Nutrition-wise blog

Orthorexia: When healthy eating becomes extreme

By Katherine Zeratsky, R.D., L.D. November 15, 2016

Orthorexia nervosa is a term used to describe an obsession with a set of rigid dietary practices or rules related to food. Often these rules are about the perceived quality of the food, such as whether a food is free of pesticides or preservatives, and how it's prepared or packaged.

Although it's not yet recognized as a unique medical diagnosis, orthorexia nervosa shares characteristics with anorexia nervosa and obsessive compulsive disorder (OCD). Like anorexia, orthorexia may lead to limited foods being consumed. People with orthorexia may also have traits similar to those seen with OCD, such as a need to have complete control over the handling and preparation of their food.

How do you know if healthy eating has become extreme? There are proposed criteria to identify someone who may have orthorexia. Here is an overview of proposed diagnostic criteria:

  • Spends many hours researching foods. Unable to focus on tasks such as work, school, or social activities.
  • Avoids foods with certain ingredients, such as fat, animal products, preservatives or other additives, or any ingredients that aren't considered "healthy" or "pure." Knowingly or unknowingly eating unhealthy or impure food may cause guilt and emotional distress.
  • Limited food choice leads to a nutritionally unbalanced diet, which can have negative health effects.
  • Worries that impure foods will have negative physically or emotionally effects.
  • Is intolerant of other people's beliefs about food.
  • Food rules don't align with religious or medical reasons (such as food allergy) for avoidance.

Orthorexia can take a toll on the body. Avoiding foods or entire food groups is a concern because it may result in deficiencies and related conditions, such as anemia, weak bones or low hormone levels.

Orthorexia also has emotional costs. When people with orthorexia are unable to adhere to their food rules, they may experience intense frustration, disgust, guilt and self-loathing. Such emotions may lead to worsening of the disorder. Furthermore, adherence to strict standards may lead to social isolation because of control issues or disagreements about food.

If food choices are taking a toll on your emotional, professional or social well-being, seek support. A team of medical and mental health professionals can help you improve your relationship with food so you can enjoy better mental and physical health.

Nov. 15, 2016