While maintaining a nutritious diet is a commendable goal, it can sometimes cross a line and disrupt daily life. With the proliferation of fad diets, the protein-enhancement of countless products, and wearable technology that monitors various biometrics, it's easy to become engulfed in the health-obsession trend. Additionally, the vast amount of information available online and on social media makes it challenging to discern what is truly necessary for one's health, particularly in nutrition. Videos across platforms often label foods as "bad" or containing "fake ingredients," further fueling a societal fascination with "eating healthy."
Understanding Orthorexia: A Growing Concern
Although there is nothing inherently wrong with eating healthily—it's an excellent way to support overall well-being—there is a threshold that healthy eating can surpass. An excessive focus on it can evolve into orthorexia, a condition that is becoming more prevalent in society. Research indicates that this increase is largely attributed to pressure from social media.
Orthorexia is not listed in the DSM-5, the official handbook for mental health diagnoses, but dietitians anticipate it may become an official diagnosis in the future. "It's subclinical disordered eating, so it doesn't have a clinical diagnosis code, but it's widely recognized in the disordered eating community," explained Beth Auguste, a maternal wellness dietitian based in Philadelphia.
"[Orthorexia] can be generally categorized as a preoccupation with healthy eating and a fixation on the purity of food," Auguste added. Beth Heise, a registered dietitian with OnPoint Nutrition, further described it as "an obsession with what someone perceives as the proper way of eating, or the healthy way of eating."
Distinguishing Healthy Habits from Harmful Obsessions
Since many people enjoy healthy foods or use diet to manage health markers like cholesterol and blood sugar, it can be difficult to differentiate between a balanced diet and a dangerous fixation. "It's so hard to spot that even professionals can have trouble spotting it—they kind of question, like, is this person just really healthy, or is [it] bordering on a disorder?" Auguste noted.
Below, Auguste and Heise outline the signs that may indicate a shift into orthorexia territory and provide guidance on what to do if concerns arise about eating habits.
Signs You May Be Crossing into Orthorexia
- Extreme Food Restrictions: "[Orthorexia] can show up some of the same ways that anorexia shows up, where it can be restricting—not eating certain food groups, having a lot of anxiety if you are not having full control over the food that you're eating and the source that it comes from," Auguste said. Heise added that this often involves creating rigid rules, such as only allowing brown rice and never making exceptions for white rice. "It winds up becoming less about healthy eating, which is usually what it starts out as, and more about an unhealthy obsession with food purity or 'clean eating,' or 'proper eating,'" Heise explained.
- Social Life Interference: "When it crosses the line is when it starts to interfere with your activities of daily living," Auguste stated. If stress about food leads to declining social plans due to uncertainty about the food situation, it could be a red flag. "When it impacts your ability to live socially in the world, comfortably, then it's a problem that you should address," Auguste emphasized. Heise noted that it becomes "less about the average person concerned about healthy food, and more just really obsessing about it where it's almost your personality."
- Excessive Ingredient Analysis: While checking ingredient lists and nutrition labels is normal, especially for allergies or specific goals, those with orthorexia may find themselves "compulsively, all the time, analyzing all the ingredients," Heise said. This can result in hours spent meal planning or researching the nutrition of every ingredient.
- Anxiety or Guilt from Breaking Rules: "I think the line comes when you start to feel like you're thinking about [healthy eating] all the time," Heise remarked. If anxiety or nervousness about eating something occurs frequently, or if guilt follows breaking food rules, it may indicate overthinking. Auguste added that any disruption to mental or physical health should prompt consideration of seeking help.
Steps to Take If You Recognize These Signs
With support from a dietitian or mental health professional, you can assess whether your healthy eating is simply that or something more concerning. "It's really important to talk to somebody like a dietitian who specializes in disordered eating, a therapist who specializes in it, who can help you figure out [if this is a problem for you]," Auguste advised. Dietitians often accept insurance and can guide you toward appropriate eating habits, regardless of specific concerns.
"You can definitely recover from orthorexia if you have the right support," said Heise, "so, as soon as you feel those feelings, address it as early as possible so that it doesn't turn into something that rules your life."
Embracing a Balanced Approach to Nutrition
Healthy eating is a lifelong journey that doesn't require perfection. Nutritional needs vary from person to person, so it's essential not to overly rely on social media trends or friends' diets, Heise suggested. Instead of fixating on the latest food craze, focus on realistic goals—"so, not focusing on whether or not a food is clean, but focusing on whether or not you have variety in your meals," Heise said. "Are you getting a variety of different foods? Are you getting a variety of different nutrients? Because that's where true nutrition comes in."
Auguste highlighted the importance of avoiding all-or-nothing thinking, which includes rigid diet plans. "I have so many patients that do that, and then it's not sustainable to be 100% all of the time," she noted. When individuals deviate from such diets, they may feel like failures and give up entirely. "I feel like that is a downside for somebody with orthorexia, is that you are afraid of letting go of the 100%, and you're afraid that if you let go, that you fall back into that nothing," Auguste explained.
Finding a middle ground and reminding yourself that perfection isn't necessary is crucial. "You can say to yourself, 'I usually eat healthy.' You don't have to say, 'I always eat healthy,'" Auguste said. Using "always" language can introduce concepts of failure and self-judgment. It's perfectly acceptable to enjoy occasional treats without viewing it as a failure.
"The more practice you can get of letting yourself find the middle, where you're not 'always,' you're just 'usually' doing something, I think the better," Auguste added. Throughout this process, practice self-compassion, as societal pressures often make it difficult to be forgiving about food choices.
"Eating and healthy eating in general, is just a lifelong journey. It's not really a set of rules and a one-and-done; it's something that you engage in throughout your lifetime," Heise concluded. Dietary needs and preferences may change over time, and occasional indulgences won't have a significant impact. Focus on obtaining what you need throughout life rather than striving for unattainable perfection.
If you're struggling with an eating disorder, support is available by calling or texting 988 or chatting at 988lifeline.org.
