The Truth About Paleo and Disordered Eating
Before I delve further into the truth about Paleo and disordered eating, allow me to share with you a discussion that I had with a friend to put this piece on Paleo and Disordered Eating into context:
FRIEND: So, you’re saying that some people use “Paleo” as an excuse to restrict food or over-exercise?
ME: Yes, but there are many people who don’t—some start following a Paleo template to heal an illness caused by food allergies or leaky gut, or lose weight for medical reasons, like obesity, insulin resistance, sugar addiction…
FRIEND: But things like obesity and sugar addiction, aren’t those a result of disordered eating?
ME: In some respects, yes.
FRIEND: So…who doesn’t have an eating disorder?
That, my friends, is one of the most difficult questions I’ve had to address, partially because the terms “disordered eating” and “eating disorder” are subject, in our nutritionally hyper-aware community, to both diagnosis and interpretation.
Here’s the deal: according to the good folks with “Psy. D.” after their names, eating disorders have some strict medical definitions. Anorexia, Bulimia, and Binge Eating Disorder mean something very specific when being analyzed in your doctor’s office.
Unfortunately, there is a lot of gray areas when it comes to the non-diagnosable disordered behaviors: compulsive eating, sugar addiction, exercise addiction, calorie restriction, orthorexia, and other things that might fall under the category of “EDNOS” (Eating Disorder Not Otherwise Specified). And in that gray area lies a world of confusion, missed diagnoses, potentially ruined lives, and “shaming” comments on each others’ blog posts and online forums.
So in an attempt to further explain my thoughts on this extremely loaded topic, let me share a couple of case studies:
• Susan comes from a world of addiction. In working the 12 steps, she’s come to understand her behaviors so much so that she is not only able to manage them, but also avoid repeating them in making choices about her nutrition and exercise. She owns every Paleo/Primal/WAP cookbook out there, and she loves searching the local farmers’ markets for new and different foods to try.
She’s not big on Paleo treats, but she also doesn’t count calories, so she’s usually okay with eating one when offered—and she both feels comfortable stopping at one or not beating herself up if she makes the conscious choice to indulge in the second. However, Susan doesn’t eat grains, beans, or legumes, so her diet is “restrictive” when compared to the Standard American Diet, and she also participates in 21 Day Sugar Detoxes once or twice a year, when she feels like she needs a reset.
• Brenda has never had a problem with addiction, but she is no stranger to competition. She started CrossFitting and was introduced to Paleo via a Whole30. In her month of “strict Paleo,” she made gains in terms of her body composition, but constantly felt defeated when another woman lifted heavier than she did, especially when those women had been doing CrossFit for far less time than she did.
At the end of the Whole30, Brenda wolfed down a longed-for “non-Paleo” dessert (flour, sugar, dairy—the whole nine yards!*). After every bite, her thought process sounded a little like this: “I hate myself. I shouldn’t be eating this. I’m going to be so fat.” Etc. She doesn’t eat every meal this way, but she, like many of us, has to remain vigilant to keep the voice from editorializing about how her meals will affect the size of her thighs or the weight of her deadlift.
• Evelyn** used to be overweight. After a difficult life experience, she found new hope in CrossFit, which eventually led her to Paleo. Evelyn quickly reshaped her body through a combination of high-intensity workouts 6-7 days per week and a low-carb Paleo diet. She logged every calorie in her calorie-tracker and weighed herself regularly to keep herself accountable.
Everyone complimented Evelyn on her slimmer stature, but inside, Evelyn still felt like there was more work to do. Even though she was buying the Paleo cookbooks and reading the blogs, she was mostly cooking the same things every day, because it was not only easier, but it was “safer” in terms of regulating her calorie intake and macronutrient ratios.
When Evelyn wasn’t working out, she felt the need to keep up with her food tracking, even though she already knew exactly how many calories she was eating. Evelyn stopped going out with friends and started cooking all of her meals at home and began to feel anxious about social events that would interfere with her food plan or exercise. But Evelyn is not underweight—she is strong. And strong is the new skinny…right?
• Jenny,** an Italian-American woman whose family frequently gets together around grain- and dairy-rich meals, gave the whole “Paleo” thing a shot when she encountered a website that promised her she’d lose 10 pounds if she did an elimination diet. 10 pounds was all the convincing she needed to go #PAF… but the real win was that her chronic fatigue, constant migraines, and frequent heartburn completely cleared up.
She didn’t lose all 10 pounds— she didn’t really need to— but by staying “strict” Paleo, she felt, mentally, 10 pounds lighter. Going back to her old way of eating just wasn’t an option, so she has become the family member who perpetually made it just this much harder for the group to find a restaurant that would accommodate her needs—although she finds a way to make it work. (And with the number of restaurants who recognize “weird” food restrictions these days, she can usually find something on the menu.)
Who’s the disordered eater here? According to the people who call Paleo out for being a restrictive diet, everyone here falls under that category. According to the DSM-V, no one here has an eating disorder. According to everyone with an opinion on the internet, however, the possibilities for name-calling are endless.
Recently, I had a conversation with Kevin Geary of The Rebooted Body, for whom I have deep respect, about this very question. He believes that people like Jenny necessarily had to “restrict” her food choices in terms of a standard, grain-and-processed-food-based diet because of the positive health benefits. Although her initial investment in Paleo occurred because she had certain ideas about her body composition, she remained invested because it allowed her to live a better life.
While not eating “healthy whole grains” or pasteurized dairy (which limited her ability to go to the Olive Garden with her family), Jenny experienced a better quality of life, which also included her change in body composition. As Kevin said to me, in this case, a little “restriction” in the context of her current diet was absolutely necessary to bring about the changes she desired.
Susan, too, should be susceptible to disordered behaviors, especially given her former addictions. However, while she limits grains, beans, legumes, and most dairy in her diet, she does not feel limited at all by the number of choices that she does have when it comes to her meals.
If anything, having that limitation has allowed her to experiment safely, without feeling out of control or in need of either a sugar binge or a yo-yo diet. Using a Paleo template allows Susan to guide her choices and support her mental and emotional health in a way that eating lots of bread and sugar never would. Again, in Susan’s case, “restriction” is a word that must be placed in the context of a typically recommended grain-based diet.
What of Brenda? She doesn’t have an eating disorder. She doesn’t normally binge, purge, or restrict; doing the Whole30 was just a challenge she was trying. Negative self-talk does not an eating disorder make, although it certainly sets you up for one if you continue to believe that you’re not good enough and need to continue restricting food and/or exercising harder in order to become some elusive “better” version of yourself.
Because Brenda has had this experience, however, she has had to become more careful about how she contextualizes her self-worth in terms of her food choices. She now follows a less restrictive Paleo template, along the lines of Susan’s, but she also has to do the work of navigating the fine line between disordered eating and disordered body image.
Evelyn’s case, on paper, seems pretty obviously disordered, however, “Evelyn” is pretty common—and not just in the Paleo community— but throughout every diet, from vegan to SAD. Evelyn started out doing what most of us do: picking a diet, following it, and maintaining some kind of points system for accountability.
Some people are okay with eating “more healthily” and exercising regularly without any negative repercussions, but more often than not we either end up on-the-wagon/off-the-wagon dieters, or we end up orthorexic/exercise addicted and scared to death of ingesting a single calorie that’s not in line with the macronutrient ratios suggested by the most recent blog post by our favorite nutrition guru.
The thing is, even though Evelyn’s body composition has garnered compliments from others to Evelyn, it’s not enough. She lives in constant fear of judgment from others—fear of losing those compliments and returning to her overweight and less-complimented self, so she imposes a restrictive diet (even though it contains enough calories or macronutrients or whatever to fuel her workouts and make her look strong) that not only restricts food groups….but also her lifestyle and happiness.
Okay, so where does that leave us? I don’t think there’s anything wrong with wanting to be “in shape” per se (although the concept of “shape” itself is another can of worms for another day); I think there is, however, something wrong with reducing the quality of your life because of how your diet may or may not affect your body. Restriction, disorder…it’s all about your perspective.
And I think it’s an inner definition that you have to come to terms with in order to truly be healthy. Susan’s quality of life hasn’t been reduced because she doesn’t eat the cookies at her weekly meetings. Jenny has had to come to terms with eating gluten-and-dairy-free in an Italian family in order to maintain her health.
Brenda has to work to make peace with a diet and a body that she thought she understood—to remove her competitive spirit from the kitchen and find the balance between her emotional health and eating healthily. Evelyn may need to see a therapist to work through her body dysmorphia and fear of judgment.
Disordered eating is a really tough road to navigate, especially because we live in a world that actively promotes disorder—from fast food and chemically processed non-foods to fad diets and fit-/fat-shaming. Our “conventional wisdom” is so far removed from traditional wisdom about healthy human diets and lifestyles, that it’s no wonder why we’re so susceptible to the disorder.
The truth about Paleo as a template isn’t that it’s inherently or unnecessarily restrictive, nor does it promote disorder in all who choose to eat that way. As Kevin said, some “restriction” is actually necessary for terms of resetting the body and restoring it to optimal health. Where I see the trouble, coming from 13 years of disordered eating and an eating disorder myself, is when the line gets crossed between body comp/fitness/self-worth and food.
It’s not a contextually limited menu that’s the problem: it’s when your menu limits your lifestyle in an unmanageable way that we begin to see a problem.
If you are feeling out of control with your food—you find yourself counting every calorie or “macro” you eat, feeling anxious about eating a meal you haven’t cooked yourself, avoiding meals with others because they interfere with your diet or exercise, eating the same “safe” foods over and over again, bingeing on foods you deem “bad” and then punishing yourself through negative self-talk, excessive exercise, or continued restriction—then I urge you to tell someone.
Seek help from a therapist or a coach who can work with you to make your life feel manageable once again. Food shouldn’t be a punishment or a prison, and Paleo, for all of its “restrictions” should never be a mentally/emotionally restrictive diet.
Where do you fall on the spectrum? Have you been using Paleo constructively or destructively? This is an important conversation that I believe our community needs to have, and I look forward to hearing your thoughts.
*Whole9 pun intended. Also, this example was not used to hate on the Whole9 team. They are doing a great service to the people who need to be introduced to Paleo through basic guidelines and accountability. It doesn’t work for everyone, but I think there’s a lot of good that can come out of approaching the Whole30, as long as it’s approached with a healthy mindset