Understanding orthorexia: The unofficial diagnosis with real risks

Have you ever heard of the phrase, “too much of a good thing?” That’s one way to look at a disordered eating pattern known as orthorexia. People with orthorexia have a disruptive fixation on healthy eating. Plenty of people do their best to make nutritious food choices, but people with orthorexia are obsessed with following a “pure” diet, often at the cost of their own mental health.

The term “orthorexia” was first coined in the 1990s and is now thought to affect approximately 30% of people across the globe. Although orthorexia isn’t officially considered a distinct eating disorder, it’s well recognized by healthcare professionals as a problem that can impact people’s health and quality of life.

How to recognize orthorexia

While eating disorders like anorexia nervosa and binge eating disorder affect the amount of food you eat, orthorexia focuses primarily on the types of food you eat. People with orthorexia have an obsession with nutritious eating and an extreme aversion to foods that they deem unhealthy.

Other common signs of orthorexia include:

• Compulsively checking nutritional labels and ingredient lists

• Excessively eliminating certain foods groups, like dairy or carbs

• Unusual interest in the health of what others are eating

• High levels of perfectionism

• Frequent concerns about body image

• Excessive concern or anxiety about what food might be served at social events

• High levels of stress when healthy foods aren’t available

• Extreme guilt when you can’t maintain your dietary standards

What causes orthorexia?

Anyone can develop orthorexia, but there are several risk factors that may increase your chances.

• Personality and temperament: One survey found that orthorexic tendencies are associated with perfectionism, preoccupation with weight and appearance, and certain insecure attachment styles. Orthorexia is also linked to obsessive-compulsive tendencies.

• Eating history and habits: Some experts believe that orthorexia can stem from picky eating, fear of trying new foods, parental feeding practices, or a history of parental eating disorders.

• Societal influences: There’s a connection between social media use and disordered eating in youth, and some social media wellness trends may contribute to an unhealthy fixation on diet and clean eating. Instagram, in particular, may contribute to orthorexic tendencies.

• Profession: Orthorexia has also been linked to professions that place a strong emphasis on health, wellness, and fitness, like athletes, dieticians, doctors, and performers.

Can clean eating become a problem?

Following a healthy diet offers countless health benefits, including stronger bones, better immunity, and a lower risk of certain chronic diseases. But for people with orthorexia, their obsession with optimal health can cause significant issues with daily living.

To start, a restrictive diet can lead to physical health problems like severe weight loss, gastrointestinal issues, and malnutrition. Orthorexia can cause mental health concerns too, with some research associating orthorexia with low self-esteem and increased anxiety. It’s also been shown to impact people’s quality of life by causing problems at work, school, and with interpersonal relationships.

Orthorexia treatment approaches

Similar to other eating disorders, treating orthorexia requires a multidisciplinary approach to care. The goal is to combine talk therapy, nutritional counseling, and lifestyle changes to help people learn to trust their bodies, practice balanced eating, and develop a more positive relationship with food.

• Talk therapy: Talk therapy, like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), can be effective tools for managing symptoms of orthorexia. With the help of a therapist, you can learn to identify and challenge unhelpful thoughts about food and health, as well as explore any underlying issues that may be driving your orthorexia symptoms.

• Nutritional counseling: Working with a registered dietitian can help you analyze your restrictive eating patterns and replace them with more balanced habits. For example, you may learn how to practice mindful eating, meet your caloric needs, and bring variety to your diet in a safe and comfortable way.

• Lifestyle choices: Simple self-care practices, like journaling, can increase self-awareness and help you fight back against habits that are not serving you. Learning to cultivate greater mindfulness and self-compassion has been associated with healing and recovery. It’s also important to surround yourself with a strong support system, so consider confiding in a trusted family member or friend or joining an eating disorder support group for a safe space to share and grow.