Orthorexia: When Healthy Eating Becomes a Dangerous Obsession



– Carolyn Moriarty, LCPC


Orthorexia nervosa (ON) describes a type of disordered eating in which an individual becomes preoccupied with consuming only healthy, “clean” foods.

Although it is not currently included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) due to a lack of research, it is still recognized by many mental health professionals as an eating disorder because of the extreme psychological distress it causes individuals.


What’s wrong with being healthy?

ON can be extremely difficult to detect or diagnose because the behaviors are not as objectively “concerning” as types of disordered eating, such as binging, purging, or restricting. On the contrary, an individual who is deep in the throes of their ON disorder may appear to be like an exemplary model of good nutrition to family and friends. Indeed, this is part of the appeal for many ON sufferers. Their “healthy eating” is a powerful shield that allows them to publicly carry out their eating disorder in peace. After all, who is going to chastise someone for eating a big bowl of vegetables, avocado and fish?

ON is also remarkably good at doing what an eating disorder best: taking over the brain of the individual at every turn to provide irrefutable rationalization for the Rules of Eating.

Look at the ingredient list on the salad dressing. No, it has soybean oil. You can’t eat that. Put it back. Read that nutrition label on this bottle of sugar free ketchup instead. There’s too much sodium in that ketchup, put it back. Get almonds. It’s okay to have almonds. Find ones that are raw and unsalted. Make sure you don’t eat more than the serving size. Salmon is a good bet for protein. But can’t buy farmed salmon, because it is too high in omega-6 fatty acids.  You need to go to another store and buy sockeye salmon because that has omega-3 fatty acids. You must keep doing this. This is good for you. You like this. What’s wrong with being healthy?


Causes of Orthorexia Nervosa


ON isn’t exclusively motivated by a desire to achieve optimal health. Like most eating disorders, ON often functions partly as a coping mechanism, giving people the illusion that they have control over something in an environment where they feel they otherwise do not. The restriction of food can provide a sense of solace and relief.

Individuals who are early on in recovery from restriction-based eating disorders can be prone to developing ON. After much treatment, the “rational” voice in their brains is beginning to stir, telling them that consuming more food is OK.  This voice is at war with the “ED voice” that has become a tumor in their brain, sending fear-based messages about the consequences of losing control in such a way. ON offers a perfect solution: they can “eat more” without sacrificing the death-grip of control they need in order to cope with “eating more”.


Symptoms of Orthorexia Nervosa


Individuals with ON have an extreme fixation on only consuming foods they deem to be pure, clean, or healthy. They might rigorously restrict their diets, eliminate entire food groups, meticulously scrutinize ingredient lists, and feel anxious or distressed if they can’t access their preferred “healthy” foods. This fixation on “clean” eating can significantly impact their social life, relationships, and overall well-being.

Here are some of the symptoms associated with ON:

  • spending an excessive amount of time thinking about food
  • spending an excessive amount of time researching and planning meals
  • adopting a strict diet that centers on “socially acceptable” restriction: veganism, vegetarianism, gluten-free, etc.
  • experiencing significant anxiety around making the “right” food choices
  • becoming upset or distressed if healthy foods are not accessible or available
  • avoiding social events that center around food
  • developing nutritional deficiencies or malnutrition


Treatment for Orthorexia Nervosa


Treatment for eating disorders such as ON usually requires a multi-faceted approach.

Consultation with a medical professional is a good place to start. It is important to screen for risk factors associated with eating disorders such as:

  • osteoporosis
  • electrolyte imbalances
  • blood sugar abnormalities
  • anemia

Long-term recovery from eating disorders also requires treatment for mental health. As mentioned earlier, eating disorders co-occur with negative thought patterns, control, perfectionism and maladaptive coping skills.

The mental health professional can help individuals:

  • identify the underlying reasons for the eating disorder
  • increase awareness of negative thought patterns and emotions that perpetuate behaviors
  • practice self-acceptance and self-compassion instead of self-punishment
  • identify triggers and techniques to navigate them in a more effective manner

Above all, treatment will allow individuals who struggle with eating disorders to discover new, more adaptive skills they can use to cope effectively with the challenges that arise in life.


Seeking Mental Health Support

If you feel that you or a loved one may be experiencing some of the signs and symptoms associated with orthorexia nervosa, it may be time to speak with a professional. Scheduling an appointment with Chicago Counseling Center may be the first step among many to regain meaningful control over your mental health. Meet our team to learn more!


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