All About

Orthorexia Nervosa

Orthorexia nervosa is an eating disorder that manifests itself as an unhealthy obsession with healthy food.

With so many people focusing on improving their health and wellbeing, some are becoming fixated on doing what they think is best. While they may have the best intentions, this fixation can lead to various eating and food-related disorders, such as orthorexia nervosa.


Orthorexia Nervosa

What is

Orthorexia Nervosa

Orthorexia nervosa is a condition where one obsesses about “healthy” eating, which can lead to serious medical issues, and extreme psychological distress.

The term orthorexia was first brought to attention in 1998 and is defined as the obsession or fixation with "healthful" eating. (1) 

It's crucial to understand that simply eating a healthy, well-balanced diet isn't an indication of orthorexia nervosa. Orthorexia is the fixation or compulsive need to micromanage what you are putting into your body at all times.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize orthorexia nervosa as an official eating disorder.

Diagnosing

Orthorexia Nervosa

Diagnosing orthorexia nervosa can be quite tricky, as there aren't any absolute guidelines about what defines orthorexia or what symptoms should be present.

Symptoms used to diagnose orthorexia include (2):

  • Eating a restricted variety of foods
  • Compulsively checking ingredient lists or nutrition labels
  • Fixating on the consumption of food considered "pure" or free from chemicals, additives, and preservatives
  • Fearing eating out or attending functions that include meals
  • An unusual interest in what others are eating
  • Showing physical and psychological signs of distress when they have no control over what food is available

Signs & Symptoms of

Orthorexia Nervosa

Orthorexia nervosa leads to extreme obsessive eating habits that may include excessive prepping and meal planning.

Some of the most common signs of orthorexia include:

  • Eating a restricted diet
  • Checking the ingredients of a food item
  • Avoiding foods that you think are unhealthier than others 
  • Eating only foods that you think are natural or from organic sources
  • Obsessively discussing food and food choices with others 
  • Avoiding eating food with additives or preservatives
  • Development of food-related rituals 

Effects of Orthorexia Nervosa

The side effects that orthorexia nervosa exhibits will vary quite drastically from person to person. That's because while some develop eating disorders, others develop compulsive disorders. Unfortunately, many will create variations of both, which can lead to a myriad of long-term and short-term effects. 5

Short-Term Effects 

The short-term effects of orthorexia may include:

  • Weight change (loss or gain)
  • Anemia
  • Chronic fatigue
  • Blood disorders
  • Bloating
  • Nausea and/or vomiting 
  • Decreased energy
  • Thyroid problems
  • High cholesterol levels
  • Intrusive thoughts
  • Fear of contamination

Long-Term Effects

The long-term effects of orthorexia may include:  

  • Compulsive rituals
  • Malnutrition
  • Nutritional deficiencies
  • Heart disease
  • Anxiety
  • Depression
  • Stress
  • Reduced resting metabolic rate
  • Sleep apnea 
  • Death 

Related Disorders

People with orthorexia often fall under the umbrella of various other mental wellness conditions. These may include:

  • Anorexia Nervosa
  • Bulimia
  • Bulimic Anorexia
  • Binge Eating Disorder


Orthorexia is also commonly associated with other underlying mental health disorders, including:

  • Anxiety disorders
  • Mood disorders 
  • Obsessive-compulsive disorder (OCD)
  • Post-Traumatic Stress Disorder (PTSD) 

When seeking treatment for orthorexia, it’s vital that you also receive treatment for any underlying co-occurring mental health or behavioral disorders to ensure your best chances at a complete recovery.

Treatment of

Orthorexia Nervosa

Therapeutic interventions for orthorexia nervosa are similar to interventions for other eating disorders. Therapeutic settings provide a safe relationship to begin to untangle the belief system that is causing the person to be trapped between their need to eat and their preoccupation with the health value of foods.

In therapeutic treatment for orthorexia, the focus will be on creating a healthy relationship with food instead of concentrating on the health value of food. The person experiencing ON may find it hard to incorporate flexibility with food due to our societal preoccupation with health and food, which ironically has led to a society that is more than ever in crisis in managing our need to eat. The medical as well as psychological consequences of diet culture, hyperfocus on the health value of food versus healthy relationship with food cannot be overstated.

Therapies for Orthorexia Nervosa

Depending on the patient's specific symptoms, they may benefit from a variety of therapy options, including: 

  • Cognitive Behavioral Therapy
  • Family Therapy
  • Support Groups
  • Nutritional Counseling 

Medications for Orthorexia Nervosa

While there are no medications specifically created to treat orthorexia nervosa, medications used to treat the symptoms associated with the condition may prove beneficial. The most commonly utilized medications may include antidepressants to manage mood disorders and nutritional supplements to ensure that patients get the nutrients they need to maintain their health.

Understanding

Orthorexia Nervosa

Orthorexia nervosa requires much more research to understand, making it challenging to identify and diagnose. Someone suffering from this disorder may be highly educated and well-informed about nutrition and wellness, but they cannot curb their obsession with healthy eating. 

Many individuals with orthorexia nervosa are highly driven and often obsessed to the point of extremes with their version of healthy eating, which tends to lead them to eating unbalanced diets. 

Living with Orthorexia Nervosa

Those with orthorexia nervosa may often go to extreme lengths to avoid eating properly balanced meals because they believe certain foods may not be "clean" or "pure" enough. 

What's more concerning is that many people with the condition will also neglect to eat regularly, or avoid certain food groups entirely. This eating pattern is linked to many health complications such as anemia, scurvy, and iron deficiency. (1)

Orthorexia can also lead to weight loss. However, individuals with this condition may lose weight through co-occurring conditions such as depression, anxiety, and stress.

Orthorexia can be very difficult to cope with on a day-to-day basis. It can cause a person to feel guilty and ashamed of their obsession with healthy eating. However, it's important to remember that the problem isn't with you for seeking out healthy food options. The problem lies in the obsessive eating habits that have been ingrained into your body and your psyche.

People with orthorexia benefit from working closely with a nutritionist, and therapist, to help overcome their daily struggles around eating. Some people find it helpful to keep a food journal to track their patterns. Speak to a healthcare provider if you are concerned about your eating habits. 

History of Orthorexia Nervosa

Orthorexia dates back to 1998, although many believe the condition is a modern development. (3) 

The term comes from Steven Bratman, MD., to describe an obsession with healthy eating. (3)  He noted that many people began to concern themselves with what they ate following the growing awareness of heart disease. During this time, health professionals began to stress the importance of eating healthy meals while also following food trends. 

This obsession with healthy eating has continued and, unfortunately, has led to the increased development of new cases of compulsory disorders and eating disorders around the globe.

Orthorexia Nervosa in Pop Culture

Eating disorders are frequently highlighted in pop culture as more and more celebrities, and well-known figures come out and discuss their struggles with various conditions.

With the rise in social media use, studies have found that as people become fixated on the idea that eating healthy is vital to being happy and successful, they are more likely to develop an eating disorder.

In 2017, a study by Springer Link stated that higher Instagram use was associated with a greater tendency toward orthorexia nervosa, with a prevalence of approximately 49% among study participants. (4) 

Some people believe this is due to  the implications social media can have on the psychological wellbeing of users, especially adolescents and young adults.

How to Help Someone with

Orthorexia Nervosa

People who have the disorder find themselves in a difficult position, as they struggle to balance their fears and desires to be healthy with the realities of modern living. For those who struggle to let go of their obsession with healthy eating, there are some ways to help:

  • Avoid making comments about food
  • Educate yourself on which foods are healthier than others so you can help your loved one make smart choices
  • Teach yourself about crafting a well-balanced diet that everyone in the family can enjoy
  • Speak to your doctor, nutritionist, or psychotherapist skilled in treating eating disorders about how to gain insight into how you can support your loved one experiencing an eating disorder
  • Get professional advice from a nutritionist or other professional who knows about orthorexia nervosa to give you tips for helping your loved one


At Within Health we believe in love without boundaries, for every body, no matter the shape or size. If you or a loved one need help with an eating disorder, like orthorexia nervosa, our care partners are available to start your healing journey. Call our admission team today.

Frequently asked questions

What is Orthorexia Nervosa?

Orthorexia nervosa is a compulsive disorder involving an obsession with healthy eating. It can lead to extreme weight loss, anemia, and a multitude of other health problems

How Does Orthorexia Differ from Anorexia?

Anorexia is a condition involving a fear of gaining weight. Anorexia's symptoms include extreme weight loss, body image disturbance, and reduced energy levels. Orthorexia is a compulsive disorder involving an obsession with healthy eating.

Is Orthorexia Nervosa a Mental Illness?

Orthorexia is a mental disorder, but is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Resources

  1. National Eating Disorders Association. (2019, December 13). Orthorexia.
  2. News-Medical.Net  (2019, February 27). History of Orthorexia. 
  3. Frontline Medical Communications Inc. (2017, June). Orthorexia Nervosa: An obsession with healthy eating. 
  4. Springer International Publishing. (2017, March 1). Instagram use is linked to increased symptoms Of ORTHOREXIA NERVOSA. 
  5. National Eating Disorders Association. (2018, February 22). Health consequences.
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