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Why health can Extreme approaches to dieting and exercise are now common and with them come a new set of disorders

It may be the height of common sense, but the age-old adage of 'eat less, exercise more' has faded into the background more than ever. Make no mistake; we are living in an age of extreme diets. Not surprisingly, in this new world order has arrived a host of new terms, many of which capture the extreme nature of modern-day wellbeing. Derived from the Greek word 'orexis' (for 'appetite'), the suffix 'rexia' appears to be gathering pace.

"These are newfangled terms that generally refer to an over-obsession on one issue, often specifically about eating," explains Dr Bernadette Carr, medical director with VHI. "Often, something has gone out of balance in a person's life and they are compensating for problems by fixating on one thing." Here are just a few of the newer terms we've begun to encounter.


An obsession with healthy eating

Before 'extreme diet' headlines became less the exception and more the rule, a highly restrictive diet might well have been regarded as tantamount to an eating disorder.

Surely this is why in the past Victoria Beckham has appeared to straddle the fine line between extreme dieting and an actual eating disorder for years? Such is the theory put forward by Dr Steven Bratman, who coined the term 'orthorexia' (the Greek word orthos, meaning 'correct') in 1997. Rather than obsess about counting calories or staying thin, orthorexics -- dubbed sufferers of 'the healthy eating disorder' -- are hell-bent on following what they perceive to be a perfectly healthy diet. Orthorexics would often rather starve than eat something not seen as 'pure'.

Unlike with anorexics, the emphasis is on quality rather than quantity. In fact, weight loss and orthorexia aren't even mutually exclusive. Some even argue that raw-food diets, organic living and even veganism, all shorthand for a purer and more holistic way of life, are a front for orthorexia.

"Orthorexia would really describe an unhealthy obsession with healthy eating," explains nutritionist Aveen Bannon of the Dublin Nutrition Centre.

"People can be aware of healthy eating but still enjoy occasional treats but, with orthorexia, healthy eating is an obsession.

"It can begin with a focus on healthy eating, herbal remedies, vitamin supplements and some food avoidance. Often quality of life decreases as the quality of the diet increases. Although it is not always recognised as an eating disorder, often sufferers might show signs of OCD. There is a lot more information readily available to people now about healthy eating."


An addiction to exercise

Is there such a thing as too much of a good thing? Alas, yes. A 2006 study concluded that excessive exercise can be defined when its postponement is accompanied by intense guilt or when it is taken solely to influence changes in your body type.

"If someone is addicted to exercise, there's a 100pc emotional attachment. They can't live without it," explains John Lark, a trainer with Sphere Fitness. The red flags are easily recognised: physical injury, declining performance, feeling burned out, and feeling stale in terms of exercise or loss of motivation.

While many studies have linked exercise addiction with eating disorders, researchers have noticed a pattern among fitness junkies: high levels of perfectionism, focus, determination and persistence. So how to determine whether you simply like the endorphin rush of 20 minutes on a cross-trainer . . . or are dependent on it?

"Try taking a week off and stick to walking every day," advises John. "If you can quite happily sit back and relax without any pangs of guilt, then there's no problem. Personally I encourage my clients to cut back every fourth or fifth week of exercise, then pick it back up again. If you exercise for the love of the feeling, the social interaction, the fun, the feeling of reward and achievement, then you're on the right track."


A preoccupation with gaining too much weight during pregnancy

Blame the Hollywood stars with their neat baby bumps and post-pregnancy pinging back into shape.

"We now know that maternal obesity predicts childhood obesity, yet on the other end of the spectrum the other extreme does as much damage," warns celebrity personal trainer Karl Henry. "You have to be sensible and get in as many nutrients as possible. There's pressure on women to get in shape as soon as possible. But we recommend that people don't train for six weeks after giving birth."

Adds Bernadette: "If an individual is insecure, fragile, or under stress, they can take these celebrity headlines seriously and not see pregnancy the way it should be. It's about being healthy, and caring for yourself, and enjoying your baby, not worrying about unrealistic weight goals."

Is pregorexia happening in Ireland? "Up to a point," concedes Karl. "The ideal scenario is that a client has six or seven pounds to lose, because she set an upper weight limit for herself during pregnancy and looked after herself for those nine months. But unfortunately a lot of Irish women don't take care of themselves during pregnancy and need to learn how to strike some kind of balance."


Obsessed with pre-wedding dieting

It's the day that most women have been dreaming of since childhood, so little wonder that the focus that many women train on their wedding can spiral out of control.

"In some respects the best clients a trainer could have are brides, as they're so disciplined," concedes Karl. "But, because they're aware that these photos will be around for decades, and they consider it one of the biggest days of their lives, they can easily become obsessed."

Yet there's one factor that brides often overlook; many of them lose four to seven pounds in the final week before their wedding through sheer stress. In other words, it's all too easy to take the slimming too far.

"Their metabolic rate kicks in and they're anxious," says Karl. "Sometimes they can look a little skeletal on the big day." Brideorexia often occurs when brides fixate on getting into their designer gown, often in a bid to block out other wedding anxieties, or even underlying emotional niggles.

"We ask our bridal clients to look at the health consequences," explains Karl. "Get into the best shape you can, but mind your health. It's important to know when to say 'no more' to exercise, even when you want to push on."


An obsession with being too small

The obsession with looking too frail is a subtype of body dysmorphia called muscle dysmorphia, nicknamed bigorexia, which is most common in men. Men with muscle dysmorphia constantly weight train and exercise to achieve a more muscular or 'manly' body.

"Often it seems as though there's an emotional trigger when people want to be bigger," observes Karl. "You can notice these guys right away as they have the big arms, shoulders, back and pecs, and wear tight T-shirts to show off their work, but their lower body -- which is less visible -- has less muscle."

Bigorexia is certainly part and parcel of bodybuilding culture, but the big question looms large . . . is it due to hit the mainstream in Ireland?

"To a point," notes Karl. "There is a massive growth in the sale of powdered protein, and supplements are a huge growth industry in Ireland. To me it seems like there's a sort of psychological gap there that needs to be filled."


Skipping food in order to drink more

The idea of saving one's daily calorie allowance for partying wreaks havoc on one's health.

"Everyone needs a certain amount of calories a day, but if you do this, you won't get essential nutrients, and you're effectively taking a toxin into your body instead of food," notes Bernadette.

"There's definitely a rise of this in Irish cultures, possibly owing to the idea that models do nothing but drink Champagne all day," notes Karl.

Indeed, statistics suggest that 30pc of 18 to 24-year-olds skip food in order to drink more.

"Unfortunately alcohol contains a huge amount of calories -- there are 300 calories in a pint of beer or cider. Gin and tonic is laced with sugar, as is wine. It all interferes with insulin production and you end up storing more fat."

Alas, the tell-tale signs are all too visible: "It's easy to spot people who don't eat a lot but drink a lot as their body is soft, with little muscle tone," observes Karl. "There's also the matter of cellulite, which I'm seeing more and more of, and in much younger girls."