In a world where kale is king and quinoa reigns supreme, it’s easy to get caught up in food rules, healthy-lifestyle, and “clean eating” hype. But what happens when your pursuit of a “perfect” diet takes over your life?

Enter orthorexia, a condition as ironic as it is serious. 

While healthful eating may be a worthwhile pursuit, orthorexia happens when those good intentions go overboard, taking a sharp nosedive into obsession.

What Is Orthorexia?

Orthorexia, or orthorexia nervosa, is an unhealthy fixation on eating “pure,” “clean,” or “healthy” foods. Coined by Dr. Steven Bratman in 1997, the term comes from the Greek words “orthos” (meaning correct) and “orexia” (meaning appetite). 

Unlike anorexia or bulimia, orthorexia isn’t necessarily about weight loss or body image; instead, it’s about achieving an impossible standard of dietary perfection.

At first glance, orthorexia might seem harmless. What’s the big deal if someone wants to prioritize whole grains, fresh vegetables, and certain nutrients? 

But when the need to eat “right” becomes a rigid obsession, severe physical, emotional, and social consequences occur. 

Think of it as the dietary version of “way too much of a good thing.” There is no balance.

What are some common thoughts, feelings, and behaviors of someone with orthorexia?

1. Worry about the quality and source of the food.

“Where was it grown? What was it fed? Is it organic? Is the food I am eating clean?”

2. Avoidance of eating out or eating food prepared by others.

“If it’s going to be done right, I have to do it myself.”

3. Fear of sickness.

You worry about how “clean” food is or if it’s “bad” for your health.

4. Physical signs of malnutrition.

When you limit the variety of foods you eat, you may not get all the nourishment you need.

5. Burying yourself in food research.

It’s one thing to spend a few minutes scanning a product label or surfing the web for more information on ingredients. But with orthorexia, you may spend hours thinking about food and planning meals. You may also have unrealistic views about “healthy” foods preventing or curing health problems.

6. Refusal to eat a range of foods.

It’s normal to avoid some foods because you don’t like the way they taste or the way they make you feel.

But with orthorexia, you might decide to drop whole categories of foods from your diet. For example, you might stop eating grains or any foods with preservatives, dairy, gluten, or sugar. You may even eliminate all foods that just don’t seem “healthy” because they don’t meet your criteria.

7. Fear of losing control.

You feel that you’re doing the right thing by eating healthy.

But you may also be afraid that eating even one meal you didn’t prepare — including dinner at a restaurant — can be disastrous.

8. Being overly critical of your friends’ food choices.

At the same time, you may have no rational explanation for your own choices.

9. Finding yourself in a vicious cycle.

Your preoccupation with food causes you to bounce between self-love and guilt as you change and restrict your diet in pursuit of “clean eating”..

10. Social isolation

You decline offers to socialize because you don’t want to eat food you don’t prepare; nor do you want to risk revealing your rigid food rules.

11. Frequently checking and rechecking nutritional labels while purchasing or preparing foods.

When someone struggling with orthorexia is not allowed to follow their strict guidelines, severe anxiety results. Panic attacks and “corrective” behaviors to address violation of the food beliefs occur. 

For example, if someone with orthorexia is required to eat something outside of their list, they decide to fast for 24 hours to remove the “unhealthy” food from their system.

These behaviors are more common when someone has rigid thinking inflexible to change. They may be hyper-focused on living by a defined set of perceived rules that they must follow to stay healthy.

What Causes Orthorexia?

Orthorexia doesn’t just emerge out of nowhere. As with eating disorders, it’s influenced by a mix of personal, cultural, and psychological factors.

Here are 5 top contributors to the development and maintenance of orthorexia:

• Diet Culture and social media

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  Let’s be honest: Most Instagram influencers aren’t exactly helping. With endless posts about detox teas, avo toast, and perfectly arranged acai bowls, it’s easy to feel like your worth depends on how “clean” your plate looks.

• Perfectionism

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  Many people with orthorexia are high-achieving perfectionists who thrive on control. The quest for dietary purity often mirrors their need for order and discipline in other areas of life.

• Health anxiety

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  Fear of illness or chronic disease can cause people to adopt extreme eating habits as a form of self-protection.

• Misinformation                                     

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  Thanks to the internet, pseudoscience about nutrition spreads faster than you can say “superfood.”
  
  People trying to educate themselves on healthy eating can easily fall prey to fear-mongering and diet myths.

• Validation and identity               

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  In some cases, a “healthy” lifestyle becomes intertwined with a person’s sense of self-worth. The praise and admiration they receive for their so-called discipline can reinforce unhealthy behaviors.

Why Is Orthorexia Dangerous?

On the surface, orthorexia might look like a quirky personality trait: the person who always reads food labels or avoids the office doughnuts. But dig deeper, and the consequences aren’t trivial.

Here are 4 examples of how orthorexia affects a sufferer’s life:

• Nutritional deficiencies.
  Restricting certain food groups can lead to malnutrition. 
• Mental health struggles.
  Constantly worrying about food purity can fuel anxiety, guilt, and even depression
• Social isolation.
  Orthorexia often disrupts relationships and social activities. When food rules dictate your life, spontaneity and connection take a backseat.
• Physical health risks.
  Severe restrictions can lead to weight loss, weakened immunity, and other health complications.

Treatment for Orthorexia

Meet Sarah: a case example of someone with orthorexia

Sarah, a 34-year-old yoga instructor, started cutting out processed foods after reading an article about how sugar “poisons” the body. She felt empowered by her new clean-eating regimen and began experimenting with green juices, organic produce, and gluten-free recipes. 

But over time, her list of “safe” foods grew smaller and smaller. Dairy? Too inflammatory. Soy? Too processed. Nightshades? Potentially toxic. 

Before she knew it, Sarah’s meals consisted solely of raw vegetables and sprouted nuts—hardly the stuff of balanced nutrition.

Social events became a minefield. She’d bring her own Tupperware to dinner parties and grill restaurant staff about every ingredient. Friends began to pull away, tired of her unsolicited lectures about their “unhealthy” choices. 

Despite her seemingly virtuous diet, Sarah felt constantly fatigued, irritable, and isolated. 

When she developed severe anemia and was forced to seek medical help, she realized her “healthy lifestyle” had veered into dangerous territory.

So how is orthorexia treated?

If you recognize yourself or someone you love in Sarah’s story, the good news is that recovery is possible. Treatment often begins with a team of specialists, including a therapist, dietitian, and sometimes a physician. They’ll address both the physical and psychological aspects of the disorder.

Here are 3 approaches to orthorexia treatment:

• Psychotherapy.       
  
  Cognitive-behavioral therapy (CBT) is a common approach for tackling the underlying thoughts and beliefs that go along with orthorexia. Acceptance and Commitment Therapy (ACT) is another helpful approach.

• Nutrition education.
  
  A registered dietitian can help reintroduce forbidden foods and create a balanced eating plan. The goal is to shift from “good vs. bad” thinking to a more nuanced understanding of nutrition.

• Mindfulness practices.
  
  Learning to trust your body’s signals and approach food with curiosity rather than judgment can be transformative. 

Food is meant to be a pleasure source…for everyone.

Let’s face it, Diet Culture has it wrong. Food is supposed to be fun. It’s about savoring flavors, sharing meals, and  even having a second slice of cake because life’s too short for self-imposed, rigid rules. 

If orthorexia teaches us anything, it’s that balance is our birthright, both on our plates and in our minds.

So, the next time you find yourself stressing over whether your smoothie has the “right” ratio of chia seeds to almond milk, take a breath. Remember that health isn’t a black-and-white game, and neither is food. Sometimes, the healthiest choice is to simply enjoy your meal — without a side of guilt.

Dr. Elayne Daniels is an international coach, consultant,  and psychologist specializing in eating disorders, body image, and High Sensitivity. She is anti-diet, Intuitive Eating certified and passionately believes comfort in your body at any size is your birthright.  Contact her here for more information.

If you’re struggling with overcoming an eating disorder, this e-book might be useful.