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  • Writer's pictureCatherine Lott


There's a lot of talk about orthorexia lately, but what exactly is it and is it really harmful?being aware of what you eat has to be a good thing, doesn't it?

Orthorexia is a term with varying levels of acceptance in the eating disorder treatment community. Some eating disorder specialists regard orthorexia as a discrete diagnosis like anorexia nervosa or bulimia nervosa. Others, however, believe that patients with orthorexia symptoms are actually suffering from anorexia. I generally see clients when orthorexia has become a serious and often chronic eating disorder such as restrictive anorexia.

Orthorexia is the term for a condition that includes symptoms of obsessive behaviour in pursuit of a healthy diet and sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia and other eating disorders.

A person with orthorexia is obsessed with defining and maintaining the perfect diet, rather than an ideal weight. She will fixate on eating foods that give her a feeling of being pure and healthy.

Someone with orthorexia typically avoids a number of foods, including those that contain:

Artificial colours, flavours or preservatives

Pesticides or genetically modified ingredients

Fat, sugar or salt


Animal or dairy

Any other ingredients considered to be unhealthy


-Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies.

-Increasing avoidance of foods because of food allergies, without diagnosis or medical advice.

-Noticeable increase in consumption of supplements, herbal remedies or probiotics.

-Drastic reduction in what constitutes an acceptable food choice, to the point that the sufferer's options typically dwindle to less than 10 foods.

-Irrational concern over food preparation techniques, especially washing of food or sterilisation of utensil.

-Similar to a woman suffering with bulimia or anorexia, a person with orthorexia may find that her food obsessions begin to hinder everyday activities.

-Her strict rules and beliefs about food may lead her to become socially isolated, and result in anxiety and panic attacks. Worsening emotional symptoms can indicate the disease may be progressing into a serious eating disorder.

-Feelings of guilt when deviating from strict diet guidelines.

-Increase in amount of time spent thinking about food.

-Regular advance planning of meals for the next day,associated with feelings of anxiety.

-Feelings of satisfaction, esteem, or 'purity' from eating 'clean'.

-Thinking critical and judgemental thoughts about others who do not adhere to rigorous diets.

-Fear that eating away from home will make it impossible to comply with diet.

-Distancing from friends or family members who do not share similar views about food.

-Avoiding eating food bought or prepared by others.

-Worsening depression, mood swings or anxiety


Orthorexia symptoms are serious and impairing, and go way beyond lifestyle choice. Obsession with healthy food can progress to the point where it crowds out other activities and interests, impairs relationships, and become chronic and enduring. When this happens, orthorexia takes on the dimensions of eating disorders such as anorexia or bulimia and becomes physically dangerous.

One effect of this drive to eat only the right foods (and often only in the right ways) is that it can give a person with orthorexia a sense of superiority to those around them. This puts a strain on relationships with family and friends, as they become secondary to holding to dietary patterns.

This obsession with 'clean' food causes a restriction of calories as an increasing selection of food isn’t considered to be good enough. The person with orthorexia will begin to lose weight in a way consistent with a diagnosis of anorexia. If the dietary restrictions continue, malnutrition can result. In some cases, particularly in the case of women with unaddressed co-occurring disorders or another addiction, orthorexia may result in severe malnutrition and weight loss, which can cause cardiac complications or even death.


Sufferers of orthorexia and anorexia may show similarities such as:

-Desire to achieve control over their lives through control of food intake

-Seeking self-esteem and a sense of fulfilment through controlling food intake

-Claiming undiagnosed food allergies or intolerance for avoiding food

-Co-occurring disorders such as OCD or obsessive compulsive personality disorder

-Elaborate routines and rituals around food that result in social isolation


Over concern with weight is one of the primary signs of anorexia, bulimia, and other eating disorders, but is not a symptom of orthorexia. Instead, the object of the orthorexic’s obsession is with the health implications of their dietary choices.

While a person with anorexia restricts food intake in order to lose weight, a person with orthorexia wants to feel pure, healthy and natural. The focus is on the perceived quality or worth of foods consumed rather than quantity.

Signs and symptoms of eating disorders must be evaluated within the context of a person’s feelings, emotions, and self esteem. It’s crucial to seek appropriate clinical advice from a professional with experience treating orthorexia, anorexia and other psychiatric conditions. The obsessive tendencies associated with orthorexia can indicate a co-occurring disorder that should be assessed and treated by appropriately.

Co-occurring disorders commonly seen in women with orthorexia may include:


-Bipolar disorder

-Obsessive compulsive disorder (OCD)

-Obsessive compulsive personality disorder (OCPD)

-Panic and anxiety disorders

-Post-traumatic stress disorder

-Substance abuse disorders.

Recovery involves helping the sufferer develop self-esteem and make positive choices that will allow her to achieve the goal of full eating disorder recovery and, where appropriate, acknowledging the complex emotional challenges that co-occurring psychiatric disorders can create for eating disorder treatment.


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