front of a judge, where they’ll be sorted into a weight class. This is important for a lot of lifters because the less you weigh, the more impressive your lifts are. This can be a catch-22 because the means through which the person tried to lose the weight can damage their lifting. Some people go weeks without carbohydrates, others don’t drink any water and sit in a sauna for hours – that will hurt their lifts if they don’t rehydrate appropriately.

The Squat

The squat is the first move performed in an event. The lifter has 3 tries to hit the heaviest weight they can do. It’s not simply the act of squatting, there’s more to it. A lifter will take the bar off the rack and step away from the rack. The judge sitting in front of them will tell them to start the lift. The lifter will then lower into a squat – depth depends on the federation. For most federations you just need your femur (thigh bone) to be parallel to the ground. Others require the crease of your hip to be lower than your knee. Make sure you look up your federation to see which is required. The lifter will complete the lift and wait for the judge to tell them to re-rack the weight. If the lifter executed the lift to completeness, a scoreboard to the side will light up with 3 white lights. Each judge has one “vote” – either white (good) or red (bad). They each evaluate different parts of the lift to make sure it was completed appropriately. The lifter will wait their turn for their second and third attempts. A lifter does not attempt all 3 in a row, they are given time to rest.

Bench Press

Bench press is one of the most well known lifts, so I’ll keep this brief. The main differences between the competition lift and the average joe involves the commands. The lifter will unrack the bar from the rack and, depending on the federation, wait for the cue to start. The lifter lowers the bar to their chest (actually touching the chest) and waits for the command to “press.” At this time the lifter will press the bar off their chest. There is no bounce, the bar must be paused on the chest. The judge will then tell them to re-rack. You miss a lift if one arm locks out before the other, or if the bar comes down then back up.


A deadlift is exactly what it sounds like – lifting dead weight from the ground. A lifter will lift the bar off the ground, lock it out, and wait for the command to lower it back to the ground. You cannot just drop the bar on the ground – if you see people let the bar go from the lock out they’re not powerlifting. They’re picking up a heavy weight and then dropping it on the ground. Part of the execution of the lift is keeping your hands on the bar the entire lift. While this lift has less commands, it can be much harder to complete for various reasons. If the bar travels downwards before completion of the lift it’s no good. If the lifter hitches the bar, the lift is no good. If the lifter’s grip slips and the bar comes out of their hand, no lift.

Every athlete gets 3 attempts at each lift. Some federations allow a 4th attempt if it’s for a world or national record. At the end of the meet lifters are awarded based on how much they lifted vs. their body weight. Different federations use different calculators, but The Wilks Score is the most popular one. Some use calculators that take age into consideration as well, since sometimes a 25 year old man and a 15 year old man will be in the same weight class. Awards are also given to best overall lifter, which will compare the 300 pound person to the 140 pound person.

If you’re interested in powerlifting, go to and find a gym or a coach, or even go to a meet!

Technology Update

Hey all!

I get asked from time to time about which apps, fitness products, etc. I’m currently using. I’m not an endorser by any means (you know, those people who show pictures of them with “cleansing” tea like it gave them a six pack) but if I believe in a product I’m going to talk about it. Today I’ll show you “One of Each” – my favorite meal planning app, my favorite headphones and my favorite fitness tracking device.

Fitness Tracker: Polar Loop 2 Activity Tracker, Black

polarloopI’ve had my Polar Loop since about October and I’m pretty content with it. Polar has long been my favorite heart rate monitor, and I’ve used them for a few years now to track the intensity of my workouts. The Loop is a little more integrated – you have a heart rate monitor you wear during exercise to give a more accurate total of calories burned/etc. during your workout vs. your day.

Screen Shot 2015-02-04 at 9.11.55 AMThe Polar Flow diary is pretty sweet too, because you can see how much time you spent in each zone with your workout. Previously my Polar watches only gave little synopses on the watch itself. This is a full program. The battery life is great and charging is easy.

The downside? I don’t think the steps counted are accurate. I can work an entire emergency shift on my feet (10-12 hours) and barely clock a few hundred steps. I also dislike the lack of community that I found with my FitBit. It’s also hard to synch with my phone, and the sleep tracker is seriously lacking. Until something better comes along this is my current go-to to make sure I don’t sit around all day on my rest days and I love the interaction with my heart rate device for workouts.

Food Tracker: MyMacros+


I’d heard about this app before but due to my long history (like 3+ years) with MyFitnessPal I was slow to convert. However, I soon found that MyMacros+ had everything I wanted from MFP. With MFP there’s a HUGE focus around calories, and trying to figure out your macros is hard to do. You have to click a few extra buttons rather than have it all there and ready for you. Additionally, unless you download an extension for your browser, macros aren’t the emphasis for MFP. You have to calculate your calories and hope your macros fall into an even percentage distribution that works in increments of 5%. Super annoying.

My Macros allows for customization of you macros with calories as more of a side note. For someone who tracked calories (in an unhealthy way) for so long, it’s great to see them so small and insignificant. You can save meals, add items quickly, etc. The database is seriously lacking (if you type in “Frozen Green Beans” like nothing comes up) and some of it is clunky, but I’m sure with increased usage this will get fixed. Overall, I like it much better than MFP. Also, you can save “meals,” so if you’re like me and eat the same thing every day it’s really, really useful.

Headphones: Powerbeats2 Wireless, Active Collection – Blue

pDSP1-18892058p275wThe Powerbeats2 are pricey ($199) but I got them for my birthday, so there’s that. I’ve long been on the hunt for good wireless headphones that don’t make me look like I have something growing on my head. Wireless has become my friend for a long time, especially because the lack of wires all in my face and down my shirt are priceless for powerlifting. I don’t know how I used wired headphones before.

HOWEVER I hate those ear bud type. I tried quite a few brands (Jaybird, etc.) and they all fell out of my ear. I just wanted something to go around my ear and hold it in place! Why was that so hard to find?! Most of the things I found were like Geordi from Star Trek’s visor. They hurt my ears, they pinched in the wrong places, and I hated them. My Motorolla’s I’d had for years stopped charging, so I was moving on.

Thankfully these babies are about 90% what I need. The battery life is horrible (6 hours) and they can be cumbersome with that hangy-cord crap. I find that making a small loop and putting it over my pony tail keeps it in the right position. Overall, I’m pretty happy with these and glad they’re in my arsenal!

What have you guys been using?

Internalized Misogyny: Stopping Girl on Girl Hate

I think it’s safe to say we all know what sexism is, right? When a woman doesn’t get hired because of her gender, or when a mechanic charges a woman more for his services because she “doesn’t know anything.” Unfortunately, there are more insidious types of sexism, and when they are spouted by women they become what’s called internalized misogyny. Need some examples? Do you have a female friend that thinks she’s cooler/better/smarter/etc. than other women because she doesn’t do “girly” things? Or a female friend that says she’d rather hang out with guys because they’re “less drama”? (Read a history book, bro) What about the woman who scolds other women who are emotional, like it’s a flaw?

Tina Fey had a poignant moment in Mean Girls where she discussed girl-on-girl hate.


These are examples of internalized misogyny. It’s the sexism we hear every day and we start incorporating into our own lives. The idea is to reject the feminine as “bad” and “weak” in an attempt to be the opposite -strong. Like a man.

I know what you’re thinking. “That’s fine and dandy, Courtney, but what does this have to do with fitness?”


I’m going to take a huge, huge problem in this post an examine it through a smaller lens: memes. We can all agree that we’ve seen a meme or two in our life, probably posted one, probably laughed about it. Memes are a cultural phenomenon that speak volumes to the way we think about certain classes in society.

Now, let me take you down the “Wall of Shame” for just a second.

Ah, yes, a very typical meme. You’ve probably heard this before from a friend on Facebook or at the gym. “Who does she think she is – wearing MAKEUP to the gym?! Doing her hair?! Doesn’t she know she’s here to WORK OUT? LIKE ME? I WORK SO HARD.” This is an underlying theme in a lot of these memes – girl on girl crime/hate. The recurrent theme is

  • Girls as competition – if another girl is doing better/more than you/looking better than you/etc. she is competition in a bad way. She should be torn down at all costs. She lifts more than you? Yeah, well she’s ugly. She runs faster than you? Well, good, she has no life, she needs something in her life.

These “better than x” posts are also very common too. The recent popularity of Crossfit has brought a ton of women into the lifting community – which is great! For far too long many of us have been the only girl at a powerlifting meet, or maybe were met with strange looks when we explain that we put hundreds of pounds on our back and squat it. With this came the barrage of “better than x” ideas. Suddenly doing something “masculine” like lifting heavy weights makes them better than you. Again – girl on girl hate. “Haha you dance for an hour? WELL I LIFT WEIGHTS FOR AN HOUR SO I’M BETTER!” This is the equivalent of the girl who says “The Bachelor? Gag. I’d rather watch Sports Center!” There’s nothing wrong with enjoying something “out of the norm” but the minute you put down another woman for her preferences (which are “typical female” preferences) you’re furthering this girl on girl hate.

And men, you’re just as guilty of this! Here are some memes that I’ve seen posted by men AND women alike.

Yes, please never grow up to be a multi-million dollar pop star that enjoys things. Cultural appropriation aside, that’s an entirely different discussion.

Large boobs are not optional. Also insert endless “MY FRIDAY NIGHT AT THE BAR HAHA” and “GOING DOWN LIKE A SQUAT NOT LIKE A SLUT” memes

Do you see a theme here? Most of these are trying to empower a certain type of woman by tearing down another – and usually solely based on looks. Don’t believe me?

You can run a marathon? Who cares you don’t have 10% body fat haha!

I know science is hard, but genetics…I mean really. And photoshop. OH GOD PHOTOSHOP.

Every time you say something about “that girl” who works out and drinks.

Every time you tear down a woman for wearing makeup or doing her hair before the gym.

Every time you put one type of “non-traditional” exercise over another.

YOU are contributing to a world of GIRL ON GIRL hate. These memes often have a deeper, darker motive as well. Sure, on the surface they may seem motivational, but they actually reinforce a gender norm a lot of these women try to steer clear of. Notice how all of these women are skinny, white and conventionally attractive? These women all embody what is conventionally attractive to the modern man (and please, let’s keep the #notallmen to a minimum). A big, firm butt, low body fat, white, etc. These memes reinforce the current beauty standard under the disguise of a new, “healthy” one. Don’t believe me?

Lift hard and heavy! …but only to an extent, that’s gross, right?

Re-affirming conventional beauty standards. If these memes were REALLY about “internal strength” or “Bettering yourself” they’d focus a range of body types and skin colors. They would show the top woman and say, “Suns out guns out!” or “Work hard, play hard!” or whatever other catchy saying currently spewed by fitness people. Instead they work to tear down women who stray from the idea of what’s “accepted.” And don’t be too shocked by the comments on these pictures – women and men alike will tear down the top image. Post a picture of Dana Linn Bailey on Facebook and wait and count how many people (women included) tell you “not to get that big” or read her countless “Ew you’re a man!” comments.

So, basically, when you post these memes you’re 1) reinforcing the beauty norm, 2) tearing down other women (you don’t think that top girl has seen this image before? How do you think she feels?), 3) negating the hard work of the individual…just to name a few.

A lot of girl on girl hate, right?

(And, on a tangent, how many of these memes are thinly veiled thinspo? How many of these reinforce guilt about food and eating disorder ideas – which is a predominantly woman’s issue? Yeah.)

So – what can you do?

  • Build other women up – don’t tear them down. Find your competition and praise her for her strengths. Find a sisterhood in your shared struggle.
  • Call out other women for their internalized misogyny. “I don’t understand why the hair style of the girl on the treadmill has anything to do with your workout?” or “Maybe she likes pink nail polish, why do you care?”
  • Accept that not everyone wants to do Crossfit or lift weights and some women just like to dance with their friends, or cycle, or run. And remember it has NOTHING to do with you.
  • Praise other women. Lift them up. Empower each other in EVERY facet of your life. Other women are NOT your competition and if they’re doing “better” than you it’s not a personal affront to you.
  • Don’t post this garbage.