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What are the warning signs of orthorexia nervosa?

Striving to follow healthy eating habits is a good thing. But being obsessed with the nutritional quality of what you eat could be a sign of a bigger problem, like orthorexia nervosa (ON).

A newly designated eating disorder that revolves around a fixation on "healthy eating," orthorexia nervosa seems to be growing in prevalence in a society that continually pushes wellness as an overall goal.1

For this reason, it can be difficult to distinguish someone who's simply trying to eat better from someone who may be struggling with ON, but there are certain orthorexia symptoms and signs that may help you determine where to draw the line.

8
 minute read
Last updated on 
November 20, 2023
November 20, 2023
Warning signs of orthorexia nervosa
In this article

What is orthorexia nervosa?

While not specifically defined in the DSM-5, the record of all officially recognized mental health disorders, orthorexia nervosa is considered a form of pathological disordered eating.

The condition centers around an obsession with "healthy eating," including "clean eating" or otherwise "superior" diets. To cater to this fixation, someone with ON may eliminate entire food groups considered unhealthy or practice otherwise rigid, restrictive, or ritualized forms of eating.3

Orthorexia nervosa can be difficult to detect from the outside. Generally, people look to bodies that are thinner or larger than average for signs of eating disorders. Still, the symptoms of orthorexia are more subtle and easily hidden in a society that upholds many standards of toxic diet culture.

Many people who are struggling with ON present as health-conscious, albeit excessively so. While the intentions behind these actions are often good, what marks the disorder is the intensity of fixation on this lifestyle and the extreme distress caused by its disruption.

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Signs of orthorexia nervosa

Medically, “signs” of a disorder are the effects that can be outwardly measured, whether through test results or the observations of doctors or close friends and family. There are a number of known signs of orthorexia nervosa.

Physical signs of orthorexia nervosa

It may sound counterintuitive that an obsession with "healthy" foods could lead to physical issues. However, people with ON frequently have an extremely restricted diet, which can lead to a number of nutritional deficiencies and other health complications.2,3

Amenorrhea
Thyroid problems
Heart disease

Emotional and behavioral signs of orthorexia nervosa

Along with physical signs, orthorexia nervosa can have some emotional or behavioral manifestations.

Extremely restricted diet
Excessive scrutiny
Obsessive following of “healthy lifestyle” social media

Orthorexia symptoms

In the medical world, "symptoms" are effects that aren’t always outwardly measured or even detected by another person. They can only be experienced and gauged in severity by the person enduring them.

Due to the complex physical, psychological, and social mechanics behind ON, orthorexia symptoms may manifest in many ways.

Physical symptoms of orthorexia

Once again, the driving factor behind so many orthorexia nervosa symptoms is the restrictive diet that marks the disorder. Nutritional imbalances caused by such diets can lead to many discomforts and difficulties for the person dealing with ON.

Gastrointestinal issues
Chronic fatigue
Comorbid conditions

Emotional and behavioral orthorexia nervosa symptoms

Many of the most serious symptoms of orthorexia manifest in a person’s emotional and behavioral reactions. As the disorder progresses, a person may find it more difficult to integrate into society due to their increasing concern over the purity of their food.3

Preoccupation with food
Extreme distress when preferred foods are not available
Social isolation

When to get help for orthorexia nervosa

As with most other eating disorders, it may be challenging to get someone struggling with ON to understand the power the condition has over them. And because the disorder centers around the concept of being “healthy,” it may be even more difficult to get someone to think anything is amiss at all.

But despite the type of food consumed, all forms of disordered eating can be dangerous and detrimental. Once orthorexia symptoms begin to disrupt someone’s daily functioning or cause them undue amounts of harm or distress, it’s time to seek help.

The good news is many different types of therapies are available that can help someone make a full recovery from the condition.

Get help for orthorexia nervosa

At Within Health, our multidisciplinary team can help you or your loved one understand the various physical and psychological factors that may be powering your eating behaviors and help you work on making positive and lasting changes.

If you or a loved one are struggling with ON or any other type of disordered eating, you can contact us today for more information on how to seek help.

Get help today

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Ramacciotti, C. E., Perrone, P., Burgalassi, A., Conversano, C., Massimetti, G., Dell’osso, L. (2013). Orthorexia Nervosa in the General Population: A Preliminary Screening Using a Self-administered Questionnaire (ORTO-15). Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 16, e127-e130.
  2. Scarff, J. R. (2017). Orthorexia Nervosa: An Obsession With Healthy Eating. Federal Practitioner, 34(6), 36–39.
  3. Koven, N. S., & Abry, A. W. (2015). The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385–394.
  4. Common Health Consequences of Eating Disorders. (2021). National Eating Disorders Association. Accessed November 2023.
  5. Orthorexia. (2021). National Eating Disorders Association. Accessed November 2023. 
  6. Varga, M., Thege, B. K., Dukay-Szabó, S., Túry, F., & van Furth, E. F. (2014). When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary. BMC psychiatry, 14, 59.
  7. Miller, K. K. (2013). Endocrine effects of anorexia nervosa. Endocrinology and metabolism clinics of North America, 42(3), 515–528.

FAQs

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Further reading

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