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Orthorexia and the New Rules of Clean Eating (Part 1)
by, Tom Venuto

Clean eating has no official definition, but it’s usually described as avoiding processed foods, chemicals, preservatives and artificial ingredients. Instead, clean eaters choose natural foods, the way they came out of the ground or as close to their natural form as possible. Vegetables, fruits, legumes, 100% whole grains, egg whites, fish, and chicken breast are clean eating staples. Clean eating appears to be a desirable, sensible, even noble goal. Eating clean is what we should all strive to do to achieve optimum health and body composition isn’t it? Arguably the answer is mostly yes, but more and more people today are asking, “is it possible to take clean eating too far?”

Physician Steven Bratman thinks so. In 1997, Bratman was the first to put a name to an obsession with healthy eating, calling it orthorexia nervosa. In his book, Health Food Junkies, Bratman said that whether they are trying to lose weight or not, orthorexics are preoccupied with eating healthy food and avoiding anything artificial or “toxic.”

Orthorexics are not only fanatical about eating the purest, healthiest, most nutritious (aka “clean”) foods available, says Bratman, they often feel a sense of righteousness in doing so.

Whether orthorexia should be officially classified as an eating disorder is controversial. The term appears in pub med indexed scientific journals, but it’s not listed in the DSM-IV as are anorexia and bulimia. Opponents wonder, “Since when did choosing a lifestyle that eliminates junk food become a disease?”

Media coverage and internet discussions about orthorexia have increased in the past year. Websites such as the Mayo Clinic, the Huffington Post and the UK-based Guardian added their editorials into the mix in recent months, alongside dozens of individual bloggers.

In most cases, mainstream media discussions of orthorexia have focused on far extremes of health food practices such as raw foodism, detox dieting or 100% pure organic eating, where some folks would rather starve to death than eat a cooked or pesticide-exposed vegetable.

But closer to my home, what about the bodybuilding, fitness, figure and physique crowd? Should we be included in this discussion?

In their quest for adding muscle mass and burning fat, many fitness and physique enthusiasts become obsessed with eating only the “cleanest” foods possible. Like the natural health enthusiasts, physique athletes usually avoid all processed foods and put entire food groups on the “forbidden” list. Oddly, that sometimes includes rules such as “you must cut out fruit on precontest diets” because “fruit is high in sugar” or “fructose turns to fat”.

According to Bratman’s criteria, one could argue that almost every competitive bodybuilder or physique athlete is automatically orthorexic, and they might add obsessive-compulsive and neurotic for good measure.

As you can imagine, I have mixed feelings about that (being a bodybuilder).

If I choose to set a rule for myself that I’ll limit my junk food to only 10% of my meals, does that make me orthorexic or is that a prudent health decision?

If I plan my menus on a spreadsheet, am I a macronutrient micromanager or am I detail-oriented?

If I make my meals in advance for the day ahead, does that mean I’m obsessive compulsive, or am I prepared?

If I make one of my high protein vanilla apple cinnamon oatmeal pancakes (one of my favorite portable clean food recipes) and take it with me on a flight because I don’t want to eat airline food, am I neurotic? Or am I perhaps, the smartest guy on the plane?

Some folks are probably shaking their heads and saying, “you bodybuilders are definitely OCD.” I prefer to call it dedicated, thank you, but perhaps we are obsessive, at least a wee bit before competitions. But aren’t all competitive athletes, to some degree, at the upper levels of most sports?

Athletes of all kinds – not just bodybuilders - take their nutrition and training regimens far beyond what the “average Joe” or “average soccer mom” would require to stay healthy and fit.

What if you don’t want to be average – what if you want to be world class? What then? Is putting hours of practice a day into developing a skill or discipline an obsessive-compulsive disorder too?

Okay, now that I’ve defended the strict lifestyle habits of the muscle-head brother and sisterhood, let me address the flipside: being too strict.

Where does the average health and bodyweight-concerned fitness enthusiast draw the line? How clean should you eat? Do you need lots of structure and planning in your eating habits, or as Lao Tzu, the Chinese philosopher said, does making too many rules only create more rule-breakers?

Debates have started flaring up over these questions and as inconceivable as it seems, there has actually been somewhat of a backlash against “clean eating.” Why would THAT possibly happen? Eating “clean” is eating healthy, right? Eating clean is a good thing, right?

Well, almost everyone agrees that it’s ok to have a “cheat meal” occasionally, but some experts - after watching how many people are becoming neurotic about food - are now clamoring to point out that it’s not necessary to be so strict.

The diet pendulum has apparently swung from:

“Eat a balanced diet with a wide variety of foods you enjoy.”


“You MUST eat clean!”


“Go ahead and eat as much junk as you want, as long as you watch your calories and get your essential nutrients like protein, essential fats, vitamins and minerals.”

Talk about confusion! Now we’ve got people who gain great pride and a sense of dedication and accomplishment for taking up a healthy, clean-eating lifestyle and we’ve got people who thumb their nose at clean eating and say, “Chill out bro! Live a little!”

The current debate about how clean you should eat (or how much you should “cheat”) reminds me of the recent arguments over training methods such as steady state versus HIIT cardio. Whatever the debate of the day, most people seem to have a really difficult time acknowledging that there’s a middle ground.

Most dieters, when they don’t like a certain philosophy, reject it entirely and flip to its polar opposite. Most dieters are dichotomous thinkers, always viewing their endeavors as all or nothing. Most dieters are also joiners, plugging into one of the various diet tribes and gaining their sense of identity by belonging.

In some cases, I think these tribes are more like cults, as people follow guru-like leaders who pass down health and nutrition commandments that are followed with religious conviction. Seriously, the parallels of diet groups to religious groups can be downright scary sometimes.

Whether the goal is to optimize health, to build muscle or to burn fat, there’s little doubt that many individuals with all kinds of different motivations sometimes take their dietary restrictions to extremes. Obviously, an overly restrictive diet can lead to nutrient deficiencies and can adversely affect health, energy and performance.

In some cases, I can also see how swinging to any extreme, even a “healthy obsession” with pure food could lead to distorted views and behaviors that border on eating disorders. If you don’t believe it’s a real clinical psychological problem, then at the very least, you might agree that nutritional extremes could mean restricting social activities, creating inconvenience or making lifestyle sacrifices that are just not necessary.

I believe there’s a middle ground - a place where we can balance health and physique with a lifestyle and food plan we love and enjoy. Even more important, I believe that your middle ground may not be the same as mine. We all must find our own balance.

I believe that going back to BALANCE, but this time with a better definition of what balance means, is the approach of the future.

I also believe that some new rules would help us find that balance.

If you'd like to learn the rules that bodybuilders and fitness models follow to "eat clean" and stay lean, then visit http://www.burnthefat.com.

About the Author:

Tom Venuto, author of Burn The Fat Feed The Muscle, is a fat loss expert, lifetime natural (steroid-free) bodybuilder, independent nutrition researcher, freelance writer, and author of the #1 best selling diet e-book, Burn The Fat, Feed The Muscle: Fat-Burning Secrets of The World’s Best Bodybuilders & Fitness Models (e-book) which teaches you how to get lean without drugs or supplements using secrets of the world's best bodybuilders and fitness models. Learn how to get rid of stubborn fat and increase your metabolism by visiting: http://www.burnthefat.com

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Orthorexia and the New Rules of Clean Eating (Part 2)
by, Tom Venuto

In part one, I described the growing obsession many people have with eating only the purest, healthiest foods, aka “clean eating.” You’d think that nothing but good would come from that, but some experts today dislike the concept of clean foods because it implies a dichotomy where other foods, by default, are “dirty” or forbidden - as in, you can never, ever eat them again (imagine life without chocolate, or pizza… or beer! you guys). Some physicians and psychologists even believe that if taken to an extreme, a fixation on healthy food qualifies as a new eating disorder called orthorexia.

Personally, I have no issues with the phrase “clean eating.” Even if you choose to eat clean nearly 100% of the time, I don’t see how that qualifies as a psychological disorder of any kind (I reckon people who eat at McDonalds every day are the ones who need a shrink).

However, I also think you would agree that any behavior - washing your hands, cleaning your house, or even exercise or eating health food - can become obsessive-compulsive and dysfunctional if it takes over your life or is taken to an extreme. In the case of diet and exercise, it could also lead to or overlap with anorexia.

It’s debatable whether orthorexia is a distinct eating disorder, but I’m not against using the word to help classify a specific type of obsessive-compulsive behavior. I think it’s real.

The truth is that many people are quite “enthusiastic” in defending – or preaching about - their dietary beliefs: no meat, no grains, no dairy, only organic, only raw, only what God made, and on and on the rigid all-or-nothing rules go.

What people choose to eat is often so sacred to them, it makes for tricky business when you’re a nutrition educator. Sometimes I don’t feel like telling anyone what to eat, but simply setting a personal example and showing people how I do it, like, “Hey guys, here is how natural bodybuilders eat to get so ripped and muscular. It may not suit you, but it works for us. Take it or leave it.”

On the other hand, I can’t help feeling that there’s got to be a way to better help the countless individuals who haven’t yet formulated their own philosophies, and who find nutrition overwhelmingly confusing. For many people, even a simple walk down the aisles of a grocery store, and trying to decipher the food labels and nutrition claims is enough to trigger an anxiety attack.

That’s where I hope this is useful. I can’t draw the line for you, or tell you what to eat, but I can suggest a list of “new rules” for clean eating which simplifies nutrition and clears up confusion, while giving you more freedom, balance, life enjoyment and better results at the same time.

New Rule #1: Define what clean eating means to you

Obviously, clean eating is not a scientific term. Most people define clean eating as avoiding processed foods, chemicals and artificial ingredients and choosing natural foods, the way they came out of the ground or as close to their natural form as possible. If that works for you, then use it. However, the possible definitions are endless. I’ve seen forum arguments about whether protein powder is “clean.” Arguments are a waste of time. Ultimately, what clean eating means is up to you to define. Whether your beliefs and values have you restrict or expand on the general definition, define it you must, keeping in mind that your definition may be different than other’s.

New Rule #2: Always obey the law of energy balance

There’s one widely held belief about food that hurts people and perpetuates the obesity problem because it’s simply not true. It’s the idea that calories don’t matter for weight loss, as long as you eat certain foods or avoid certain foods. Some people think that if you eat only clean foods, you’re guaranteed to lose weight and stay lean. The truth is that eating too much of anything gets stored as fat. Yes, you can become obese eating 100% clean, natural foods. There’s more to good nutrition than calories in versus calories out, but the energy balance equation is always there.

New Rule #3: Remember that “foods” are not fattening, “excess calories” are

There’s a widespread fear today that certain foods will automatically turn into fat. Carbohydrates – particularly refined carbohydrates and sugars - are still high on the hit list of feared foods, and so are fatty foods, owing to their high caloric density (9 calories per gram). Foods that contain fat and sugar (think donuts) are considered the most fattening of all. But what if you ate only one small donut and stayed in a calorie deficit for the day – would you still say that donut was fattening?

If you want to say certain foods are fattening, you certainly can, but what you really mean is that some foods are calorie dense, highly palatable, not very satiating and eating them might even stimulate your appetite for more (betcha can’t eat just one!). Therefore, they’re likely to cause you to eat more calories than you need. Conversely, “non-fattening” foods have no magical properties, they’re simply low in caloric density, highly filling and non-appetite stimulating.

New Rule #4: Understand the health-bodyfat paradox

Two of the biggest reasons people choose to eat clean are health and weight loss. Health and body composition are intertwined, but dietary rules for health and weight loss are not one in the same. Weight gains or losses are dictated primarily by calorie quantity. Health is dictated primarily by calorie quality. That’s the paradox: You can lose weight on a 100% junk food diet, but that doesn’t mean you’ll be healthy. You can get healthier on an all natural clean food diet, but that doesn’t mean you won’t gain weight… and if you gain too much weight, then you start getting unhealthy. To be healthy and lean requires the right combination of calorie quantity and quality, not one or the other.

New Rule #5: Forbidden foods are forbidden.

Think of you on a diet like a pressure cooker on a burner. The longer you keep that pot on the heat, the more the steam builds up inside. If there’s no outlet or release valve, eventually the pressure builds up so much that even if it’s made of steel and the lid is bolted down, she’s gonna blow, sooner or later. But if you let off a little steam by occasionally having that slice of pizza or whatever is your favorite food, that relieves the pressure.

Alas, you never even felt the urge to binge… because you already had your pizza and the urge was satisfied. Since the “cheat meal” was planned and you obeyed the law of calorie balance, you stayed in control and it had little or no effect on your fat loss results. Ironically, you overcome your cravings by giving in to them, with two caveats: not too often and not too much.

New Rule #6: Set your own compliance rule

Many health and nutrition professionals suggest a 90% compliance rule because if you choose clean foods 90% of the time, it’s easy to control your calories, you consume enough nutrients for good health, and what you eat the other 10% of the time doesn’t seem to matter much. Suppose you eat 3 meals and 2 snacks every day, a total of 35 feedings per week. 90% compliance would mean following your clean eating plan for about 31 or 32 of those weekly feedings. The other 3 or 4 times per week, you eat whatever you want (as long as you obey rule #2 and keep the calories in check)

You’ll need to decide for yourself where to set your own rule. A 90% compliance rule is a popular, albeit arbitrary number – a best guess at how much “clean eating” will give you optimal health. Some folks stay lean and healthy with 80%. Others say they don’t even desire junk food and they eat 99% clean, indulging perhaps only once or twice a month.

One thing is for certain – the majority of your calories should come from natural nutrient-dense foods – not only for good health, but also because what you eat most of the time becomes your habitual pattern. Habit patterns are tough to break and what you do every day over the long term is what really counts the most.

New Rule #7: Have “free” meals, not “cheat” meals

Cheating presupposes that you’re doing something you’re not supposed to be doing. That’s why you feel guilty when you cheat. Guilt can be one of the biggest diet destroyers. Consider referring to these meals that are off your regular plan as “free meals” instead of “cheat meals.” If having free meals is part of your plan right from the start, then you’re not cheating are you? So don’t call it that. What can you eat for your free meals? Anything you want. Otherwise, it wouldn’t truly be a free meal, would it?

People sometimes tell me that my bodybuilding diet and lifestyle are “too strict.” I find that amusing because I love eating clean 95-99% of the time and I consider it easy. I had a butter-drizzled steak, a glass of wine, and chocolate sin cake for dessert to celebrate my last birthday. I had a couple slices of pizza just four weeks before my last competition (and still stepped on stage at 4.5% body fat). Oh, and I’m really looking forward to my mom’s pumpkin pie and Christmas cake too. Why? How? Because as strict as my lifestyle might appear to some people, I’ve learned how to enjoy free meals and I will eat ANYTHING I want - with no guilt. Meanwhile, my critics are often people with rules that NEVER allow those foods to ever cross their lips.

New Rule #8: For successful weight control, focus on compliance to a calorie deficit, not just compliance to a food list

Dietary compliance doesn’t just mean eating the right foods, it means eating the right amount of food. You might be doing a terrific job at eating only the foods “authorized” by your nutrition program, but if you eat too many “clean” foods, you will still get fat. On the fat loss side of health-bodyfat paradox, the quantity of food is the pivotal factor, not the quality of food. If fat loss is your goal and you’re stubbornly determined to be 100% strict about your nutrition, then be 100% strict about maintaining your calorie deficit.

Lesson #9: Avoid all or none attitudes and dichotomous thinking

If you make a mistake, it doesn’t ruin an entire 12 week program, a whole week and not even an entire day. What ruins a program is thinking that you must either be on or off your diet and allowing one meal off your program to completely derail you. All or nothing thinking is the great killer of diet programs.

Even if they don’t believe that one meal will set them back physically, many “clean eaters” feel like a single cheat is a moral failure. They are terrified to eat any processed foods because they look at foods as good or bad rather than looking at the degree of processing or the frequency of consuming them.

Rest assured, a single meal of ANYTHING, if the calories don’t exceed your energy needs, will have virtually no impact on your condition. It’s not what you do occasionally, it’s what you do most of the time, day after day, that determines your long term results.

New Rule #10: Focus more on results, less on methods

I’m not sure whether it’s sad or laughable that most people get so married to their methods that they stop paying attention to results. Overweight people often praise their diet program and the guru that created it, even though they’ve plateaud and haven’t lost any weight in months, or the weight they lost has begun to creep back on. Health food fanatics keep eating the same, even when they’re sick and weak and not getting any stronger or healthier.

Why would someone continue doing more of the same even when it’s not working? One word: habit! Beliefs and behavior patterns are so ingrained at the unconscious level, you repeat the same behaviors every day virtually on automatic pilot. Defending existing beliefs and doing it the way you’ve always done it is a lot easier than changing.

In the final analysis, results are what counts: weight, body composition, lean muscle, performance, strength, blood pressure, blood lipids, and everything else you want to improve. Are they improving or not? If not, perhaps it’s time for a change.

Concluding words of wisdom

We need rules. Trying to eat “intuitively” or just “wing it” from the start is a recipe for failure. Ironically, intuitive eating does not come intuitively. Whether you use my Burn The Fat, Feed the Muscle program or a different program that suits your lifestyle better, you must have a plan.

After following your plan for a while, your constructive new behaviors eventually turn over to unconscious control (a process commonly known as developing habits). But you’ll never reach that hallowed place of “unconscious competence” unless you start with planning, structure, discipline and rules.

Creating nutritional rules does NOT create more rule breakers. Only unrealistic or unnecessary rules create rule breakers. That’s why these new rules of clean eating are based on a neat combination of structure and flexibility. If you have too much flexibility and not enough structure, you no longer have a plan. If you have too much structure and not enough flexibility, you have a plan you can’t stick with.

To quickly sum it all up: Relax your diet a bit! But not too much!

About the Author:

Tom Venuto, author of Burn The Fat Feed The Muscle, is a fat loss expert, lifetime natural (steroid-free) bodybuilder, independent nutrition researcher, freelance writer, and author of the #1 best selling diet e-book, Burn The Fat, Feed The Muscle: Fat-Burning Secrets of The World’s Best Bodybuilders & Fitness Models (e-book) which teaches you how to get lean without drugs or supplements using secrets of the world's best bodybuilders and fitness models. Learn how to get rid of stubborn fat and increase your metabolism by visiting: http://www.burnthefat.com

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