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What is Orthorexia?

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Orthorexia actually means “fixation on righteous eating.” People who have orthorexia don’t necessarily count calories, nor are they driven by thinness, although they can have those elements. But they do channel perfectionism into eating according to a health standard that is rigid and pure, such as a perfect paleo diet, or only organic and unprocessed foods, etc. It’s about food quality and adherence to “clean” eating. There’s nothing wrong with healthy eating or wanting to give oneself good quality food, and many people who like to eat healthy may identify with the above habits. However, for those who suffer from orthorexia, the disorder begins to affect their social and psychological functioning.

What’s it Like?

Orthorexia is not an official diagnosis in the DSM, but it can certainly feel consuming and debilitating to those who have it. It can feel like a strict religion, in which there is much flagellation if piety is not achieved at every meal and snack. Following the rules feels very soothing, but there could be an obstacle at the next meal that causes anxiety. For some, orthorexia can feel very aligned with someone’s sense of ideal self, but their loved ones are ready to give ultimatums because it’s affecting their social lives. The person with orthorexia may, more and more, choose to stay home to avoid prohibited foods and conflicts with loved ones. It becomes very isolating.

When we restrict ourselves to the detriment of pleasure or free will, we can often rebel with binge sessions on foods outside the rules. When this happens, people with orthorexia may feel extremely guilty or shameful and want to make up for this moment of “weakness” by exercising more, restricting, or beating themselves up endlessly. There can often be a phase of repentance after breaking the rules. People may feel discomfort or pain in their guts from eating foods they consider bad for them. But it’s difficult to parse out whether the stomach clenching is because the food is no good for them, or their anxiety about the food tightens their stomach. And, when we feed our bodies according to rules without listening to our body’s cravings, we can rob our bodies of essential nutrients and health.

How Does It Start?

Orthorexia usually starts as an attempt to get healthy. Many people develop orthorexia after being put on restrictive diets by a holistic practitioner while treating a condition like Candida, mold, parasites, or autoimmune disorder. This can be very confusing, because after much discomfort, people may for the first time feel relief, and then what started as wellness turns into disorder.

Others develop orthorexia through sports that draw perfectionist temperament types such as triathlons, track, rock climbing, bodybuilding, and cross fit. It starts as a specific diet to enhance performance and get that extra edge. Again, this can be confusing because it first feels comforting to have a culture of other like minded people supporting a way of eating, but something feels different to the person with orthorexia. They may feel good at first for adhering to the rules better than anyone, but the prize starts to become loneliness, anxiety, and a feeling of impending failure.

Underlying Components

Similarly to those who have anorexia, people suffering from orthorexia may have underlying traits of OCD and anxiety, along with high persistence and perfectionism. Although on the surface habits appear to be about health, there’s often a component of very rigid thinking and avoidance of vulnerability.

People with orthorexia may be channeling a psychological insecurity into obsession with food because it’s a more tangible and fixable problem. Some feel a spiritual component to their diet, which enhances a feeling of body-mind connection, similar to those who fast for deeper meditation. But there can be an underlying component of escaping the body because uncomfortable feelings live there. People with orthorexia may have an extreme fear about getting sick, which may have stemmed from one’s own health scares or that of a family member’s.


Again, it’s a good thing to want to nourish one’s body and give it health. People recovering from orthorexia may need to widen their version of health to include wholeness—body, mind, heart and soul. Because when we consider all those elements, avoiding our child’s soccer party because there will only be cake and pizza goes against our value to show up for the important stuff. Our values will start to guide choices, and when decisions are made from values, it can diminish the guilt that comes from not adhering to rigid rules.

There’s a balance to health. The dose is the medicine or the poison. Eating an apple a day may keep the doctor away, but eating 20 apples a day and nothing else could diminish nutrients, destroy blood sugar, and activate an autoimmune response. Recuperation is just as important as exertion with exercise. There’s a synergistic effect, in fact. It’s all in the balance.

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