The term orthorexia refers to an “unhealthy obsession with eating healthy food,” from Dr. Steven Bratman. Orthorexia can be a particularly insidious form of disordered eating. Many of the behaviors associated with orthorexia are celebrated in our “wellness culture” as being healthy or morally superior. For this reason, the five warning signs of orthorexia are often missed by friends, family, and even doctors.


At the time of writing this, orthorexia is not considered an official eating disorder diagnosis, but is nonetheless a helpful term to define a unique subset of disordered eating thoughts and behaviors. If you are concerned that you or a loved one may be struggling with eating, you will find it helpful to familiarize yourself with the five warning signs of orthorexia.


What are the 5 warning signs of orthorexia?


1. Fixating on the nutrient content, quality, and preparation of foods


Someone with orthorexia might gravitate towards “raw,” “unprocessed,” “organic,” “natural,” or “real” foods. They might spend a large amount of time researching specific nutrients, foods, or cooking techniques to ensure the food they eat is “pure” or of the “highest quality.”


2. Having increasingly rigid rules and behaviors around food


They often cut out specific nutrients, foods, and/or entire food groups if they deem them “unhealthy.” Foods are labeled as either “good” or “bad,” depending on their nutrient content, quality, or preparation. Someone with orthorexia may also develop complicated rituals around the shopping, cooking, and eating of their food, and have a difficult time deviating from this routine without experiencing intense anxiety.


3. Feeling impure or unclean when eating “unhealthy” foods


Someone with orthorexia might experience Intense emotional turmoil following eating something “unhealthy” that results in severe anxiety, guilt, shame, or depression. They will go to great lengths to avoid negative emotions associated with eating these foods by avoiding “unhealthy” foods at all costs.


4. Having obsessive thoughts about improving health through nutrition


They not only avoid “unhealthy” food to avoid negative thoughts, but they also worry about becoming sick or developing a disease as a result of eating “bad” foods. Someone with orthorexia will feel obsessed with improving their health through their diet. They might invest in expensive “superfoods” or supplements that promise to “cleanse,” “detox,” or “purify” their body.


5. Avoiding “unhealthy” foods at all costs


The lengths that someone with orthorexia might go to to avoid eating “unhealthy” foods tend to be very isolating. They may no longer attending shared meals, events, or any scenario where one might encounter “unhealthy” food. It can become difficult for them to tolerate being near or even in the same room as a food that they fear will harm their health.

How could wanting to “eat healthy” be bad?


Leads to malnutrition


Cutting out foods or whole food groups will decrease macronutrient variety and can lead to eating less than they need to sustain their bodies. Variety also ensures adequate micronutrient intake. Without it one can develop dangerous vitamin and mineral deficiencies. It’s important to note that one can become malnourished even if one do not lose weight or is not underweight—and even when eating exclusively “healthy” foods.


Progresses to other eating disorders


Orthorexia is unique to other eating disorders in that individuals are not typically focused on weight loss or body image. However, obsession with quality of food can progress to obsession about quantity of food or body size with time, leading to the development of other eating disorders like anorexia, bulimia, binge eating, or ARFID.


Loss of sense of self and lower self-esteem


Those with orthorexia tend to hinge much of their self-worth on their ability to adhere to strict “healthy” eating rules. Over time, other hobbies or passions that might contribute to a healthy sense of self take a back seat to the large amount of effort individuals with orthorexia invest into their eating. The constant pursuit of perfection in eating is often accompanied by guilt, shame, and fear which lowers self-esteem over time.


Decreased overall quality of life


Those with orthorexia may find themselves disengaging mentally, emotionally, and socially in their lives to accommodate the large burden that “healthy” eating takes on their lives. The obsession with “healthy” eating can lead to isolation and depression, which tends to make symptoms worse over time.


It’s important to note that yes, of course, there is value in eating a variety of fresh, nutrient dense foods. However, there is no evidence to suggest that “eating clean” or “eating to detox” is beneficial to overall health. Our bodies are equipped with organs, like our liver and kidneys, that provide all the detoxing necessary for healthy living.


Many of the “clean eating” diets, “detoxes,” “health promoting” supplements, and “superfoods” that you can buy are simply marvels of modern marketing. There is no one food or nutrient that will magically make you “healthy”, just like there is no one food or nutrient that will suddenly make you “unhealthy.” And, just a reminder, eating healthfully should never come at the expense of your mental or emotional health.

What is the treatment for orthorexia?


Early intervention is key to successful treatment of orthorexia, or any eating disorder. If you are concerned that you or a loved one is struggling with orthorexia, please consider scheduling a consult with both a dietitian and a therapist who specialize in eating disorders. Most generalized providers will miss the five warning signs of orthorexia or mistake them as innocent attempts to eat healthier. An eating disorder professional will never recommend restrictive eating, and will have the tools to help you challenge disordered thoughts and behaviors around food.


Take a free eating disorder assessment on our website then reach out to one of our eating disorder dietitians today for additional support on your journey to recovery.


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Kristin Jenkins is a dietitian nutritionist based in Maryland. She has been involved in the field of eating disorders and disordered eating for over 6 years and brings both personal and professional experience to her work serving clients who struggle with their relationship with food and their bodies.