Orthorexia: When Eating Well Becomes an Illness

Woman on the beach struggling with co-occurring disorders

Contributor: Chelsea Clarke, MS, RDN, LD of EDEN Treatment Center

Variety, balance and moderation. These are the essential hallmarks of a healthy diet. Food is intended to be an enjoyable aspect of life while providing the nourishment required to keep a body functioning well. Unfortunately, due to factors such as social media, the diet industry, and our country’s unwavering commitment to thinness, how and why people consume foods has altered radically in recent decades.

What is Orthorexia

Although not yet included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), orthorexia nervosa is on the increase, as is the number of people seeking treatment for it.

Orthorexia entered the public consciousness in 1997 through Stephen Bratman, a medical doctor. He identified a paradox in many of those who were profoundly committed to healthy eating. Although their stated intention was to promote positive health, their restrictive, obsessive behaviors achieved the exact opposite effect.

A woman with this disorder is consumed by the necessity to eat only “good” foods and cut all “bad” foods from her diet. This black-and-white approach to food is referred to as dichotomous thinking and is unhealthy. Food should never be given positive or negative labels.

As with most eating disorders, the initial steps are well-intended and start quite innocently. It can start with any “health” food guideline combined with a little bit of science. In no time at all, it evolves into a strategy defined by rigid, unhealthy rules and a very short list of acceptable foods. Popular buzzwords such as “clean” and “pure” determine what appears on her daily menu.

This fixation with doing what is right is often exacerbated by a passion for the environment. Acceptable foods are those that leave the smallest carbon footprint. Initially, this may appear healthful, but it is not.

The human body requires everything from vitamins and minerals to protein, carbohydrates and healthy fats to maintain homeostasis. Obviating entire food groups can lead to malnutrition, illness, and even death.

Another component of orthorexia is equally troubling. Those with this disease engage in extensive fact-based research and are therefore, very knowledgeable about food, agriculture and nutrition. This need to know everything ultimately proves deleterious.

Vegetarian man working on Orthorexia and HealthAn individual with orthorexia spends hours researching products, planning meals, searching for stores that carry clean food, and then standing endlessly in grocery aisles analyzing ingredient labels. Such pursuits inevitably take time away from work, hobbies, recreation, and, importantly, family and friends. Social isolation often becomes the norm.

The very idea of having to attend a family function or social engagement at a restaurant where food has not been vetted can trigger a full-fledged anxiety attack. Frequently, the only solution is to bring food to the event, which can be socially awkward and offensive to others.

A woman with orthorexia is often very strict, controlling and self-righteous—she may be convinced her belief system and behaviors are just and correct. Therefore, and by default, everyone else in the world is wrong.

A woman can live in the shadow of orthorexia for a long time. However, when this disordered eating starts to compromise her body, destroy relationships or infringe on work, treatment is encouraged. With the right clinical team, a woman can restore her health and develop a positive relationship with food.

**Please note that though this article is addressed toward females, orthorexia and all eating disorders are experienced by various genders.


Eden Treatment Center, a Las Vegas-based program, was launched in 2020 to meet a critical need. Women 18 and older were searching for a private, protected environment to heal from an eating disorder.


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 July 22, 2020, on EatingDisorderHope.com
Reviewed & Approved on July 22 2020, by Jacquelyn Ekern, MS, LPC