Orthorexia Nervosa: Symptoms, Risks, and Treatment of Obsessive Healthy Eating

An extreme focus on “clean eating” can lead to malnutrition, anxiety, and social isolation. Here’s how to recognize orthorexia and when to seek help.

Many people are familiar with eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder. Though those are among the most well-known, they are far from the only eating disorders that people may experience.

What is orthorexia nervosa?

According to the National Eating Disorders Association, orthorexia nervosa is an eating disorder characterized by an obsession with eating healthy foods. Of course, this isn’t a concern in and of itself, but people with orthorexia nervosa tend to go beyond mere healthy eating and take things to an extreme, often experiencing weight loss, malnutrition, and other health problems because of their restrictive diets.

“People with orthorexia nervosa are often very concerned with the ingredients on food labels,” says Eytan Stern, M.S., R.D., a clinical dietitian for the Crohn’s & Colitis Center with the University of Miami Health System. “What ends up happening is they begin eliminating entire foods groups, such as carbs, dairy, animal proteins, and the like. The result can end up being micronutrient deficiencies and malnutrition.”

Though orthorexia nervosa is not officially listed in the most recent version of the Diagnostic and Statistical Manual for Mental Illnesses (DSM-5), a growing number of health professionals recognize the condition as a distinct disorder and treat it as such. In fact, a 2022 article in the medical journal Eating and Weight Disorders provided a definition and diagnostic criteria for the disease.

“A variety of factors play a role in the development of eating disorders, but certain sources of information, such as social media, may be driving some cases lately,” says Stern. “As practitioners become more aware of the condition, it becomes easier to spot and diagnose.”

Recognizing orthorexia

According to Stern, recognizing that someone has orthorexia and needs medical care can be challenging, since a focus on healthy eating is often perceived positively.

“It can seem like a good thing upon your initial conversation, but you may need to do a little more digging to recognize if a problem is present,” he says. “People with orthorexia go beyond healthy eating and become rigid in their views on food in a way that becomes harmful. For example, they may avoid certain foods entirely, refuse to go to restaurants or eat out with friends, and are constantly thinking about the next food they eat.”

Over time, Stern says these habits can lead to extreme weight loss, nutritional deficiencies, and frequent digestive issues such as nausea, bloating, constipation, and diarrhea.

“People with orthorexia also experience low energy levels, fatigue, anxiety, and other impacts to their quality of life,” he says.

Treating eating disorders

If you think that you or a loved has orthorexia nervosa, Stern says that it’s critical to seek out treatment from a dietitian or another health care professional who specializes in eating disorders. A mental health professional such as a psychologist likely will also be part of the care team.

“Dietitians trained in eating disorder treatment have the tools and resources to help people develop a healthier relationship with food,” says Stern.

“They can teach people to eat intuitively and pay attention to what their body is asking for.” It takes time and plenty of follow-up, but gradually, many people with eating disorders can be successful in overcoming their issues and eating in a way that is truly healthy for their minds and bodies.

Written by Wyatt Myers. Expert review by Eytan Stern, M.S., R.D.

Tags: clean eating obsession, disordered eating patterns, Nutrition, orthorexia recovery strategies