What is orthorexia?
When can good intentions to eat 'clean’ become an unhealthy obsession? We take a look at the signs, symptoms and dangers of orthorexia and when and how to get help
There is lots of talk about 'clean eating' in the media, and while it appears to promote healthier choices, it could be doing more harm than good. In fact, some believe that labelling foods as 'clean’ or 'dirty' encourages restrictive eating behaviours and imposes unhelpful values and judgements on food. Emer Delaney, a registered dietitian, explains what orthorexia is, how it might start, why it can be problematic, and when to seek help.
Read about intuitive eating. Plus, get tips on how to manage stress eating and find out how many calories your body needs to function.
What is meant by 'orthorexia'?
A healthy, balanced diet is important for physical, mental and emotional health but when eating healthily turns into an obsession it can cause distress and impair your quality of life as well as your health and wellbeing.
Orthorexia nervosa (orthorexia) is a condition that was first described by the Californian doctor Steven Bratman in 1997. Although it has yet to receive a formal medical definition, it is often described as a ‘fixation on righteous eating’. The term is increasingly being used to describe strict and inflexible eating behaviours and appears to be on the increase, potentially due to the rise of social media and the popularity and obsession with ‘clean’ or ‘pure’ eating.
How does orthorexia start?
The condition starts with a well-meaning intention to eat healthy foods, but over time these good intentions become all-encompassing, until it occupies the majority of an individual’s day.
Those with orthorexia may regularly miss out or not participate in social occasions because of a dislike or fear for the food that may be available. There may be both genetic and environmental factors that influence the development of orthorexia as well as a number of underlying motivations that lead to its advancement, these may include:
- A strong need for control
- A desire for perfection both in terms of body weight and appearance
- A means by which to create and improve one’s self-esteem
- A way to shape an identity
Many with orthorexia are also exercise enthusiasts, where exercise is an equally important aspect of their lives.
What are the warning signs of orthorexia?
Those with orthorexia create a set of self-imposed rules about how to eat – the timing and location of meals, which foods are acceptable based on their perceived ‘healthiness’, and they typically focus on the quality rather than quantity of the food.
Signs of orthorexia may include:
- Cutting out entire food groups without a medical reason to do so – common ones include dairy, grains and meat
- Experiencing emotional distress when ‘acceptable’ foods are not available
- Compulsively checking nutritional labels and ingredient lists
- Obsessing over food procurement, preparation and consumption
- Experiencing anxiety and guilt when forbidden foods are eaten
- Viewing food as a path to health and acceptance rather than as fuel and nourishment
What are the symptoms of orthorexia?
What starts as a genuine intention to become healthier, may develop into a diet that becomes restrictive in both calories and variety and this may cause your health to suffer. Consequently, you may experience symptoms such as:
- Weight loss
- Malnutrition
- Depression
- Anxiety
- Irritability
- Social isolation or withdrawal
Is orthorexia an eating disorder?
Eating disorders that can’t be diagnosed as anorexia, bulimia, or binge eating disorder might be diagnosed as an 'other specified feeding or eating disorder' (OSFED). Orthorexia is an example of this classification so although not currently recognised in a clinical setting it is commonly referred to both in and out of clinic.
Who can help someone with orthorexia?
Seeking help at an early stage is key, although recognising the signs and symptoms can be challenging. First discuss the situation with your GP or contact a specialist dietitian. The type of help you may expect may include individual or group therapy including nutrition counselling and meal coaching with the objective being to restore balanced eating habits and improve your quality of life. In some circumstances a team of experts, such as a doctor, psychotherapist and dietician, may be the best approach.
The role a dietitian can play will include informing a patient about the nutritional value of different types of foods, highlighting that there are everyday foods which have a role to play in a varied, balanced diet. These include carbs like rice, pasta and bread, as well as dairy foods and lean meats. Occasional ‘treat’ foods may also be enjoyed as part of a balanced and varied diet. It is important to move away from distinguishing food as ‘good’ or ‘bad’, as this may help eliminate the guilt associated with some foods. I encourage my patients to enjoy a range of foods from all of the food groups including wholegrain breads, cereals, pulses, vegetables, lean meat, fish and eggs. A handful of nuts and seeds, for example, are a great snack and should be encouraged in the diet.
If the signs and symptoms of orthorexia are familiar to you or you have a loved one experiencing these challenges, check out Beat Eating Disorders.
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This article was last reviewed on 20 January 2025 by Kerry Torrens.
Emer Delaney BSc (Hons), RD has an honours degree in Human Nutrition and Dietetics from the University of Ulster. She has worked as a dietitian in some of London's top teaching hospitals and is currently based in Chelsea.
Kerry Torrens is a qualified Nutritionist (MBANT) with a post graduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including Good Food.
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