You are what you DON’T eat

A proliferation of very specific diets and eating styles, partly encouraged by social media, is making food more complicated than ever. How much of this is good for you, and when does it cross the line into eating disorders?

February 9, 2018

A 21st-century family dinner may feature vastly different plates of food than it did 10 years ago, with two vegetarian parents, a paleo teenage daughter, and a gluten-free son. This is not an uncommon occurrence, with a recent rise in Americans following various diets or popular eating trends, and at younger ages.

There has been a 500 percent increase in veganism in six years, and a 120 percent increase in voluntary gluten-free dieting between 2009 to 2014.  According to the website of Eating Disorder Hope, a non profit organization which offers resources for the treatment of eating disorders and is sponsored partly by the National Eating Disorder Association (NEDA), 40 percent of nine-year-olds have been on some form of a diet.

A simultaneous increase in eating disorders and eating trends and diets may show a relationship between the two, with people reporting their families, social media and societal pressure to be influences on their eating.

In an anonymous poll on paper of 50 Shalhevet students Sept. 28, 13 students, or 26 percent, said they were on some kind of diet. Of those, two were vegetarian or pescatarian, two were vegan, one was dairy-free, three were voluntarily gluten-free, and six said they were either “on a diet,” or followed a “healthy” diet.

But more than half — 26 students — said they restricted their eating in some way even if they weren’t dieting (some responses may have been referring to kashrut restrictions), and 13 said their eating choices had been influenced by social media, a new phenomenon whose impact has yet to be closely measured.

And as everyone from families to school lunch administrators tries to accommodate and adjust, it’s unclear what exactly is going on, and whether it’s a good sign, a threat to health, psychology or just kitchen convenience — or all of those things.

 

Junior Donna Grunfeld adopted a pescatarian diet — no animal meat except for fish — in eighth grade.

She said she wanted to lose weight, which she did.

“The reasoning was actually that I wanted to eat less, and I was kind of on this health craze type thing,” said Donna. “I was really obsessive, and I thought that by not eating meat, that would be a way to diet and lose weight.”

In ninth grade, she began to follow a vegan diet — no animal products at all, no fish, cheese or eggs — and stayed with it for six months. Donna said this way to restrict her eating further and gave her a feeling of control over her life.

“Obsession” and “control” were words several students used about their attention to their food.

“Ninth grade was really hard for me emotionally and physically,” said Donna. “It was just really hard and I guess it’s just that feeling of not knowing what to do. This was a way to do something that I kind of knew how to do, or that I could trick myself into thinking I knew how to do.”

She said her parents became concerned that she was not eating properly, and quickly made sure that she reintroduced foods, like eggs, into her diet. Although she achieved her goal of losing weight, she really started feeling better when she shifted her mindset to one that desired strength, rather than thinness.

An anonymous student we’ll call Jane (not her real name) said that although she was never diagnosed with an eating disorder, she found herself in a mindset of endlessly wanting to lose weight, beginning in the summer between 8th and 9th grade.

“I got a little bit obsessed,” Jane said. “It was definitely very important to me all of a sudden.”

She said she was influenced by her family.

“It just happened that I was raised to be very aware of what I was eating, and how much is too much, and to be body conscious,” she said. “If I asked my mom if I should lose weight or something, she would be like, ‘Oh yeah, maybe like five pounds.’”

Jane described keeping a daily journal with a friend of their weights and the calories that they consumed throughout the day to ensure that they did not gain or lose.

“We would write down what we ate at the beginning of the day, and then everything we ate, and then we would write down how much we weighed the next day,” she said. ‘I would also always be downloading different workout apps or apps to count your calories.”

 

According to the website of NEDA, the National Eating Disorders Association, there are at least four specific eating disorders: anorexia, bulimia, binge eating disorder, and avoidant restrictive food intake disorder, or ARFID.

Anorexia, the organization says, is the third-most-common disease among “young people” after asthma and Type 1 diabetes, and is characterized by significant weight loss, calorie restriction and distorted body image.

Bulimia sufferers binge on mass qualities of food at a time, and then force themselves to purge, or vomit the food.

Binge-eating disorder, the most common eating disorder in the United States according to the organization, is similar to bulimia in that it involves binging on unhealthy amounts of food in one sitting, But it does not involve vomiting.

And ARFID, a newly defined eating disorder, is severely limiting food intake, but without a concern with body image or weight loss.

Since 2013, there has been a 70 percent increase in eating disorders in both women and men, with over 30 million people having eating disorders in the United States, according to NEDA.

The group also reports that 40 percent of newly identified cases of anorexia are in girls 15 to 19 years old, and that there has been a rise in incidences of anorexia in young women 15 – 19 every decade since the 1930’s.

Ms. Elyse Resch, a registered dietitian nutritionist and author, said the teenage years are a time when people are susceptible to eating disorders as a desire to maintain control in their lives.

“Adolescence is… a time of uncertainty in terms of the future, it’s a time of pressure,” said Ms. Resch, who has become popular for her theory of what she calls “intuitive eating.”  “There’s very little within the control of the teenager, especially as the parents are present and set limits. So they focus on something they think they can fix — nobody can force them to eat or not eat, it’s their own thing essentially.”

Seventeen-year-old Hanna Rokah, who attends Santa Monica College, adopted a vegan diet – free of all animal products – amidst a period when she ate restrictively.

It started when she gave up competitive gymnastics training and began to obsessively monitor her calorie and food intake.

“After I stopped gymnastics at 14 years old, naturally since I wasn’t training and doing crazy cardio for six hours a day, I gained some weight,” Hanna said.

She began limiting the amount that she ate in an attempt to halt this change and lose weight.

“I would go for days and sometimes just not eat anything,” she said. “Maybe on the fourth day I would be like, okay, I can have 200 calories.”

Her eating restriction increased in severity over time, until she was barely eating at all, eventually leading to what she looks back on as anorexia. Eventually, she became a vegan and she now eats normally.

 

So when does a diet obsession become an eating disorder?  And is this question historical, cultural or personal?

According to health.com, a commercial site delivering health and medical information to consumers, the first fad diet in America was the grapefruit diet, also known as the Hollywood Diet, which was popular in the 1930s. It was a low-calorie diet encouraging people to eat a grapefruit with every meal.

Since then, Americans have followed numerous strategies in an attempt to become thinner, with many diets promising quick results. Some of the most popular have been the Weight-Watchers weight loss program, starting in 1963; the 1977 Slim-Fast diet consisting of two shakes and one food-based meal per day; and the high-protein, low-carb Atkins diet, which debuted in 1992.

“Quick-fix” diets are still high in popularity. According to Business Insider, an analysis of Google searches showed that more than half of searches for weight loss included the words ‘quick’ or ‘fast.’

But in addition, there has been a rise in popularity of more long-term diet changes — what many call “lifestyle” changes, influenced by social media as well as peer pressure and societal norms.

These include vegan, vegetarian and pescetarian diets, which prohibit consumption of animal products on various levels; the gluten-free diet and the low-carb “paleo” diet which focuses on consuming mostly protein and vegetables, and eliminates refined sugar, dairy and grains.

Diets and eating disorders have existed for generations, but a new factor of influence has recently come into play: social media.

Ms. Resch said that diets have become more accessible due to the internet.

She said that the current generation experiences more pressure to diet than hers did, partly due to social media’s influence.

“There’s such a perpetuation of perfectionism and feeling bad about oneself,” she said. “People post things on Instagram or Snapchat or Facebook and they’re only presenting the times that they think they look the best.”

Hanna said she was drawn to veganism by the influence of vegan Youtubers like Freelee the Banana Girl and Nina and Randa Nelson, who display their daily meals to platforms seen by millions of young followers.

“If you’re watching their videos on the topic of eating, you’re looking at them and seeing how you want to be when you turn vegan,” she said. “You’re comparing yourself not just in a physical way but it’s everything about them.”

Hanna said she’s grateful for the path her life has ta

ken, as it has led her to her vegan lifestyle.

“My restriction did lead me to veganism because it was just another eating trend that I was trying, even to try to escape this crazy eating disorder of not eating,” she said. “I’m happy that I found one to really stick with. Ever since I’ve become vegan, I’ve found a way to deal with eating basically.”

Senior Justin Silver said that his vegan diet did not stem from a place of insecurity, but rather from a desire to strengthen his body.

“This past month, I’ve been trying to gain weight because I do martial arts, and it helps to build muscle,” Justin  said. “I’m trying to hit a goal weight, so I have to eat an excess of 500 to 600 calories. It makes me stronger.”

He said that he has found a way to use social media’s influences to benefit and inform himself about nutrition, but that it’s important to think critically about information in the media.

“Just because something is very mainstream does not mean it’s necessarily correct,” Justin said.  “I choose to follow people that are very knowledgeable, like professional fighters, or fitness trainers.

“I learn about things I wouldn’t have had access to unless I had gotten it through social media,” he continued. “I learn about martial arts, nutrition, certain workouts and why they’re beneficial, and why there’s pros and cons to certain movements or exercise.”

As a jiu jitsu fighter, Justin now maintains a strict food journal of his daily diet, consisting of a variety of protein shakes and other plant-protein based meals. He said his focus on nutrition is part of perfecting his martial art, and becoming as healthy as possible.

“I’m just trying to figure out ways I can improve my health and efficiency,” he said. “Our bodies are essentially a machine. You can’t just feed it crap and then expect it to perform well.”

 

Whether different diets or lifestyles are cures or a catalysts for eating disorders, or whether they are related at all, remains a question, and may vary based on the individual.

But the data show that as one variable is increasing, so is the other.

According to a study done by the Journal of the American Medical Association (JAMA), the percentage of Americans voluntarily limited themselves to a gluten-free diet without medical requirement has risen from .5 percent  to 1.7 percent of the population.

Meanwhile, according to theguardian.com, an international news source, In the last six years, the number of both women and men being admitted to the hospital with eating disorders has risen by 70 percent, with eight million americans suffering from some form of an eating disorder.

Dr. Gil Melmed, a gastroenterologist at Cedars-Sinai Medical Center, said that dieting itself can be problematic, depending on the purpose.

“Are you doing it to look better, or what you perceive is looking better to other people?” Dr. Melmed said. “Or are you doing it to achieve a healthier body?”

He said gluten is falsely stigmatized as “unhealthy” by the food industry, with that being the core reason for the trending gluten-free diet.

“There is a real disease out there, called celiac disease, where people have a true allergy to gluten — where you must avoid gluten or else your intestinal lining will become inflamed,” he said.

Celiac disease, which is genetic, affects 1 percent of the population, according to the Celiac Disease Foundation.

The Foundation says another .4 percent of the population is allergic to wheat, though not to other products Celiacs can’t eat.

But a trend away from gluten is happening anyway.

“There’s this social fabric that has been developing around gluten-free products in our society,” said Dr. Melmed. “People kind of remove gluten because they’re sucked into the marketing thing that gluten is somehow harmful and unhealthy, which is not true for the vast majority of people.”

He added that dieting generally should not be the main focus for people.

“One needs to be very careful not to restrict,” he said. “One needs to learn how to make healthy choices. I think that’s a very different approach.”

 

SAS Psychology teacher Ms. Tove Sunshine said that eating trends and disorders are generally culture-specific.

“We don’t find eating disorders, we don’t find anorexia, we don’t find bulimia, in poorer less developed countries,” Ms. Sunshine said. “That seems to suggest that we’re looking at cultural phenomena rather than biological phenomena.”

She said that having the luxury to make changes to one’s life is a display of a better-off society, and diets are no different.

“It’s a reflection of an affluent society that can afford to not just eat what’s available growing near you, or to get the calories in whatever form they come because otherwise you’re going to starve,” she said.

“In an affluent society, where the basics are not a question, you distinguish yourself in other ways, and you try to control your life and shape it in other ways.”

People with what she called “food security” can focus on other things than ensuring they have enough food to eat.

“We have, for most people, access to calories or adequate calories, so our food interest and drives get diverted into other directions,” said Ms. Sunshine. “It is ironically typical of countries that are well-to-do and have plenty of food, but are now creating these cultural expectations around food and body image,”

In research done by the U.S. National Library of Medicine, more developed, Western countries see from 0.2 to 4.1 percent more eating disorders than developing countries, aligning with Mrs. Sunshine’s idea of eating disorders being cultural.

Also, although eating disorders tend to be associated with women, there has been an increase in the condition among men too, and Ms.Sunshine said that the dieting culture may be even more difficult for them.

“Those things had been viewed as women’s disorders, so it’s been harder for men to acknowledge that they are suffering from them,” she said.

“But we’re seeing very marked increases as men seem to come under the same demand that women have been under for a long time, of greater sensibility about your body, and awareness about your body, and self-consciousness about your body.”

She said that this was most likely due to the media’s evolving and increasingly extreme portrayal of men.

“I remember when the Schwarzenneger body kind of image first appeared, and the majority of people reacted to that as being grotesque,” Mrs. Sunshine said. “Already now in our own time, being ‘cut,’ having a six-pack, has become almost a normalized expectation that’s a very unrealistic one in a lot of ways.”

 

Regardless of the influence, people at all ages are receiving messages that diet and body image are things to be focused on.

In the Shalhevet poll, 22 students said that social media influencing people’s eating habits could be a negative thing.

But Donna and Justin are examples of how the media can influence mindsets towards eating positively. Donna said her life changed when she was introduced to the competitive obstacle course reality series American Ninja Warrior, adding that she was especially inspired by female contestant Jessie Graff.

“Before, I was obsessed with being really thin and really skinny, model-type thin,” she said. “But then I saw American Ninja Warrior and now I’m all about that.

“It’s not only about being physically strong, but also really mentally strong, and you just watch what they have to go through to get to where they are, and they just keep on going. It was really motivational for me.”

Senior Summer Gershon eats fish but otherwise follows a vegan diet. She was inspired by a friend’s private instagram account, or finsta.

“My friend on her finsta wrote, ‘Oh I’m going vegan, you guys should do it,’” said Summer. “I thought it sounded interesting so I looked it up and I saw what you can and cannot eat. I feel like it’s just a healthier lifestyle to live, it makes me feel more confident in a way.”

Although many are intrigued by popular diets’ promise of weight loss, some are medically required to eliminate foods from their diets.

Junior Adam Ritz is insulin-resistant, causing him to follow a diet with very little carbohydrates or gluten.

“My body does not know how to properly break down complex sugars and carbs, which means I can’t really eat almost any carbs in a day,” said Adam “It’s not easy — my favorite food is pasta, and I can’t eat pasta.”

He said that while people can choose gluten-free diets, they should be more sensitive in doing so.

“I totally support someone trying to eat as little gluten as possible, but I don’t like people making a big deal about it if they do it by choice, because I don’t really have a choice,” he said. “You don’t have to be so strict about it, being that it’s not a necessity.”

Mrs. Sunshine said that while exploration of different diets is okay, questions are crucial.

“I don’t think that doing gluten-free or paleo or any of those things — that does not equal eating disorder,” she said. “The only thing I will say is that as attractive as these things may be, to be a little skeptical.”

 

Back at the dinner table, Summer’s mother, Mrs. Edie Green, said that while the process of preparing meals for her family has changed due to her daughter’s vegan diet, it has only been for the better. Summer is the only one in her family with eating restrictions.

“We just have to be really careful what we’re eating now,” Mrs. Green said. “Reading the ingredients has become very important for us. We make more salads, and we shop at the farmer’s market for fruits and vegetables.”

She said that Summer’s diet has impacted her family’s positively.

“Everyone’s eating healthier,” she said. “It’s a healthy change, not just for her, but we were able to incorporate it into the entire family, and it’s something that ultimately makes us healthier and happier.”

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