I was 18 years old gnawing on raw tofu, spinach, berries, and hard boiled eggs during lunch.
Everyone praised me for being “the healthy one.”
Taking pride in this identity, I posted photo’s of my Tupperware full of colorful foods carefully arranged in rainbow order.
I was proud of my “healthy” persona. I liked being known as the girl who ate “clean.” Until, to my surprise, I learned that being hyper vigilant about nutrition— as I was— isn’t healthy at all.
Everything changed when I learned about Orthorexia.
In this blog post, we’re going deep on Orthorexia Nervosa (ON), a form of disordered eating characterized by an unhealthy obsession with health.
More specifically, I’ll cover:
What is Orthorexia?
Orthorexia Nervosa (ON) is a form of disordered eating characterized by an obsessive focus on healthy or “clean eating,” causing rigidity, anxiety, and distress that interferes with quality of life.
Steven Bratman, the alternative medicine practitioner who originally coined the term, defines Orthorexia as, “preoccupation with buying, preparing and consuming food believed to be healthy, which is not due to culinary reasons but stems from overvalued ideas about the healthy-promoting and l health-damaging properties of certain foods of food classes.”
Orthorexia is a relatively new form of disordered eating (coined in late 1990s) and it’s not yet listed in the DSM. There are 2 main reasons for this:
- There is no agreed upon diagnostic test. Part of the reason why its been hard to create a diagnostic test is because researchers have not been able to create a a way of capturing the difference between an “innocent” interest in healthy eating vs. a pathological fixation. There are several tests that currently exist but no one universal, recognized one.
- Orthorexia is often co-occurring with other mental health diagnoses such as anxiety and OCD. Researchers are trying to determine whether or not its a standalone diagnosis, or if it’s a part of other conditions.
Regardless of the fact that Orthorexia is not yet “official” in the sense that it’s not listed in the “holy grail” of mental health diagnoses, it’s very much something that providers recognize and clients identify with.
In my own story, when I first learned about ON, I felt so much relief knowing that I wasn’t alone. The anxiety I was feeling around healthy eating was something recognized as problematic. And I’ve seen the same for several of my clients.
For folks with symptoms consistent with ON, they often feel so seen knowing that this term exists, even if it’s not “official” in some book. (if you want to nerd out on the history of ON, and the latest on developing a diagnostic test, here’s a webinar I taught when I was in my internship to become a registered dietitian)
What are the symptoms?
Maybe you landed on this blog post because you just learned the term Orthorexia, and you’re wondering if you have the symptoms consistent with this condition.
The symptoms of orthorexia include:
- Obsessively checking nutrition labels/ scrutinizing ingredient lists — which might look like standing in the grocery store aisle comparing peanut butter labels looking for the “cleanest” option
- Cutting out an increasing number of food groups — which might look like creating self-imposed restrictions like no refined sugar, no white flour, no dairy, no animal products, etc.
- Unusual interest in the health of what others are eating — which might look like analyzing, keeping tabs on, or judging other people’s food choices
- A feeling of superiority because of your diet — which might look like feeling morally above those who don’t eat as “clean.”
- “Healthifying” recipes instead of making them as intended — which might look like feeling uncomfortable making regular recipes for baked goods; instead, making swaps for “safer” ingredients (i.e black bean brownies, chickpea cookies, etc.)
- Experiencing distress when foods deemed “healthy” are unavailable — which might look like feeling stressed about traveling because of fear that there won’t be healthy enough options available
- Bringing your own food to social events to maintain eating in alignment with “health” standards — which might look like packing a Tupperware of “safe” food instead of joining in by eating the food being served at the event
- Social isolation— which might look like saying no to plans, trips, or social events because of fear that you’ll break your self-imposed rules for “clean” eating. Or, it also could look like attending social events but not really being present because you’re so in your head about food.
If you’re not sure how to tell if you’re interest in “healthy” eating is disordered, this question is a good place to start:
Does my relationship with “healthy” eating get in the way of the quality of my life?
How can healthy eating become unhealthy?
More isn’t always more.
Too much of a “good” thing can become harmful.
Drinking water is healthy, but it is possible to be over hydrated.
Exercise is beneficial for the body, but too much can cause injury.
Taking supplements can help with vitamin deficiencies, but high levels can become toxic.
With food, a focus on nutrition can be positive, but it can quickly devolve into disordered eating.
Orthorexia can lead to inadequate energy intake, nutrient deficiencies, social isolation, high stress levels, and binge eating patterns.
Nutrient Deficiencies & Inadequate Energy Intake:
An over-obsession with “health” can lead a person to start limiting more and more foods and food groups. We know that variety is an important component to meet our body’s nutrition needs. Removing types of foods or food groups— even things like gluten, “processed” foods, or animal products— can impact a person’s ability to get enough variety in their diet.
Limiting entire groups of foods can also impact your ability to eat an adequate amount of food. For example, if you’re on a road trip and you’re hungry but the only options are packaged foods you deem “unhealthy,” you might choose not to eat.
The most important consideration when it comes to nutrition is adequacy. If you’re not eating enough, it doesn’t matter how nutrient-dense your diet is, your body will be in a stressed out state from not getting its energy needs met.
In some cases, making certain foods or foods groups off limits can lead to nutrient deficiencies. For example, if you say “I don’t allow food with ingredients that I can’t say or pronounce” — a classic wellness culture ‘rule’— you may end up avoiding any products enriched or fortified with nutrients.
From a public health perspective, the food industry fortifies and enriches certain products to help people avoid nutrient deficiencies. For example, many products that use flour (cookies, crackers, breads) are enriched with the B vitamins. But the scientific names for the B vitamins are words that go in the category of things you can’t pronounce— things like Riboflavin, Niacin, Thiamine, Folate. So if you were avoiding foods with these types of ingredients, overtime, you might develop a B vitamin deficiency.
Beyond inadequate energy intake and nutrient deficiencies, over-obsession with health can lead to social isolation and increased stress levels, two factors that are known to have negative impacts of the body.
Social Isolation
Connection and community is one of the social determinants of health; a group of factors that make up ~50% of the overall factors that contribute to you health.
Folks who have strong social ties and sense of community are seen to have better health outcomes compared to folks who live more isolated lives.
A great example illustrating the true impact of social and community context on health outcomes comes from a well-known epidemiological study called “the Roseto effect.” In this study, a community of Italian immigrants were curiously found to have very low incidences of heart disease despite having diets that were very high in foods that we normally associate with higher rates of heart disease (red meat, alcohol, lard).
Researchers found that this group of people was extremely close knit, having strong cohesion and community. It was determined that these close social relationships were what lead to the low rates of heart disease in the community (PBS).
Many people would likely be surprised to learn that community context can actually have a greater impact on health than diet. There have now been various other epidemiological studies with identical findings: social and community ties is an incredibly strong predictor for health outcomes.
In this sense, staying home from the social event because the food their doesn’t meet your standard of “health” is probably more unhealthy than going and eating the pizza.
Chronic Stress
Orthorexia creates a situation where food is a trigger for stress. Every eating decision comes with thoughts like “is this healthy enough? What does the nutrition label say? What will this do to my body?”
We have to make eating decisions multiple times a day every single day. So, if food is a trigger for stress, you can end up in a situation where your stress levels are chronically elevated.
Chronic stress can lead to impaired digestion, disrupted sleep, inflammation, weekend immune system, anxiety and depression, and other negative health outcomes.
The stress of fixating on “perfect” eating is not healthy— the greatest irony, that is so often overlooked.
Binge Eating
Orthorexia results in lots of of-limits or forbidden foods like cookies, candy, baked goods, or packaged foods. When you limit foods or food groups, it leads to increased fixation which can result in eventual binge eating.
For example, if you made ice cream off limits (regular ice cream, none of this frozen banana “healthified” ice cream) it could lead you to put good ole regular ice cream on a pedestal.
Having foods on a pedestal can make them feel especially tempting, consuming your brain space. It’s common to get to a point where you just can’t take it anymore and you end up eating the ice cream.
When this happens, you’ll likely be unable to stop at just a few scoops. This is because your brain is in the last supper mentality. It feels like, this is my last chance to have real ice cream, I better get it all in now before I lose my chance— cue binge eating.
Binge eating can lead to high levels of stress, guilt, shame, inhibited digested, body image distress, and it can also be physically very uncomfortable.
Risk factors for developing Orthorexia
Some risk factors for developing an unhealthy fixation on health include:
Preexisting anxiety or OCD diagnosis — can contribute to fear, obsession, and fixation
High achieving, “type A,” perfectionist tendencies — can predispose someone from taking “health” to an extreme.
Social Media Usage— Spending large amounts of time on social media, particularly looking at health/ wellness content can lead to becoming “radicalized” by the algorithm feeding increasingly extreme health protocols, trends, and practices
Perceived vulnerability to disease or excessive fear of developing a disease — folks with a history of a disease in their family might feel like they have to be extra vigilant about healthy eating to try and prevent it. Similarly, seeing a love one go through a health struggle can also contribute to increased fear, turning to “clean” eating in attempts to feel a sense of control over health outcomes.
Current or past ED diagnosis— sometimes orthorexia is a stop along the way from true recovery. You might say, “I no longer binge/ purge or limit calories but now I just eat “healthy.” Going from obsession with calories and weight loss —> obsession with health can be a form of previous ED behaviors simply taking on a new form.
Higher socioeconomic status — it takes lots of time, money, energy, and access to be able to obsess over “clean” eating. Folks with more financial means are more at risk of developing Orthorexia because they have the time to research nutrition, the money to afford “clean” ingredients and the access to health food stores.
Again, if you want to nerd out on the research looking at risk factors for developing ON, you can watch this research webinar I gave here.
Are you hiding behind the veil of health?
As Christy Harrison writes about in her book, The Wellness Trap, often the pursuit of wellness is actually just another form of dieting in disguise.
Diet culture is always changing form. When people started catching on to the idea that traditional diet like Weight Watchers, Optavia, and Atkins, diet culture shifted to remain relevant. “It’s not a diet, it’s a lifestyle” the wellness plans claim.
But these approaches— that leverage the idea of focusing on health, not weight— still have all the underlying characteristics of a diet.
There are right and wrong foods. The “right” foods are the ones with few ingredients. The least processed. Organic. Non-GMO. No added sugar.
The “bad” or wrong foods are everything else.
They can try and tell us that it’s not a diet, but your body doesn’t know the difference between calorie counting and eating “clean.” It registers restriction as restriction, no matter how you spin it.
And often, even when we tell ourselves it isn’t about weight, it really is.
Let me ask you this: if you ate all the “clean” foods and never lost weight, would that be okay for you? This question will help you determine where your motivation really lies.
How to heal from Orthorexia
If you have been resonating with this post so far— aware that your relationship with “healthy” eating might actually be unhealthy— you’re probably wondering where to go from here.
Healing from disordered eating in any form — orthorexia included— is nuanced and the best route is to seek out individualized 1:1 support.
But if you’re looking for some tools to start with, here’s what I recommend:
Explore the Intuitive Eating Framework. This approach to eating as been shown to lead to lower stress levels, improved mental health, increased connection to bodily cues, greater reports of life satisfaction and happiness, and even improved biomarkers of health such as lower cholesterol, bp, inflammation markers
Familiarize yourself with the factors that actually contribute to health outcomes (diet plays a much smaller role than we’ve been led to believe. This can help to take some of the pressure off “clean eating.” More on that here.
- Unfollow any wellness blogs, influencers, or other content that feeds into the fixation on “healthy” eating. Often, the more information we have, the more obsessive we can get. Unsubscribing/ unfollowing this type of content can help you quiet outside noise and practice leaning into your own body’s cues.
- Flip the focus. Instead of thinking about how a food is supposedly going to harm you, challenge yourself to think about what that food has to offer you. All foods have something to offer the body—even “processed” foods like cookies, chips, and candy. When you focus on how a food is supposedly harming you, sympathetic nervous system is activated and the body goes into a stressed state. When you focus on what a food has to offer you, parasympathetic nervous system is activated, putting the body in the optimal state for digestion and nutrition absorption.
- Instead of a rigid relationship with nutrition, focus on “gentle nutrition”— a flexible approach to nutrition in alignment with the intuitive eating framework. This relaxed approach to health encourages you to think about nutrition from a place of self care, not self control. This blog post on 8 tips for honoring your health with gentle nutrition is a excellent place to start.
- Address underlying issues with a therapist or mental health professional. If you are someone who navigates anxiety, OCD, perfectionism, and/or you identify as a high achiever, it might be supportive to seek out support. If these issues go unaddressed, you’re at greater risk of channeling the need for control into your eating and developing Orthorexia.
Wrap-up
We don’t do things for no good reason. An obsession with health often develops out of some desire for control or safety. Working with a professional to unpack why you’re seeking safety/ control— and how you can get those needs met in a sustainable, non-disordered way— can be a helpful starting point.
If you’d like to learn more about 1:1 counseling here at Leah Kern Nutrition, you can click here.
Orthorexia FAQ:
What is orthorexia?
Orthorexia is a form of disordered eating marked by an obsessive focus on eating “healthy” or “clean” foods in a way that creates anxiety, rigidity, and distress, and interferes with quality of life.
How do I know if I have orthorexia?
A helpful question to ask is: Does my focus on healthy eating get in the way of my life?
If food rules cause stress, guilt, fear, social avoidance, or constant mental preoccupation, your relationship with food may be disordered.
How is orthorexia different from healthy eating?
Healthy eating feels flexible and supportive. Orthorexia feels rigid, stressful, and consuming — food choices begin to control your thoughts, emotions, and daily decisions.
Can orthorexia exist without weight loss?
Yes. Orthorexia is not about weight or body size. Someone can be at any weight and still experience distress, restriction, and loss of flexibility around food.
Is orthorexia an eating disorder?
Orthorexia is not currently listed as an official diagnosis in the DSM, but it is widely recognized by healthcare providers as a serious and harmful pattern of disordered eating.
Can orthorexia be healed?
Yes. With compassionate, individualized support, many people are able to rebuild a flexible, peaceful relationship with food and health.
Last modified: January 17, 2026
