When it comes to cutting certain foods out of your diet, Thomas Grainger has done it all.
"I would have cut just about everything at one stage," Grainger told The Huffington Post Australia. "I would be doing things like completely cutting out soy products and then hitting soy harder than anything else suddenly.
"Dairy and gluten... they are often the first ones to go. They were in and out [of my diet] constantly.
"I was constantly focusing on particular things, such as having to have lots of quinoa for a while and then not eating any for ages.
"The irony is now I have an inflammatory bowel disease which I have to treat and it’s a pain in the arse, and I believe it's because of what I have done in previous years. I didn’t have anything like this prior."
When Grainger refers to "previous years" he is talking about the roughly two-year period in which he had orthorexia nervosa. Never heard of it before? You're not alone.
"Orthorexia nervosa is a proposed eating disorder where sufferers focus on the types of food that they eat, and the quantity, for health reasons," Dr Rebecca Reynolds, lecturer and nutritionist at the School of Public Health and Community Medicine, University of New South Wales, told HuffPost Australia.
"Informally, it's an obsessively healthy eating style. Formally, it's a health food eating disorder.
"Basically, orthorexia nervosa comes about from an extreme diet for intended health benefits, when in actual reality the benefits might not really exist and the negatives might be more pronounced than the benefits."
In other words, it's clean eating gone wrong.
For Grainger, who has a previous history of anorexia, orthorexia nervosa started off as an attempt to eat healthily.
"In the beginning it wasn’t restrictive, though I started to develop ritualistic eating patterns," Grainger said. "I wasn't trying to lose weight. I just became more and more involved in -- I guess you'd call it a cult -- asking 'what is health, what is wellness?'
"I think you'll find there are a lot of quasi-health experts out there, flaunting new diets and trends and wellness rituals which, in principal, may have very sound and ethical thought patterns behind them, but in actuality can be oppressive, restrictive and dogmatic.
"A lot of people who get swept up in these health practices -- myself included -- come to be in a situation where by focusing wholeheartedly on their ‘health’, they are actually slowly killing themselves. I did have some serious health problems as a result of this."
Grainger says the prevalence of clean eating, raw food and detoxes on social media has meant the more alarming symptoms of orthorexia nervosa can actually be easily hidden or, worryingly, congratulated.
"I would get the occasional comment from people time to time about how disciplined I was. Often it was kind of praise, like, 'oh I could never do that, you eat so healthily'," Grainger said.
"From time to time at social gatherings people would be annoyed, but even though I lost more weight than when I had anorexia, it's actually much easier to mask. It’s socially acceptable almost."
However, it eventually became apparent to Grainger that for someone who was pursuing the perfect ideal of health, he was a far cry from actually living healthily.
"I was physically ill, and I realised there must be a problem with what I’m doing. I wasn't getting healthier. My focus was to try and nourish my body as well as I possibly could, but instead, my alarm bells were well and truly ringing," Grainger said.
"Towards the end, there were more and more foods I deemed weren't acceptable to eat."
Not only did certain foods get crossed off the list, but the way Grainger prepared them.
"At my worst it was pretty much just fruits and veggies and meat and nuts and seeds. Almost a paleo-style diet but more complicated than that -- I would get really stressed out about it," Grainger said.
"I was steaming my veggies, for instance, only they had to be in metal steamer in case there were toxins from plastic.
"Or I would become fixated with a high-fat diet because that was the new 'thing', then a low-fat diet because I read somewhere else that was better. I kept on getting sick because I was going from a huge influx of one particular thing to practically nothing. For example, high, high levels of protein to nothing."
This level of fixation is what can separate orthorexia nervosa from someone who actually just wants to eat healthily, Reynolds points out.
"It's important to note it’s not just someone who likes to eat healthily and might be a bit obsessive about it," Reynolds said. "Someone who never eats chocolate or whatever -- it's not those people, necessarily -- though that could be the start of a more serious obsession.
"To have orthorexia nervosa you would have to have impairment of physical health like malnutrition or weight loss and/or a level of distress or impairment of functioning in your life which is enough to make it a problem.
"Your social life might be impaired, your work life might be impaired. It may start off that you're going to dinner with friends but you’re really funny about what you eat, and only eat side dishes of balanced beans and the like.
"As time goes on, you may get more obsessive and it snowballs into you having an intense fear about what you're eating, to the point where you are bringing your own food to a restaurant or avoiding going at all because you can’t fulfill your nutritional desires, which have become your priority."
In terms of warning signs, Grainger says there are a couple of things to look out for.
"People talking about it too much -- food, diet, exercise," Grainger said. "People following heaps of 'health' people on Instagram and constantly posting pictures of what they are eating.
"Alternatively, not wanting to eat when they go out or avoiding situations where they go out.
"Sudden weight loss, general anxiety, or constantly changing what they are eating. You might say 'I thought you were vegetarian?' and they will say, 'That was last week. I've since read it’s bad for you, so now I only eat organic meats and I will do that four times a day.
"I think a lot of people don’t even recognise they have a problem because they don’t know what it is. Or they might say, 'I am an extreme orthorexic, but I am happy to be on be one because that means I am healthy'.
"My view is the average Australian person cannot live a lifestyle that dictates a constant, very restrictive eating regime and at the same time, a happy, social, healthy life.
"It really is all about balance. Food is important, but it's not most important thing in your life. It's just one spectrum that needs to be weighed in -- pardon the pun."
For specific information or support relating to eating disorders call Butterfly Foundation on 1800 ED HOPE or talk to your GP, local health professional or someone you trust.Suggest a correction