Orthorexia & Processing Emotions

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Despite not being an officially recognized eating disorder diagnosis, orthorexia nervosa (ON) has become fairly well-known. Characterized by an unhealthy obsession with “healthy” eating, orthorexia impacts approximately 21 to 57.6% of people in the United States [1].

A great deal of research has been done on symptoms of “official” eating disorder diagnoses such as anorexia nervosa, bulimia nervosa, or binge-eating disorder.

One common symptom that stands out in all of these is alexithymia, or, having difficulty identifying, describing, and regulating emotions. Researchers recently conducted a study to learn whether or not individuals with orthorexia experience similar symptoms.


This word is fun to say and encompasses a lot. It literally translates as “no words for feelings,” and it is used to describe individuals that experience just that – an inability to identify or verbalize their feelings.

It is commonly seen in individuals with psychosomatic problems, substance use, and anxiety disorders, but it is not a hard-and-fast syndrome [2]. Alexithymia exists on a spectrum. As such, there may be some individuals more challenged by symptoms than others [2].

The top symptoms of alexithymia are:

  1. “Difficulty identifying feelings and distinguishing them from bodily sensations (e.g. ‘I have feelings that I can’t quite identify.’)
  2. Difficulty communicating or describing emotions to others (e.g. ‘It is difficult for me to find the right words for my feelings.’)
  3. An externally oriented style of thinking (e.g. ‘I prefer talking to people about their daily activities rather than their feelings.’) [2].”

Alexithymia and Orthorexia

Again, despite alexithymia being commonly seen in individuals with eating disorders, no research has yet been conducted on the potential relationship it has with orthorexia. To learn about this possible relationship, researchers assessed 196 individuals with 4 questionnaires and analyzed the results.

Bowls of food for orthorexiaThe questionnaires used were as follows and given to participants in this order:

  1. Orto-15: A 15-item scale that recognizes orthorexia nervosa symptoms.
  2. Toronto Alexithymia Scale (TAS-20): A 20-item scale that identifies the presence of alexithymia symptoms.
  3. Eating Attitudes Test (EAT-26): a 26-item questionnaire that measures symptoms and characteristics of eating disorders.
  4. Difficulty in Emotion Regulation Scale (DERS-16): A 16-item scale that measures emotion regulation [3].


The study results were what researchers believed they would be – difficulty regulating and identifying emotions was significantly associated with symptoms of orthorexia nervosa [3]. 

Additionally, “individuals with high orthorexia tendencies had more difficulties identifying and accepting their feelings, and resisting impulses, engaging in goal-directed behaviors and finding the right strategies when upset compared to people with low orthorexic tendencies [3].

However, the study did not find that difficulty in describing emotions was associated with orthorexia symptoms.  

The researchers that conducted the study “suggest that orthorexia behaviors may be used as a coping strategy in order to feel in control in these participants who have poor emotion regulation abilities [3].”

The hope is that more research is conducted on this to determine whether or not orthorexia nervosa shares enough symptoms to be “officially” categorized as an eating disorder.


[1] Unknown (2020). Orthorexia: statistics, causes, signs, and symptoms. Retrieved from https://www.therefuge-ahealingplace.com/eating-disorders/orthorexia/effects-symptoms-signs/.

[2] Zaidel, E., Kaplan, J. (2007). The cross-cultural brain – alexithymia. Fragments of Mind and Brain

[3] Vuillier, L., Robertson, S., Greville-Harris, M. (2020). Orthorexic tendencies are linked with difficulties with emotion identification and regulation. Journal of Eating Disorders, 8:15.

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published May 28, 2020, on EatingDisorderHope.com
Reviewed & Approved on May 28, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

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