01.22.24
What’s the Deal With Orthorexia?
It isn’t in the DSM, but it can wreck your life.
Trying to eat healthier—whatever the fuck that means—is a thing a lot of us can probably relate to. But there’s a big difference between attempting to get more green stuff into your fridge and obsessing over things like nutrients, pesticides, ingredients with long names, or other alleged indicators that your food is or isn’t good for you. And if the latter becomes a way of life that interferes with how you function, that could be a sign of orthorexia nervosa—or orthorexia for short.
You might’ve seen people talk about orthorexia on your FYP (the TikTok tag has over 40 million views), but the term’s been around since ‘97. It definitely sounds like a type of anorexia—and some experts think it could be—but, right now, it’s not an official disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). That means it’s not ~technically~ a diagnosable mental health condition.
Still, the experts we spoke to stress that it’s very much a thing people struggle with and mental health pros recognize—it’s also worth seeking help for. Ahead, we explain what orthorexia is, what it looks like, and how to get support.
One quick thing before we dive into the details: Mental health is complex and everyone has a unique experience, so don’t go diagnosing yourself just because you read a few articles on the internet (though, we do appreciate you stopping by to learn a few things). If this resonates with you, consider it a jumping-off point in your journey to getting care. OK, let’s get into it...
What is orthorexia?
When healthy eating becomes a person’s whole life and/or negatively impacts the other stuff they’ve got going on, that behavior could fall into orthorexia territory.
Like we said, there’s no official list of orthorexia symptoms right now, and the issue can look different depending on the person. That said, orthorexia is “an obsessive concern with eating a healthy or ‘pure’ diet that is typically very restrictive,” per the American Psychological Association.
Unlike the eating disorders you might be more familiar with, people with orthorexia symptoms aren’t necessarily trying to make their bodies smaller, says psychologist Christine Peat, PhD, a fellow in the Academy for Eating Disorders and director of the National Center of Excellence for Eating Disorders. Instead, they’re worried about how healthy their food is, she says.
While that all sounds pretty specific, it’s unclear whether orthorexia is its own eating disorder or a type of existing one, like anorexia nervosa. Most of the time, people with orthorexia are diagnosed with an eating disorder called other specified feeding and eating disorder (OSFED), says clinical psychologist Thom Dunn, PhD, a professor of psychological sciences at University of Northern Colorado who researches orthorexia. That basically means they’re showing signs of an eating disorder but don’t meet all the criteria for any of the conditions listed in the DSM-5-TR.
Because of its (lack of) DSM-5-TR status, we also don’t know quite how common orthorexia is. So, even though the definition can sound a lot like your friend who’s obsessed with being a vegan (good for you, friend!), Dr. Dunn says orthorexia is relatively rare. In his experience, he’s seen less than five cases of it in a clinical setting.
What causes orthorexia is just as murky. Dr. Dunn literally called the scientific research on it “messy.” But Dr. Peat says diet culture could definitely be a factor. One study that surveyed 680 women who follow health food Instagram accounts suggested that using the app more was associated with more symptoms of orthorexia.
How can I tell if I have orthorexia?
With all of that gray area, it makes sense if you’re left thinking, “Um, so do I have this or not?” And while, yeah, orthorexia is not uber common, there are a few symptoms that might be worth looking into.
The first one: You feel incredibly guilty or anxious for eating something you deem dirty or unhealthy, says Dr. Peat. People with orthorexia might convince themselves that they did a horrible thing to their bodies after munching on an Oreo even though, in reality, there’s no real damage done, she explains.
Another thing to look out for is an all-consuming obsession with healthy eating. Dr. Peat says this could look like spending hours planning meals or Googling info about different diets and food online.
Because of that fixation, your social life could tank, says Dr. Peat. Going out to eat with friends or attending a party can be torture when nothing on the menu fits your standards. It could even make you want to isolate yourself at home to have more control over what you eat. Any of that can cause some weirdness in your relationships, she notes.
Orthorexia can wreck work too—you might not be able to concentrate on a performance review with your boss because you’re too busy worrying about what you ate the night before. “It's sort of like, how do you get your work done when 75% of your mental real estate is focused on what you eat?” Dr. Peat says.
Finally, your health could be at risk. It’s possible that cutting out certain food groups in the name of health ultimately leads to malnourishment, both experts say.
How is orthorexia treated?
There isn’t a specific treatment for people with orthorexia, according to the National Eating Disorder Association. But, like with a lot of eating disorders, people who show signs of orthorexia would benefit from working with a team of pros, says Dr. Peat. A therapist can help you get unstuck from rigid thought patterns around food, while psychiatrists can prescribe meds for anxiety or depression that might be tagging along with orthorexia, she explains. Plus, a dietitian can help introduce a balanced diet and explain why it’s OK to eat carbs and fats and processed foods. Of course, you could also see a doctor to address any medical issues stemming from orthorexia, Dr. Peat adds.
It’s worth noting that some people might also need to go to an inpatient facility if they’re super malnourished, but it depends on how severe their orthorexia symptoms are, says Dr. Peat.
In the end, if you’re concerned about your relationship with food, whether you think you have orthorexia or not, it's worth reaching out for help, notes Dr. Peat. “Being connected to care may help you get back to a place where you feel more balanced—where food is a part of your life, but maybe not the whole thing.”
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
