When Food Is Family

Key ingredients in the eating disorder mix

Gluten-Free: Fad, Friend, or Foe?"

Is a Gluten-Free "life-style," really code for an Eating Disorder?

There are no fewer than 100 types of diets posted on WebMD’s list of  “Weight Loss and Diet Plans.” http://www.webmd.com/diet    Some of them are memorable  - shock value intended – the Grapefruit Diet, Personality Type Diet and Blood Type Diet.   Some of them are true attempts at finding a healthy way to eat and live – true lifestyle diets  – Mediterranean Diet and Dr. Andrew Weil’s Eat Right for Life.  Some of them are down right dangerous – Raspberry Ketones, No Fat Diet and African Mango, to name just a few.   

The basis of the overwhelming majority of diets is to restrict one or more types of food or ingredients in food in order to achieve the goal – the promise of permanent weight loss, improved health and ah yes, happiness.  If most diets don’t already insult our bodies by depriving them of proper nutrients, they certainly insult our sensibilities, or should.  Diets don’t work.  Most of us have come to understand and accept this. Those of us who treat eating disorders know full well the seduction that diets have over our patients.  Helping them eat normally is the goal  (that means a full range of foods including complex and simple carbohydrates, protein and fat.)  In eating disorder recovery, no food is off limits, bad or forbidden, which metaphorically translates to no feelings, thoughts or issues are prohibited from being understood and dealt with in therapy and in relationships. 

The latest craze sweeping up the minds and pocket books of many Americans in the hopes of finding health, body and emotional bliss is – Gluten-Free Diet or rather, Gluten-Free Lifestyle.   Entire companies, stores and restaurants have discovered a marketing strategy that works to get us to buy their gluten-free products in supermarkets or eat in their shops and restaurants.  Clever, brilliant perhaps, on the part of American marketing who has found a new way to prey on the psyches of consumers. 

Two points to consider: 

1.  A person who truly needs to eat Gluten Free has a very serious medical condition known as Celiac Disease.   

2.  Eating Gluten Free food for the rest of us denies our bodies of complex and rich carbohydrates necessary for hunger satiety, digestion, stamina and fuel during exercise.  Is it possible therefore that this life-style approach is really an eating disorder in disguise?   

 POINT 1 

What is Celiac Disease? Celiac Disease is an immune reaction to eating gluten, a protein found in wheat, barley and rye. The condition is hereditary and it t is estimated that 1 in 100 people are affected worldwide. If you have Celiac Disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction produces inflammation that damages the small intestine's lining and prevents absorption of some nutrients (mal-absorption). The intestinal damage can cause weight loss, bloating and sometimes diarrhea. Eventually, your brain, nervous system, bones, liver and other organs can be deprived of vital nourishment. In children, mal absorption can affect growth and development. The intestinal irritation can cause stomach pain, especially after eating. (www.mayoclinic.com/health/celiac-disease

Left untreated, Celiac Disease can lead to additional serious health problems including Type I Diabetes, Multiple Sclerosis, infertility, neurological conditions like epilepsy, short stature and intestinal cancers. (www.celiac.org)  

There is no cure for Celiac Disease — but following a strict gluten-free diet can help manage symptoms and promote intestinal healing.

Adults who have been diagnosed with Celiac Disease or parents of children with the disease are routinely confronted with the stress and rigor that comes along with maintaining a true gluten-free diet.  Even trace amounts ingested can cause a variety of painful abdominal and physical distress.  Adults feel miserable when gluten has been ingested; children with Celiac, especially those still non-verbal or with few verbal skills, cannot articulate their distress other than through constant crying, irritability, and oppositional behavior.   

Many aspects of “normal” living are affected – i.e. can my child attend a birthday party and have available only gluten-free foods? (Often parents have to bring along their child’s food.)  Can a young child not accept food with gluten when offered by another child? (Not likely – kids are kids.) Can a parent keep gluten rich foods in the house for other members? (Is this fair for the child with Celiac or the ones without?)   

POINT 2 

Aside from the genius of marketers to find yet another way to convince us how we can buy happiness, health and bloat-free bellies, here is the thinking behind going gluten-free as the next new ‘diet’ ………ah...ehm….  “life-style eating.” (Euphemism, if you ask me.)  Eating gluten-free without the diagnosis of Celiac Disease promises to provide a body aesthetic (no bloated bellies) and purports that its followers will come to feel mentally alert and physically less tired and stressed and even lifts depression.    Seems to me that a lifestyle based on healthy eating from all food groups, sleep, exercise and good relationships will do the same thing.  But that takes time and involves emotions and thinking.  Eating gluten-free food offers the faster road to Happy Rome…..thus, appealing.  Quick fix – gets us most of the time to capitulate and adhere to more quick fix solutions.   

“Based on little or no evidence other than testimonials in the media, people have been switching to gluten-free diets to lose weight, boost energy, treat autism, or generally feel healthier. This doesn’t make much sense to Dr. Daniel A. Leffler, director of clinical research at the Celiac Center at Beth Israel Deaconess Medical Center in Boston.

“People who are sensitive to gluten may feel better, but a larger portion will derive no significant benefit from the practice. They’ll simply waste their money, because these products are expensive,” says Dr. Leffler, who is also an assistant professor of medicine at Harvard Medical School.  (Strawbridge, www.health.harvard.edu.)  

Here are some reasons to consider NOT going gluten-free unless there is a medical need to do so:

Gluten-free food will likely set you up for deficiencies of important nutrients, including B vitamins, especially, B9 (folic acid) – Whole food breads and cereals are loaded with B vitamins.   Eating fiber rich foods are important, especially for breakfast, in order to get and maintain normal intestinal and bowel movement.  Removing whole grains will add to digestive problems overall, not correct them. Most Americans do not eat enough fiber.  It is possible to get more fiber from brown rice and fruit, which are gluten-free, but a person must be committed to eating enough of these foods on a daily basis to achieve a similar effect of foods rich in fiber like wheat breads and cereals.  

Is it possible, therefore, that a gluten-free diet in the absence of Celiac Disease is a code phrase for what can really be an eating disorder? Orthorexia, perhaps?  

Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.”  Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity.  They become consumed with what and how much to eat, and how to deal with “slip-ups.”  An iron-clad will is needed to maintain this rigid eating style.  Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise).  Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake. (www.nationaleatingdisorders.org)

Crumbs Bake Shop, a major specialty cupcake retailer opened a gluten-free shop in NYC’s Greenwich Village in September.  The company states that the gluten-free products will be baked at a completely gluten and peanut free bakery and delivered to their Village store.  The President and CEO of Crumbs, Julian Geiger, stated, “Now, those who live a gluten-free lifestyle will be able to enjoy the Crumbs experience.” (http://investors.crumbs.com/releasedetail)

Neither Crumbs nor Mr. Geiger stated, however, that their gluten-free cupcakes are safe for people with Celiac Disease. 

What I find particularly distressing is the fact that the bakery has opened in Greenwich Village – yes, home of NYU and lots of impressionable, vulnerable young adults eager to find a fix for whatever emotionally distresses them or as a quick fix to better self-esteem.  Brilliant marketing, once again.  

People with Celiac Disease do not have that choice and many, likely, would not choose eating gluten-free, given the option, as a lifestyle. Ask any parent of a kid with Celiac.  

Dieting sets us up for more dieting.  Restricting food sets us up for craving the food we restrict and often leads to bingeing.  Rigid eating (without medical necessity) is often linked to eating disorders.  Using food in an attempt to seek emotional equilibrium or when diet or body image is relied upon as the primary or sole approach to finding self-esteem and feeling acceptable, some, including me, call this an eating disorder.   

Best, 

Judy Scheel, Ph.D., LCSW     

Judy Scheel, Ph.D., L.C.S.W., author of When Food Is Family, is the Founder and Executive Director of Cedar Associates Foundation.

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