Orthorexia, which the National Eating Disorders Association (NEDA) defines as an obsession with proper or ‘healthful’ eating, is on the rise.
Although the term was coined in 1997, orthorexia has not been formally recognized in the Diagnostic and Statistical Manual DSM-5; however, that doesn’t mean it isn’t a problem.
One thing that makes orthorexia especially tricky is that it often hides in plain sight – and it’s often praised or rewarded, which only adds fuel to the fire.
While being aware of health and nutrition isn’t inherently a problem, individuals suffering from orthorexia become fixated on ‘healthy eating’ to an unhealthy degree, which comes with consequences that often escalate in severity over time.
“Physically, orthorexia can lead to nutrient gaps, electrolyte imbalances, malnutrition, and other serious health complications,” said Elizabeth Harris, a registered dietitian nutritionist and Certified Intuitive Eating Counselor.
“It can also cause mental and emotional distress, including guilt, shame, or anxiety around eating that may make it difficult to be fully present and engaged in everyday activities or relationships or lead to social withdrawal or isolation,” Harris told FI.
“Orthorexia is harmful because it often narrows a person’s world,” added Alison Swiggard, founder of In Good Company Nutrition and a registered dietitian specializing in eating disorders.
“It can reduce dietary variety, increase anxiety, interfere with social connection, make eating feel joyless, and create a sense of failure or shame,” Swiggard told FI.
And reduced variety and diet restriction can lead to deficiencies in vitamins and minerals, plus severe weight loss, according to Anna Mapson, a registered nutritional therapist, author, and podcast host.
Catherine Schuler, a clinical psychologist specializing in OCD and anxiety disorders with a strong background in eating disorders, says orthorexia is not generally fueled by a desire for thinness; however, “a person with orthorexia might enjoy the weight loss they experience from their eating pattern and then develop a desire to maintain thinness that morphs into anorexia,” Schuler told FI.
Tiffany Bruno, a registered dietitian and the director of education at Switch4Good, believes that orthorexia is on the rise because of social media inundation.
“We are always seeing someone who is skinnier, leaner, has bigger muscles, or has something about their body that we desire,” Bruno told FI, noting that social media also makes it easier than ever to spread info about nutrition, which is dangerous when it’s misguided or taken out of context.
“There may be one small study that shows a food can have negative effects, and then an influencer takes that information and runs with it, failing to discuss it in a broader context. Nutrition requires a lot of nuance and supporting information, and it’s easy to fall into the trap of seeking ‘perfection’ without it,” Bruno explained.
Signs and Symptoms of Orthorexia
According to NEDA, signs and symptoms of orthorexia include:
- Compulsive checking of ingredient lists and nutritional labels
- An increase in concern about the health of ingredients
- Cutting out an increasing number of food groups (sugar, carbs, dairy, meat, etc.)
- An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
- Unusual interest in the health of what others are eating
- A feeling of superiority around their nutrition and intolerance of other people’s food behaviors and beliefs
- High levels of perfectionism
- Spending hours per day thinking about what food might be served at upcoming events
- Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
- Obsessive following of food and ‘healthy lifestyle’ blogs on social media
- Body image concerns may or may not be present
- Psychosocial impairments in different areas of life
“It’s important to note that orthorexia’s food rules are not universal, so the rules one person has may not be the same as the rules another person has,” Schuler advised.
“It may feel as though someone is trying to fit their life around food, instead of food fitting easily into life,” Harris added.
Dr. Lara Zibarras, a registered psychologist and nutrition/eating disorder recovery coach, says this dynamic can be especially detrimental when the individual who’s dealing with orthorexia is a parent.
“When a parent has very rigid food rules, children pick that up. They notice what foods are treated with fear or disgust, they notice when mum won’t eat the birthday cake, they notice the stress around mealtimes. I used to be that parent – and it’s a really important reason to address orthorexia beyond just yourself,” Zibarras told FI.
“If you suspect someone may have an unhealthy relationship with food, it’s best to suggest they seek out professional help. It’s too easy to tease someone for sticking to their diet or being too strict, but that will not be helpful,” Bruno advised.
Ashley Moser, LMFT, CEDS, Clinical Education Specialist at The Renfrew Center, recommends adopting an “all foods fit” mindset and moving away from labeling foods as “good” vs. “bad” or “healthy” vs. “unhealthy.”
“It’s also important to eat regularly and aim for balance and variety across meals. Beyond nutrition, food can serve as a source of connection, so I often encourage people to value time spent with others over striving for perfection in what they’re eating,” Moser told FI.
Food for Thought Leadership
Food retail is undergoing a fundamental transformation, and few people have a better vantage point than the SupermarketGuru Phil Lempert. In this episode of Food for Thought Leadership, Lempert joins FI’s Chris Campbell to discuss the forces reshaping grocery, from inflation and private label growth to changing consumer expectations around health, wellness, and transparency.
