Guest blog from Sharon Trueman Accredited Practising Dietitian
https://bluemountainsdietitian.weebly.com/
Living with a genuine food intolerance often requires careful attention to diet and a diagnosis is often through following a diagnostic elimination diet which can be a valuable medical tool when used appropriately.
These diets are designed to help identify foods that may be contributing to symptoms such as digestive issues, migraines or eczema.
Typically, an accredited practising dietitian recommends temporarily removing specific foods from the diet and then gradually reintroducing them while monitoring symptoms, if improvements are seen whilst on the diet.
However, elimination diets are intended to be short-term, diagnostic and purposeful.
When followed without the guidance of a dietitian, they can become unnecessarily restrictive and may increase the risk of nutritional deficiencies and have negative effects on our gut microbiome.
For some people, particularly those vulnerable to perfectionism or anxiety around food, elimination diets can also contribute to the development or worsening of Orthorexia—an unhealthy obsession with eating in a way that is perceived as "pure," "clean," or "healthy."
What begins as a well-intentioned effort to improve health and symptoms can gradually evolve into increasingly rigid food rules, fear of certain ingredients, avoiding eating out or social occasions and avoidance of entire food groups without clear medical need.
People with diagnosed or suspected food intolerances may be at increased risk of developing orthorexia because their focus on avoiding certain foods can gradually expand beyond medically necessary restrictions. A legitimate need to eliminate one or two trigger foods may evolve into the exclusion of multiple food groups, driven by fear of symptoms, misinformation, or the belief that increasingly restrictive eating is healthier.
In other words, the need to monitor food choices closely can sometimes blur the line between necessary dietary management and an unhealthy preoccupation with eating.
It is important to distinguish between medically necessary dietary restrictions and those driven by fear or misinformation.
While people with conditions such as coeliac disease or confirmed food allergies must avoid certain foods to protect their health, and those with genuine food intolerances may find symptom relief by reducing intake of trigger foods, eliminating foods without evidence of intolerance, allergy or other medical diagnoses is unlikely to provide benefit and may negatively affect both physical health, nutritional adequacy, gut microbiome and psychological wellbeing.
Social media, wellness influencers, and unvalidated food sensitivity tests can reinforce these fears by promoting the idea that common foods are inherently harmful or that optimal health requires the elimination of gluten, dairy, sugar, or other foods without clear medical evidence. This can lead individuals to adopt increasingly rigid eating patterns that are difficult to sustain and may result in negative consequences and heightened anxiety around food.
Importantly, managing a food intolerance is not the same as having orthorexia. The key distinction lies in the motivation and impact of the dietary restrictions. People with food intolerances avoid specific foods to prevent genuine physical symptoms and are generally able to maintain a varied, balanced diet within those limits. In contrast, orthorexia is characterised by an excessive fixation on food quality or purity, rigid food rules, significant distress when those rules are broken, and dietary restrictions that interfere with physical health, psychological wellbeing and daily life.
If you suspect you or someone you know has a food intolerance or is at risk of Orthorexia, visit your GP to discuss a referral to an accredited practising dietitian and/or psychologist.
See https://www.faid.com.au/ for more information on food allergies and intolerances.