What Is Orthorexia, and How Does It Differ From Other Eating Disorders?

Orthorexia — also known as orthorexia nervosa — is an eating disorder hallmarked by an obsession with healthy eating. Orthorexia affects less than 1% of the U.S. population. With this disorder, an individual’s focus is on the quality of food, not the quantity. 

An individual with orthorexia may have no interest in losing weight. Instead, they concentrate on the nutritional values and health benefits associated with foods. 

Although the term “orthorexia” has been in use since the 1990s — and is recognized by the National Eating Disorders Association (NEDA) — it hasn’t been officially recognized by the American Psychiatric Association (APA) as a diagnosis. This means that there isn’t agreement on clinical signs and symptoms, or how to recognize them.

Having this framework would help with research, prevention, and awareness of orthorexia. Read on to learn more about what orthorexia is, as well symptoms, diagnosis, and treatment.

How does orthorexia differ from other eating disorders?

With orthorexia, a person’s focus is on the quality, nutritional values, and health benefits of foods. These individuals don’t usually have concerns about their body weight or shape. 

Having a hyper-focus on the quality of foods — being “clean, healthy, or pure” — leads to limited choices and possible health issues.

Other eating disorders, such as anorexia, are focused on body image and food quantities. These individuals may have a negative (distorted) body image and change their behaviors to prevent weight gain.

When does healthy eating turn into “obsessive” eating? 

When healthy eating has negative effects on daily life — such as distress over food quality and avoiding meals with others — it may be an obsession. 

Research suggests orthorexia can begin with normal, healthy eating intentions. But over time, rigid dietary rules can turn into an obsession. 

Although good nutrition can improve wellness, it’s a problem when it becomes a fixation. Untreated eating disorders can cause serious social and medical problems that lead to disrupted relationships and social isolation.

What causes orthorexia?

It’s not quite clear what causes orthorexia, but it can start when a person has an unhealthy relationship with food. Other factors have been identified that increase a person’s risk of developing it as well. They include:

• History of eating disorders

• Perfectionism

• Obsessive compulsive behaviors

• Preoccupation with weight

• Poor body image

Findings show that orthorexia shares emotional and physical symptoms with obsessive compulsive disorder (OCD) and other eating disorders. Social media can perpetuate these obsessions, too.

What are the warning signs and symptoms of orthorexia?

Signs and symptoms of orthorexia may be hard to notice at first, until weight loss or symptoms of emotional distress surface. Anyone can get an eating disorder, so it helps to be aware of common behaviors associated with orthorexia.

These can include:

• Checking ingredient lists and nutrition labels compulsively

• Worrying about how healthy foods/ingredients are

• Eliminating entire food groups (dairy, meat, carbohydrates)

• Eating foods that only meet your definition of “healthy”

• Having high levels of stress when “acceptable” foods aren’t available

• Following healthy living social media accounts obsessively 

If you’ve had an eating disorder in the past, or you live with OCD, being aware of your eating behaviors is helpful. If you have any signs or symptoms of orthorexia, let someone know who can help you.

How do doctors diagnose orthorexia?

Orthorexia is recognized by NEDA, but it hasn’t been officially recognized by the APA as a diagnosis. This means that there isn’t agreement on clinical signs and symptoms, or how to recognize them. 

Proposed diagnostic criteria focus on two things — an obsession with healthy eating and disruptions to daily life from disordered eating. 

Symptoms can vary in severity, and they’re often hard to recognize. Unless they’re self-reported, mild to moderate symptoms may be easily overlooked. 

If you’re noticing negative physical or social impacts because of your diet, consider contacting a healthcare provider. They can support your physical and emotional well-being, and refer you to other specialists as needed. Left untreated, an eating disorder can affect your health and quality of life, so it’s important to ask for help.  

What are the treatment options for orthorexia?

Treatment options for orthorexia are therapy, nutritional counseling, and medications. Therapy can help an individual use physical cues — instead of food rules — to guide eating habits. It can also help identify and treat any underlying mental health issues that could be contributing to unhealthy relationships with food. 

Medications to treat anxiety or OCD may be necessary for some individuals with orthorexia. 

The goals of treatment are to:

• Recognize the condition

• Decrease symptoms

• Provide tools for support

This means that a person with orthorexia will maintain therapy sessions, learn new habits for healthy eating, and have a support network in place. Changing thought processes about foods can be hard, but orthorexia is a treatable condition. The earlier it’s detected and treated, the greater the likelihood of recovery is. 

What resources are available to help manage orthorexia and other eating disorders?

Therapy is a vital part of managing orthorexia. Eating disorders can be a sign of something else — not just an issue with food. A person may have anxiety, obsessive-compulsive tendencies, or another mental health issue. Therapists are successful at helping people with all types of eating disorders. 

If you’re struggling with orthorexia, help is available. 

NEDA is dedicated to preventing, treating, and providing education about eating disorders.

If you need help, talk to your healthcare provider or contact NEDA’s helpline:

• Call 1-800-931-2237, Monday to Thursday, 11AM to 9PM (ET) and Friday 11AM to 5PM (ET).

• For crisis situations, text “NEDA” to 741741 to be connected to a trained volunteer at the Crisis Text line.

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Written by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, BA, is an Arizona-based registered nurse with 22 years of hospital-wide clinical nursing experience and 11 years of medical writing and editing experience. She was a former healthcare content creator for a digital health tool at HealthLoop and director of clinical content operations at GetWellNetwork.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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