Orthorexia Nervosa: When Clean Eating Becomes an Obsession


What is orthorexia nervosa, and could you be struggling with this eating disorder?

You take extra precaution to read ingredient labels and avoid any ingredients that you’ve heard are bad for you. You might feel that anything less than whole, unprocessed, organic foods shouldn’t have a place in your home or in your body, and you take pride in following an extremely clean diet.

You scrutinize labels, ingredients, food sources, and might even worry about how foods are grown, handled and prepared. Creating a sense of purity in the way you eat feels like an achievement, but the rigid food rules you might have in place might be taking up too much of your precious mental space.

Does this sound familiar?

Is it possible for your focus on healthy eating to go too far to the point that it actually becomes unhealthy?

After all, taking steps to ensure that you and your family are eating healthy foods and following a healthy lifestyle seems like a good thing, right?

But can there be too much of a good thing, especially when it comes to eating and food choices?

The answer is YES. It is possible to be so wrapped up in healthy eating that it actually becomes an obsession or creates disordered eating behaviors in your life.

For some women, the desire to follow healthy diets can actually create obsessive behaviors that become detrimental to overall mental health and physical well-being. For some, the preoccupation with eating “clean” and following a healthy lifestyle can begin to interfere with relationships or normal daily life.

An obsession with healthy eating can actually be classified as a type of eating disorder known as Orthorexia Nervosa. What is this eating disorder and the symptoms of orthorexia? Let’s take a closer look.

What is Orthorexia Nervosa?

Eating disorders are commonly associated with the more known mental illnesses, such as anorexia nervosa and bulimia nervosa. Although lesser known, Orthorexia Nervosa can be just as damaging and can negatively impact a woman’s life, including her family and loved ones.

Because orthorexia is often hidden under the guise of “healthy eating”, it is often missed or not picked up on. In fact, our society and culture often praise and elevate those individuals who are vested in healthy eating and lifestyles. So when does this become a problem that should trigger concern?

Orthorexia can be described as an unhealthy preoccupation with eating foods that are considered “clean” and “pure”. With orthorexia, a woman will rigidly avoid foods that are considered to be unhealthy, and as a result, can cut out a majority of foods from her diet.

Women dealing with orthorexia may be more concerned about the quality of foods they are eating rather than the quantity. This is in contrast to eating disorders, such as anorexia nervosa, where there is an overall restriction with intake.

Orthorexia is defined by a fixation on the quality of the food itself: whether or not it is organic, whether it is considered a “clean” food, where it is sourced from, or whether or not it has additives, preservatives, etc. Foods that don’t meet the rigid criteria of what is considered healthy, clean and pure are often cut out.

Many women struggling with orthorexia avoid eating these foods at all costs, to the point that they may restrict certain foods or entire food groups.

A woman with orthorexia may avoid social functions, eating out with family or friends, or eating anything prepared by other people, as there can exist an underlying fear and anxiety about the ingredients used, where the food came from, and more.

Some of the common foods that might be feared or restricted with orthorexia might include:

  • Packaged or processed foods

  • Foods that are non-organic

  • Foods with added sugars

  • Anything with preservatives, additives, hormones or genetically modified ingredients

  • Foods high in fat or salt

  • Fast-food, or foods from chain restaurants

There is often a sense of morality attached to food, where foods are clearly defined by a “good” versus “bad” label. With orthorexia, if and when a “bad” food is eaten, whether intentionally or accidentally, this can create intense shame and self-loathing.

On the other hand, the amount of mental effort and time that goes into following rigid food rules that are part of orthorexia can also create overwhelming anxiety and angst around eating.

The strict following of a diet that is deemed clean can create a sense of superiority, as though a degree of righteousness is obtained from how a person eats and/or the type of foods she chooses to eat.

What Causes Orthorexia Nervosa?

Eating disorders, such as orthorexia nervosa, are severe mental illnesses that can be influenced by a variety of factors.

When it comes to eating disorders, be aware that there is no single cause that can contribute to the development of these illnesses.

Eating disorders, including orthorexia nervosa, are the result of many different triggers, including:

  • Genetics, where some individuals may be genetically predisposed to having an eating disorder

  • Certain character traits, including perfectionistic tendencies or obsessiveness

  • Co-occurring mental health conditions, such as anxiety or depression

  • Family history

  • Psychosocial factors, including the experience of trauma, violence, bullying, health scares, or physical/emotional/sexual abuse

  • The experience of a major life transition, such as the birth of a child, loss of a loved one, relocation, etc.

  • Environmental stressors, such as exposure to fad diets

The experience of multiple risk factors often trigger the development of an eating disorder. Eating disorders are often misunderstood to be illness of “vanity”, where a person is thought to purposefully engage in these destructive behaviors for reasons directly related to their appearance.

However, this is an eating disorder stigma that perpetuates dangerous myths around these serious mental health disorders. In the case of orthorexia nervosa and other eating disorders, there are multiple contributing factors involved - many which are not in a person’s choosing or control - such as their genetics, neurobiology. and the experience of trauma.

What are Signs of Orthorexia Nervosa?

So how might this play in real life?

You might be struggling with orthorexia if:

  • You have an obsession with healthy food and clean eating that preoccupies your time, energy, and mental space

  • You feel anxious if you don’t have control in how food was prepared or if you’re unsure what ingredients are in a dish

  • You avoid eating with others or social functions due to lack of food options that meet your criteria of what is “safe” and “healthy”

  • You’ve cut out a variety of foods or entire food groups because you’re worried that they are unclean or bad for your body

  • You feel guilty, ashamed, or anxious about eating something that is unclean or unhealthy

  • Your food choices of what you can eat are extremely limited

  • You regularly try different methods of cleansing your body or extreme forms of dieting to rid it of impurities, like juicing, fasting, supplements, diet cleanses, etc.

  • If you have a family, you may rigidly impose your guidelines on your partner, spouse, etc of what they are allowed to eat and not eat

  • Your preoccupation with healthy eating leaves you little time to focus on the things and relationships that matter most in life

  • You obsessively research the nutritional values or ingredients of foods or dishes

  • You have a specific method of preparing your meals and spend an excessive amount of time planning out future meals

  • You’ve become socially isolated for fear of deviating from your dietary regimen

  • You fear eating foods that are processed, packaged, or anything that is not considered a whole food

  • You idolize certain people, accounts, social media platforms, blogs, etc. that promote “clean” eating

  • Any violation of your dietary rules can create extreme emotional distress

  • You pride yourself in achieving a perfect sense of health through the foods you eat, exercise regimen, etc. and feel inadequate when you’re unable to measure up to your own standard of health

Orthorexia Symptoms: Impact on Physical and Mental Health

Interestingly, research has found that while so many steps will be taken to reach a goal of perfect health, individuals with orthorexia typically experience diminished physical and mental health with symptoms that may be due to severe dietary restrictions.

Because food choices can become extremely limited, malnourishment, weight loss and poor mental functioning can result in a woman dealing with orthorexia.

Some of the common physical symptoms of orthorexia may include:

  • Fatigue and lethargy

  • Digestive issues, such as constipation, bloating, indigestion, or gastrointestinal discomfort

  • Skin changes, such as dryness, flakiness, or increasing breakouts

  • Weight fluctuations

  • Sleep disturbances

  • Cardiac complications, in cases of severe malnutrition

Orthorexia behaviors may also result in mental symptoms, such as:

  • Mood swings or drastic mood changes

  • Anxiety or mood disorders, such as depression

  • Co-occurring addictive behaviors

  • Poor self-esteem

  • Negative body image

Some individuals may struggle with co-occurring mental health issues alongside orthorexia, such as anxiety disorders, including obsessive compulsive disorder.

Orthorexia Eating Disorder: Redefining a Healthy Relationship With Food

Does it mean that it’s wrong to care about choosing organic foods or being intentional about including more whole foods in your diet or avoiding processed, packaged foods? Of course not. What is more important is to understand the intent behind your behaviors and how your overall food choices are impacting your relationship with your body.

If your behaviors around food are causing you stress, anxiety, fear and guilt - these are red flags that should not be ignored. Pursuing health and wellness should never include feelings of guilt, shame or fear, and it is precisely these feelings that can actually make you unwell, physically and mentally.

True wellness includes having a healthy relationship with food and your body. Developing a healthy relationship with food means being able to relate to food and your body in a positive way; one that allows you to experience joy, satisfaction, and nourishment from eating, not anxiety, stress, guilt, or self-loathing.

A healthy relationship with food is not defined by the kinds of foods you eat, nor is it something that can be perfected by food choices.

It is about building an alliance between your body and food so that you can eat from a place of trust, flexibility, permission and joy. This is the foundation for a healthy lifestyle, not rigidity, chaos, or compensation.

If you’re constantly stressed about only eating certain types of foods and avoiding others, this is not healthy for your mind or body. Often the severity of stress that women regularly expose themselves to when following rigid food rules is more harmful for their health than any food they could possibly eat.

Orthorexia Treatment and Eating Disorder Help

If you are struggling with these things, please know that you are not alone and that there is hope for living a life that allows you to be free from overwhelming food rules and the anxiety that often comes with them.

It is possible to achieve a true sense of health without being obsessive about eating a certain way or following any extreme form of eating.

It may feel counterintuitive to follow food rules or a rigid eating pattern to get healthy. After all, all these things are encouraged in our society and often praised by everyone around us. Our social media feeds and media is infiltrated with “fitspiration”, but what is really lying beneath the surface?

You have to remember, eating disorder behaviors are reinforced by the pervasive diet culture we live in, but you don’t have to live this way anymore. This is not a true sense of health, living, or freedom.

It’s important to understand that you don’t need to fit into a certain criteria to get help for an eating disorder. If eating is a struggle, if you feel at war with yourself and your body, if you don’t regularly experience freedom and joy around your food choices and how you care for your body - these are enough indicators that you may need help.

To start, consider reaching out to a nutritional therapist or eating disorder dietitian who understands intuitive eating and who can help you heal your relationship with food. You don’t have to do this alone, and there are many people and resources you can help you form a trusting alliance with food and your body.

Understand that eating disorders, like orthorexia nervosa, are complex mental health illness; therefore, having a comprehensive treatment plan can be an effective approach for recovery.

This might include treatment that offers:

  • Nutrition counseling

  • Meal support

  • Psychotherapy or therapeutic modalities with a trained therapist

  • Support groups

  • Medication management

  • Check-ins with a physician

Because every person has unique needs, having an individualized treatment plan for orthorexia is important.

Orthorexia Recovery Strategies For Moms Who Want a Healthy Relationship With Food

Are you missing out on your kids’ lives because of an unhealthy preoccupation with clean eating? Do you hyperfocus on what your child is eating or feel like you need to strictly control their diet?

In many ways, creating a tight sense of control around your health and food can create a superficial sense of having it all together, especially when your life or environment feels chaotic (um, hello motherhood!). But again, extreme rigidity and obsessiveness around food choices and eating habits can be dangerous, for you and your family. Orthorexic tendencies can develop at any stage of motherhood, including pregnancy, postpartum, or while raising children.

Many mothers who struggle with orthorexia may unintentionally pass on dangerous eating behaviors and habits to their kids. If a mom has an unhealthy relationship with food, her children may learn that food is unsafe or that their bodies cannot be trusted.

If you are a mother who may be dealing with orthorexia tendencies, know that there is hope. By focusing on healing your own relationship with food, you are also building trust with your child around food and breaking a generational cycle of disordered eating.

Work with an eating disorder professional to help support your healing and to implement some of the following orthorexia recovery strategies:

  • Learn to practice flexibility with meal planning and food preparation

  • Exposure to eating fear foods to increase flexibility and food neutrality

  • Decrease anxiety and obsessiveness around food and eating

  • Eliminate rigid food and eating rules

  • Rebuild trust with your body through intuitive eating

Remember that food is not something that should be perfected, but rather, something that should be shared and enjoyed, for you and your loved ones.

If you need help or more resources, please connect with me today, or visit the National Eating Disorder Association for more information.