We’ve all experienced guilt after indulging in foods we should only have occasionally, but for most of us, that feeling fades, and we return to a healthy diet. However, for those dealing with orthorexia, the story is different. Individuals with orthorexia develop a fixation on ‘clean’ eating, and even the slightest dietary deviation can trigger significant anxiety and guilt. If you or a loved one is currently displaying signs of orthorexia, it’s crucial to seek professional help.

What is orthorexia?

Orthorexia, or orthorexia nervosa, is a term used to describe an obsession with eating foods that one considers healthy. It involves an extreme and unhealthy focus on consuming only ‘pure’ or ‘clean’ foods, often to the detriment of overall well-being. People with orthorexia may become fixated on the quality and purity of their diet, leading to restrictive eating patterns and social isolation.

Is orthorexia classed as an eating disorder?

While there is a general consensus in the scientific community that orthorexia is an eating disorder, it is not technically classified as one. This lack of classification stems from ongoing debates about orthorexia and the appropriate diagnostic category for it. This debate is one reason why the DSM-V currently does not include a specific diagnosis for orthorexia.

Some feel that orthorexia shares key features with conditions like Obsessive-Compulsive Disorder (OCD) and anorexia.

Other research suggests that orthorexia should be diagnosed as Avoidant/Restrictive Food Intake Disorder (ARFID) due to sensory issues with foods, as well as the consequences of eating the food (such as becoming unhealthy).

Health professionals will usually use the term orthorexia to identify a pattern of behaviour related to an extreme focus on healthy eating.

What causes orthorexia?

While the exact causes of orthorexia haven’t been extensively researched, it is believed to result from various factors:


Research shows that individuals with orthorexia exhibit perfectionistic tendencies, potentially showing a link between the two. It could mean that they may be more susceptible to orthorexia, as they may set unrealistically high standards for themselves, including those related to their diet.

Psychological issues

A 2022 study found a significant relationship between anxiety, low self-esteem and orthorexia. Interestingly, they found that high self-esteem scores would decrease the overall tendencies shown by people with orthorexia, while high anxiety scores increased the tendencies.

While not a ‘cause’ of orthorexia per se, it’s also interesting to note that orthorexia was found to be unrelated to stress or negative emotions; instead, it exhibited a correlation with enhanced overall well-being. These findings are intriguing, especially considering that many eating disorders are typically associated with stress and negative emotions.

Environmental influences

Societal pressures and cultural emphasis on health and appearance can contribute to the development of orthorexia. The constant exposure to messages promoting “clean” eating and a particular body image can influence individuals to adopt extreme dietary patterns.

Biological factors

As with a lot of eating disorders, there may be genetic or neurobiological factors that increase susceptibility to orthorexia, but more research is needed to understand these potential influences fully.

What are the signs and symptoms of orthorexia?

People showing signs of orthorexia will usually display some or more of the following behaviours and thoughts towards food:

  • Obsessive focus on food quality: People with orthorexia may become preoccupied with the quality, purity and origin of their food. They may spend significant time researching and planning their meals.
  • Strict dietary rules: Individuals with orthorexia often follow strict dietary rules and may eliminate entire food groups or categories deemed “unhealthy” from their diet. This can lead to nutritional imbalances.
  • Feelings of guilt or anxiety: Breaking self-imposed dietary rules can lead to feelings of guilt, anxiety, or self-loathing. This can contribute to a cycle of restrictive eating and negative emotions.
  • Social isolation: Individuals with orthorexia may withdraw from social events that involve food, as they may be concerned about the ingredients and preparation methods used by others.
  • Physical symptoms: Extreme dietary restrictions can lead to physical symptoms such as weight loss, nutritional deficiencies, fatigue, dizziness and gastrointestinal issues.
  • Impact on daily life: When the preoccupation with healthy eating becomes all-consuming and interferes with daily life, work, relationships and overall well-being, it may indicate orthorexia.
  • Rigid thinking: People with orthorexia may exhibit rigid thinking patterns regarding food, making it difficult for them to adapt to different eating situations or try new foods.
  • Judgement of others: Individuals with orthorexia may judge others based on their food choices, believing that their own dietary preferences are superior.

How is orthorexia diagnosed?

Due to the controversy surrounding orthorexia in the scientific community, there needs to be more solid research and established diagnostic criteria. In response to this gap, researchers Dunn and Bratman proposed their own diagnostic model for orthorexia, which includes the following components:

  • An obsessive focus on “healthy” eating and emotional distress related to food choices perceived as unhealthy.
  • Clinical impairment resulting from the behaviour and preoccupation.

To facilitate diagnosis, these components are typically accompanied by the use of the ORTO-15, a self-report questionnaire. Currently, these tools are among the most well-known resources for diagnosing orthorexia.

Debunking myths surrounding orthorexia

While controversy surrounds orthorexia and its diagnosis, numerous myths and misconceptions have emerged during this time. Below, we aim to debunk some of the most common misconceptions:

“Orthorexia only affects people who want to look a certain way.”
While some eating disorders are linked to body image concerns, orthorexia can be driven by a desire for overall health and wellness. It’s not solely about achieving a specific appearance.
“Orthorexia is just a lifestyle choice, not a mental health issue.”
Orthorexia involves an obsessive preoccupation with food quality and purity, impacting one’s life negatively. It goes beyond a conscious decision to adopt a healthy lifestyle and can have serious mental health implications.
“Orthorexia is less serious than other eating disorders.”
Orthorexia can have significant physical, emotional and social consequences. It is a serious condition that may require professional intervention and support, similar to other recognised eating disorders.
“Orthorexia only affects a specific demographic group.”
Orthorexia can impact individuals of any age, gender, or background. It is not limited to a particular demographic and can affect anyone who develops an unhealthy fixation on clean eating.
“Orthorexia is just about eating healthy; that’s a good thing.”
Orthorexia involves an extreme focus on healthy eating, leading to rigid dietary restrictions and negative impacts on physical and mental well-being. It can develop into a serious condition that should be addressed with appropriate care and support.

How is orthorexia treated?

Orthorexia treatment is a comprehensive approach that combines rehabilitation and nutritional guidance to address the underlying factors contributing to a person’s fixation on maintaining an excessively clean diet. The primary goal of orthorexia rehab is to delve into the root causes of this disorder.

In the rehabilitation process, you are guided to identify and understand these issues, equipping you with tools and skills to manage them in a healthy manner. The treatment programmes at rehab centres usually incorporate various therapeutic modalities:

  • One-to-one therapy: Individual sessions with professional therapists help explore the unique aspects of your orthorexia and develop healthy coping mechanisms tailored to your specific needs.
  • Group therapy: Collaborative group sessions create a supportive environment, reduce feelings of isolation and enable you to learn from the experiences of others facing similar challenges.
  • Cognitive-Behavioural Therapy (CBT): CBT plays a crucial role in identifying and transforming negative thought patterns and behaviours related to your relationship with food.
  • Family therapy: Particularly beneficial for those with orthorexia, family therapy addresses any family dynamics contributing to the disorder. It also provides support to families throughout the treatment process.
  • Holistic therapies: A holistic approach involves activities such as yoga, meditation, art therapy and music therapy. These holistic therapies aim to manage stress, alleviate symptoms of anxiety and depression that may worsen orthorexia and promote overall physical and emotional well-being.
  • Nutritional counselling: Rehab centres usually collaborate with a professional nutritionist and focus on developing a healthy and balanced diet. They will also guide you on how to eat without unnecessary restrictions. This nutritional guidance is essential for establishing a foundation that helps you maintain your health and prevent orthorexia relapse even after completing the treatment programme.

What are the next steps?

Although it may feel daunting to reach out for help, you can take the first step towards reclaiming your health and happiness by contacting a healthcare professional. With their help, you’ll have every opportunity to beat orthorexia.

Reach out for expert guidance today and discover that recovery is possible. Start your journey to a healthier you.

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What is the difference between orthorexia and anorexia?
Orthorexia is an obsession with eating only healthy foods, emphasising food quality, while anorexia involves intense fear of weight gain, leading to severe food restriction and self-induced starvation.
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