What is Orthorexia Nervosa?

“Having an eating disorder” can bring up ideas of many symptoms that seem to only fall into two categories of eating disorders: anorexia or bulimia. Due to this incomplete picture of these illnesses, other eating disorders, such as orthorexia, might go unnoticed, leaving many eating disorders inaccurately diagnosed or not diagnosed at all. It is important to bring awareness to eating disorders that can fly under the radar, such as orthorexia.

By: Elizabeth Foot

Orthorexia is an eating disorder categorized by an unhealthy focus on healthy eating. While this disease is not formally in the DSM-5, orthorexia can significantly impact an individual’s physical and mental well-being. Many studies on orthorexia find that people with this eating disorder also have comorbid conditions such as obsessive-compulsive disorder.

Since this disease is a bit more nuanced than other eating disorders, keep reading to find some common signs and symptoms of orthorexia below.

Food Quality and Health Obsession

Do you or someone you know always look at food labels and insist on getting particular brands or types of food? People with orthorexia sometimes follow a specific diet pattern that only emphasizes fresh, organic food and ignores all processed food. While not always a sign of orthorexia, these habits are signs of this restrictive, health-focused eating disorder.

Avoiding Eating Out or Eating Something Prepared by Someone Else

Another sign of orthorexia is refusing to eat something cooked in a restaurant or cooked by somebody else. For younger sufferers, this can also include only eating food cooked by a trusted adult, as opposed to a friend’s parent or school cafeteria chefs.

Making Unsolicited Comments On What Others Eat 

People with orthorexia tend to comment on others’ meals, categorizing the foods as “healthy” or not due to their disordered view. These comments can be laced with judgment that has much less to do with what is being eaten and more to do with the person’s preoccupation with health. It is important to note that in some cases, the person’s judgment of health may not be based on anything other than personal preference or experience.

Anxiety Around Foods That Do Not Fit the “Healthy” Rules

When a predetermined food rule is broken, a person with orthorexia may be distressed and preoccupied. Orthorexia may also cause general anxiety around food, particularly around rules and foods perceived as unhealthy.

What Are The Health Risks of Orthorexia? 

While there has not been much research on the health consequences of orthorexia specifically, the health risks of severe restriction have been studied in depth. Prolonged restriction can impact a person’s cognition, immune system, bones, organs, and more. Orthorexia can also increase the risk of compulsive exercising. Both restriction and compulsive exercise increase the risk of malnutrition and the aforementioned health risks.

Eating disorders that fly under the radar can be incredibly dangerous, as it can be hard to identify symptoms and recognize when help is necessary. Paying attention to a person’s flexibility around food could help you or someone you love notices the development of orthorexia. It is important to talk to a treatment team or health professional if you believe that you or someone you know may be showing signs of an eating disorder. Just because orthorexia does not have formal diagnostic criteria in the DSM-5 does not mean that it is not a serious health concern or worthy of treatment and care.

At BALANCE eating disorder treatment center™, our compassionate, highly skilled team of clinicians is trained to diagnose and treat the spectrum of eating disorders, including orthorexia, anorexia, bulimia, binge eating disorder, and other disordered eating and body image issues. BALANCE is excited to announce our new Fall Transition Daytime IOP Program, designed to get you the compassionate, expert care you need without sacrificing your evening commitments. Learn more about our Daytime IOP Program here.

Our admissions team would be happy to answer any questions you may have about our programs and services. Book a free consultation call with our admissions team below, or read more about our philosophy here.

This post was written by BALANCE Blog Contributor, Elizabeth Foot (she/her).

Elizabeth is currently pursuing her Master's of Public Health in nutrition and dietetics from the University of Michigan, on track to become a registered dietician. Prior to returning to school, Elizabeth received her B.A. in Public Policy from Hamilton College in 2020.

Since graduating Hamilton, Elizabeth has worked for an infertility insurance company as a marketing associate, has volunteered with Multi-Service Eating Disorder Association (MEDA), and has advocated on Capitol Hill for expanding insurance coverage to registered dietitians as part of the Eating Disorders Coalition (EDC). Elizabeth is also a strong supporter of intuitive eating, HAES, and is excited to become a licensed practitioner working in the ED field. In her free time, Elizabeth can be found creating recipes, practicing yoga, or counting down the days until she can get a dog.

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