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It’s no wonder, then, that the young cheerleaders found the increasingly prevalent condition of gluten sensitivities the perfect cover for what turned out to be very real cases of anorexia. By the end of the school year, two out of the three girls were in treatment for eating disorders and the third was taken out of school by her parents.

Julie Dorfman, director of Nutrition at Philadelphia’s Renfrew Center, the country’s first residential facility for the treatment of women with eating disorders, is not surprised. “With the eating disordered population, I’d say that 110% of them are using intolerances or food ‘problems’ as a means to avoid eating these foods in a socially acceptable way. Gluten just happens to be the fad right now.”

Stacey Rosenfeld, Ph.D, a psychologist who specializes in eating disorders is in the camp of those who believe that using medical or pseudo-medical reasons for restrictive diets is often a cover-up for disordered eating.  “Nobody wants to be called out on an eating disorder or obsessive eating,” she says, “so anything they can do to hide it, they will.”

Orthorexia: An Obsession With Healthy Food “Orthorexia is an obsession with eating healthy food — to such an extent that the person may restrict their diet very severely and limit their functioning, such as not socializing in situations where there is ‘unhealthy’ food,” says Sheela Raja, PhD, an assistant professor and clinical psychologist in the Colleges of Medicine and Dentistry at the University of Illinois at Chicago. There has been no research into eating disorder statistics to know how widespread orthorexia is, but in general the idea of “good” and “bad” foods is relatively common in people with eating disorders. The advent of so many fad diets hasn’t helped matters either. No carbs, only raw food, macrobiotics — diets with such strict food rules can certainly lead to confusion about what really is healthy and what isn’t, and in turn can contribute to orthorexia. Warning signs can range from negative feelings about “impure” foods to trouble dealing with stress. Avoiding social situations or bringing your own food to restaurants or get-togethers can be another red flag, as can insisting that good health is totally dependent on the quality of the food you eat. It can also be more common in people who have obsessive or black-and-white thinking that a food is either all good or all bad. Orthorexia is not an official psychiatric diagnosis, given that the symptoms overlap significantly with diagnoses of other eating disorders. “No classic treatment plan is available, but I work with people to normalize food and take away magical thinking about the ‘right/perfect’ foods,” says Esther Kane, MSW, a registered clinical counselor in private practice in Courtenay, British Columbia, Canada, and author of It’s Not About the Food: A Woman’s Guide to Making Peace with Food and Our Bodies. Nutritional education and finding other ways to deal with stress and negative moods are important steps. Raja, for example, suggests participating in an activity unrelated to eating, such as going for a walk or taking a bath, when feeling stressed. Focusing on moderation is also key, as is emphasizing the idea that no food should be excluded from the diet.