Orthorexia: healthy eating obsession

Orthorexia is an unhealthy obsession with eating healthy food. Although orthorexia is not an officially recognized eating disorder, it does share some characteristics of both anorexia nervosa and bulimia. Orthorexia nervosa refers to a fixation on eating "pure," "right" or "proper" food rather than on the quantity of food consumed.

While healthy food choices are a cornerstone of good health, when taken to extremes, the pursuit of a healthy diet can become unhealthy. Orthorexic eaters may start by adopting a socially accepted diet such as vegetarian, vegan, organic, or gluten-free. They become strict and inflexible in their food choices, and the list of foods avoided continues to grow. Foods most often eliminated include fried or other high-fat foods, desserts, and combination foods such as pizza or pasta.  Eating at restaurants or with friends and family poses a challenge for orthorexic eaters and they may choose to avoid these situations or bring their own food.

The obsession of eating “healthy” foods can lead to diets that are so strict they lack essential nutrients and energy to support a healthy body and healthy weight. In addition, the disordered thoughts have the potential to develop into an eating disorder diagnosis such as anorexia nervosa or bulimia.

Orthorexia may lead to social isolation and overwhelming thoughts about planning meals, as well as resisting the temptation of once enjoyed foods.  Orthorexic eaters often experience feelings of guilt and anxiety after eating food considered off-limits. In contrast, they may experience feelings of superiority, perfection or control as they continue their disciplined eating style. This sense of control may be a way of avoiding negative emotions or managing stress.

Similar to other eating disorders, orthorexia often results in negative health consequences. Social isolation may impact emotional health and mental well-being. Physical health can be compromised due to low body weight and possible nutrient deficiencies. Orthorexic eaters often admit that they have difficulty enjoying life due to the obsessive thoughts about “healthy” eating that control their lives.

Treatment for orthorexic eating involves a team of healthcare providers including a physician, therapist and dietitian. As a Registered Dietitian, I educate clients about how food fuels their bodies and provides essential nutrients for health. We discuss diet myths and challenge their thoughts related to a healthy diet. We work on legalizing all foods and creating a meal plan that is helpful for clients to understand the amount and balance of food for their individualized needs. By gradually incorporating “forbidden” foods, orthorexic eaters relearn that a truly healthy lifestyle consists of moderation and balance and that all foods can fit into a healthy diet.

Ginger Meyer, MS, RD, LD