All diet fads have a few things in common: hyped-up names like “raw” or “warrior,” a basis on dodgy science, the demonization of an ingredient or an entire food group, and a promise that you’ll easily achieve your weight loss goals. Nevertheless, diet fads keep coming and we keep falling for them.
But one doesn’t simply get over a diet fad and welcome another like a new fashion trend; diet fads can come with serious risks including nutritional imbalances, metabolic problems, or even disordered eating. All of this has lasting effects on physical and emotional health, experts warn, that can lead to a condition one doctor has dubbed post-traumatic dieting disorder, or PTDD.
According to obesity expert Dr. Yoni Freedhoff of the University of Ottawa and author of The Diet Fix: Why Diets Fail and How to Make Yours Work, the hallmarks of emotional trauma caused by PTDD include feelings of shame, guilt, a loss of healthy body image, social withdrawal, and feeling of constant threat by food.
Athletes can suffer from PTDD as much as anybody else. But athletes, in particular, also run a special risk of crossing the line into what might be described as a type of obsessive-compulsive “clean eating” behavior.
Orthorexia nervosa, while not yet officially recognized as a psychiatric disorder, is a psychopathological condition involving an obsessive preoccupation of eating “healthy food” and avoiding foods that are believed to “be unhealthy or impure” that is more frequently seen in athletes, according to sports medical psychologist Dr. Cristina Segura-Garcia of the University Magna Graecia, Catanzaro, Italy, who published her findings in 2012.
According to Segura-Garcia’s research on about 600 Italian athletes, about 30 percent of females and 27 percent of males showed symptoms of orthorexia nervosa. Diagnostic criteria included obsessive categorizing of foods into ‘good or ‘bad,’ thinking excessively about calories and sugar content, fear of eating certain types of food, or fear of eating in front of people.
Earlier this year psychologists Nancy Koven and Alexandra Abry of Bates College added these symptoms to the diagnostic criteria: “spending considerable time scrutinizing the source, processing, and packaging of foods,” “guilty feelings and worries after transgressions in which ‘unhealthy’ or ‘impure’ foods are consumed,” and “spending excessive amounts of money relative to one’s income on foods because of their perceived quality and composition.”
Eating issues like orthorexia nervosa can be medically concerning, cause mental anguish, and even be potentially devastating, but Dr. Freedhoff warns against arriving at the conclusion that an athlete you know might have a medical problem too hastily. If a diet fad were to “interfere with the ability to meet nutritional needs,” then certainly it would be a concern, he said, but if all it does is “lead someone to being ridiculously challenging to have as a dinner guest” then it’s probably not really a disorder.
The key to avoiding the fad-diet cycle, orthorexia nervosa, and PTDD is to avoid striving for perfection, making unreasonable restrictions, and being overly self-critical. Instead, be flexible—that means indulging in chocolate and ice cream once in a while.
Easier said than done, right? Thankfully there are new technologies that seek to help everyone—including athletes—eat healthfully without fad dieting. Smartphone apps like MyFitnessPal allow users to more easily track their calories and adjust macronutrients like protein, fat, and carbohydrates.
Athletes of all types might, in fact, may benefit from looking at food as macronutrients rather than through a diet lens. Take a movement currently going on in the world of bodybuilding called IIFYM, or “if it fits your macros.”
The story goes that IIFYM was born when people posting on bodybuilding.com discussion forums kept asking: “Is this food OK? Is that food OK?” In response others kept answering with, “Sure, as long as it fits your macros,” and finally it was shortened to the acronym.
IIFYM now exists as a kind of counter movement against fad diets—including “clean eating.” It involves tracking food intake on apps like MyFitnessPal, and not restricting any foods so long as it meets macronutrient requirements, says Layne Norton, a pro bodybuilder and who received his Ph.D. in nutritional sciences from the University of Illinois.
Fitting your macros shouldn’t be confused with having permission to eat nothing but junk food. But it does allow athletes to find spots for including pizza, ice cream, and beer in their diets as long the amounts stay within their protein-carb-fats and total energy requirements. IIFYM is “far more sustainable” than diet fads, Norton says. “Anything that allows people to be more consistent and have a better handle on their nutrient intake is going to lead to improved performance over time, especially if it helps them with sustainable fat loss.”
Norton says he’s been focusing on macronutrients for more than a decade. “When people ask me when the last time it was I had a ‘cheat meal’ I tell them I can’t remember, because I’m always mindfully tracking my macronutrient intake.”