What is Orthorexia Nervosa?

Orthorexia is the unhealthy obsession with eating healthy. Unlike other eating disorders, orthorexia mainly revolves around food quality, not quantity. People with orthorexia are obsessed with eating foods that are ‘clean,’ healthy, or ‘pure.’ These individuals become so fixated on eating only these ‘clean’ foods that their healthy eating lifestyle becomes damaging to their well-being and mental health. Those with orthorexia will restrict the amount and variety of foods eaten, putting them at risk of becoming malnourished. 

Here are some warning signs of orthorexia and behaviors that represent disordered eating:

 Showing high levels of distress when “safe” or “healthy” foods aren’t available

Inability to eat anything they don’t deem as ‘healthy.’

Compulsively checking ingredient lists and nutrition labels

Cutting out entire food groups perceived as ‘unhealthy’, i.e., carbs, all dairy, all sugar

Inability to eat anything but a narrow group of foods deemed ‘healthy.’

Self-worth is based on the healthiness of one’s diet

Spending hours per day worrying about what food will be served at an event

Obsessive following of nutrition and healthy lifestyle blogs

Unusual interest in the health of what others eating

Avoids eating out or eating food prepared by others

Criticizing others’ foods choices

There are currently no official criteria for diagnosing orthorexia.

The key is recognizing that even though eating ‘healthy’ food is beneficial, the way that’s gone about can cause harm. Unlike Orthorexia, Disordered Eating does not have a diagnosis, it’s a descriptive phrase, and often individuals are diagnosed with EDNOS (Eating Disorder Or Not Otherwise Specified).

Disordered Eating is used to describe a range of irregular eating behaviors that may or may not warrant a diagnosis of a specific eating disorder.

The warning signs of Disordered Eating include:

  • Frequent dieting, anxiety associated with particular foods, or meal skipping
  • Chronic weight fluctuations 
  • Rigid rituals and routines surrounding nutrition and exercise 
  • Feelings of guilt and shame associated with eating
  • Using food restriction, exercise, fasting or purging to “make up” for ‘bad’ foods consumed. 
  • Preoccupation with food, weight, and body image that negatively impacts the quality of life 
  • Feelings of loss of control around food, including compulsive eating habits 
  • Participating in fad diets

Systemic basis of Disordered Eating

Both Disordered Eating and orthorexia display a pattern of disordered eating behaviors that create a lot of mental strain around food. All symptoms of orthorexia are disordered eating behaviors. These behaviors are considered Disordered Eating even if someone is on the verge of an eating disorder or just concerned with eating healthy. Regardless, it’s still Disordered Eating.

Orthorexia is not often recognized in our culture as it’s not a clinically diagnosable condition. There’s no firm agreement on its symptoms or how to identify them. 

Orthorexia can often be praised in our culture, and it’s easy for it to fall under the radar. People are praised for cutting out food groups or exercising to burn off calories in our culture. Often, people who develop this obsession are told they have to get healthier. Sometimes this is worse for those who live in larger bodies as healthcare providers tell them that they need to lose weight by dieting. Healthcare providers often use BMI to determine if they should recommend weight loss to their patients. Subsequently, patients with a higher BMI are told they should try going on a diet or try a specific diet to jumpstart weight loss. 

Healthcare providers are telling them to eat in a disordered manner.

They end up praising the patient when they partake in behaviors like, i.e., not resting from exercise, not eating dairy, fasting/skipping breakfast. According to the National Eating Disorders Association, 35% of “normal dieters” progress to pathological dieting, and 20-25% of those individuals develop eating disorders.

Therefore, it’s safe to say that those who go on a diet are more at risk for developing a disordered relationship with food or an eating disorder than those who have never dieted.

It’s evident that we live in a world that’s constantly promoting disordered eating behaviors, whether from your healthcare provider, an influencer online, an ad on tv, etc. Orthorexia is idolized everywhere. To help prevent orthorexia, we should stop using BMI to determine someone’s health or need to go on a diet. We should stop using shaming language around food.

Today, many health care practitioners are joining the HAES (Health at Every Size) movement to support advances in social justice, create inclusiveness and a respectful community, and support people of all sizes in finding compassionate ways to take care of themselves. For more information on HAES and to sign the pledge visit HAES COMMUNITY.

About the Author:

Tirzah Thompson

Tirzah Thompson is passionate about helping women (and men) find the best version of themselves through building a healthy relationship with food and finding the root cause of their health issues through functional Nutrition. She knows what it’s like to feel frustrated with your health and how you think.

Tirzah graduated from the University Of Cincinnati’s Dietetic Coordinated program in May 2019. She then went on to get her Master’s degree and completed that in December 2020. She has a Master’s in Nutrition & is working on her Intuitive Eating Counselor certification. She has been practicing for two years as a Registered Dietitian.

She has seen how short and long-term periods of dieting negatively affect our hormones, metabolism, gut health, and relationship with food. She’s determined to help you make peace with food and your body to find a nutrition approach that works best for you.

Her mission is to advance the quality of one’s health through building a healthy relationship with food and emphasizing a healthy gut and hormonal balance. She’s passionate about helping individuals end the stress and cycle of dieting and disorder to reclaim a healthy relationship with food and their bodies.