TL;DR: Go listen to today’s interview with Mickey Trescott!

I want to start off by saying that “orthorexia” is not actually considered to be an actual DSM-V diagnosable eating disorder. I also want to start off by saying that orthorexia is taking over our collective first-world, health-obsessed consciousness, and it might as well be an actual DSM-V diagnosable eating disorder for all of the pain, struggle, and emotional distress it’s causing.

I also also want to start by saying that eating as well as you can as often as you can is probably a good idea, and may have some positive impacts in terms of environmental ethics and the treatment of animals in addition to being good for your overall health. And I three-times also want to start by saying that if you can’t eat “perfectly” all the time, it is neither a crime nor a cause for panic.

With very few exceptions, not eating a perfect diet is not going to cause you to die on the spot.

(I realize that there were a lot of “alsos” and double negatives in the above, and I apologize for being convoluted in advance. But even a professional writer can’t be a perfect grammarist all the time. [Aside: see what I did there?])

Yet, for some reason, we associate the perfect diet with perfect health—and develop deep fears around straying from the perfect path.

But not eating a perfect diet all of the time isn’t bad—because there a) is no perfect diet and b) humans aren’t perfect. If we were, we’d still be dancing around naked in a garden, and while that sounds like a perfectly lovely way to be, we’re mostly clothed and usually not dancing. That’s just life.

The myth

Now, all of this to say: there is a really, really, really fine line between eating for your health and eating for perfection—and eating for what perfection usually implies.

If you ask the dictionary, “health” means “the state of being free from illness or injury.”

But if you ask anyone who has existed in the first world for even a fraction of a millisecond, the answer will probably involve a simple math equation: mass times gravity.


Even the most brilliant health writers with the deepest understanding of biochemistry—those who can biohack their biomarkers or who put the function in functional medicine—will still nod toward the loss of mass relative to gravity—weight—as a sign that your body is becoming or staying healthy.

On Monday, I touched on the difference between “health” and “weight loss,” and how they are not mutually exclusive, but one is not always an indicator of the other.

Unfortunately, in orthorexia or “right” eating, there is almost always a layer of weight loss factored into the health and perfection conversation, which is what makes following a strict eating plan so dangerous to people who are prone to being disordered eaters.

I’ll explain:

Many people begin “eating clean” (whether that cleanness is sold by, Kris Carr, Loren Cordain, or anyone in between) specifically because they think that something is wrong with the way their body looks and functions. The trouble is that because we’ve been so disempowered by the world of marketing, advertising, and Big [Insert Food Industry Here], we don’t know how to make decisions about food without consulting a guide. And so we turn to our diet guru of choice and download the list of “yes” foods and “no” foods and cling desperately to the idea of perfect adherence because the testimonials page says we’ll experience the results we want (weight loss/optimal health, etc.) if we do.

The strict eating plan becomes our path to optimal health and moral righteousness, but…

The trouble happens when optimal health—or weight loss—doesn’t happen on a strict eating plan.

Because that’s when we start searching for something stricter.

Let’s use the Autoimmune Paleo Protocol as an example, since it’s something with which I am intimately familiar.

The Autoimmune Paleo protocol (AIP ) is an elimination diet meant to take out potentially inflammatory foods like nightshades, dairy, or eggs for 30 days only to add them back in one at a time in order to see how the body reacts. AIP is actually a really great tool when there is a suspected autoimmune disorder and, while the results may lead someone to a more restrictive diet (and, really, what is life without tomatoes?), it actually can be a fantastic tool for managing real disease in conjunction with whatever other therapies your doctor, nutritionist, or other health care professional prescribes.

That said.

Because it’s a strict diet, and because we come from a culture that is addicted to cleansing, detoxing, and perfecting our diets for “health” (weight loss), AIP (among other diets) has real sex appeal to the average disordered eater.

And it’s very likely that the average disordered eater will stumble upon a restrictive “perfect” diet plan like this because she is experiencing serious health problems, even while eating an already “perfect” diet. Health problems like thyroid dysfunction or amenorrhea. [Side note: that’s how I found out about it!]

Because if a perfect Paleo diet can’t help us get our periods back, we reason, then a more perfect Paleo diet will. And as we cling desperately to the hope that not eating eggplant will make our thyroids work, we also secretly keep our fingers crossed that we’ll also lose five pounds.

Because, conventional wisdom says, when you get healthy, you lose weight. When you lose weight, it’s a sign that you’re healthy.

And it is in that reasoning that something like the AIP, which has real, practical application for people who are struggling with severe disease, becomes a self-sabotaging tool for the sado-masochistic disordered eater, who hasn’t gotten her period, not because she has lupus but because she’s chronically exercising or still underweight.

So, while I know this has probably been said before, let me just say it again for complete clarity: Autoimmune Paleo is not perfect Paleo. It is not a tool meant for weight loss. It is a tool  meant for managing a chronic illness, not for adding to your list of righteous vs. non-righteous, fattening vs. non-fattening foods.*

We have to have the presence of mind to start making this healthy distinction if we actually want to be able to eat for our health, and not for ED.

The reason that this is on my mind is because I interviewed Mickey Trescott on this week’s podcast. Mickey is the author of The Autoimmune Paleo Cookbook, and we had a really candid conversation about what it means to eat for your health versus what it means to eat for your eating disorder. I was nervous to talk about AIP because there are so many triggers when we talk about restrictive eating for disease management, but I was really pleasantly surprised to learn that Mickey has actually worked toward loosening some of her own medically-necessary restriction as she has healed, and she has a really balanced viewpoint when it comes to working with clients who are disordered eaters.

I really enjoyed this interview, and I think it might shed some light on the differences between orthorexia and eating to heal disease—and how you can avoid some of the pitfalls that lead us down the road from health toward disordered eating.

Go Listen Now!


Stay hungry,


*i.e. Cutting out potatoes—they’re a nightshade, so eating AIP gives disordered eaters a convenient excuse cutting out one source of carbohydrates…