Avoiding Orthorexia: Maintaining Nutritional Balance at College

Contributor: Staff at Timberline Knolls Treatment Center

Healthy breakfast on a meal plan while avoiding orthorexiaEating healthy food is an advisable, even an admirable, pursuit in today’s world of fast food dining and the obesity epidemic. However, a person hyperfocused on “healthy eating” needs to be cognizant of avoiding orthorexia.

But, just as most people know that one alcoholic drink may be fine, but ten are too many, behavioral health professionals also recognize that healthy eating, when done to an extreme, can be very dangerous, even lethal.

Orthorexia Nervosa

The term orthorexia was coined in 1997 by Dr. Steven Bratman, the author of the book Health Food Junkies. Even though the condition is not formally recognized in the Diagnostic and Statistical Manual, awareness about orthorexia is on the rise.

Orthorexia is defined as an obsession with righteous eating. Although this definition appears relatively benign, this eating disorder is concerning and dangerous.

There is no problem showing concern about the nutritional quality of your food. However, individuals with orthorexia become so fixated with the idea of “healthy eating” that ithey often allow food choices to be a character reflection upon themselves, rather than just a choice of what to eat.

Those with orthorexia are often fairly obsessed with a health lifestyle. Their devotion to “clean eating” transcends mere practice and ultimately functions more like a religion.

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In the absence of an official diagnostic criteria, the precise number of people who have orthorexia remains uncertain. Furthermore, there is still ambiguity as to whether orthorexia is an independent eating disorder similar to anorexia.

Or, is orthorexia an extension of obsessive-compulsive disorder? Studies have shown that many people with orthorexia also have obsessive-compulsive disorder.

Avoiding Orthorexia: Preoccupied with Nutrition and “Purity”

Those struggling with Orthorexia are inordinately preoccupied with the nutritional content of what they eat. All foods they deem “unhealthy” are avoided, and they often spend extreme amounts of time and money in search of the “most pure” foods.

Their passion is not confined to personal food consumption but is frequently global in nature. If any food item can be even tangentially connected to the destruction of wildlife, deforestation of the planet, the polluting of groundwater, or any other such unacceptable activity, then that food may be demonized.

This pathological obsession often permeates all aspects of their lives. They must bring food with them everywhere and often refuse to travel due to the tremendous fear that clean food might not be available.

Extreme diets like fruitarianism are, at times, similar to orthorexia. They do not provide nutritionally sound diets and are fraught with obsessive behaviors.  Even with a nutritionally sound diet, what needs to be prioritized is not the theory or science behind it – it’s how it impacts you as a person.

Healthy Habits Taken to the Extreme

As is the case with so many eating disorders, it can begin quite innocently. An individual may be making a genuine effort to eat healthier in order to take better care of their body.

This may start with eliminating white sugar and flour, cutting out processed foods, and increasing the intake of fruits and vegetables. If the pursuit of good nutrition and health stops there, it may be okay.  Still a very restrictive diet which can lead to food obsession, binge eating and other disordered eating behaviors though.

In the case of orthorexia, the pursuit never ends. Foods are labeled “good” and “bad.” Very few foods are deemed pure enough for inclusion in the good group, the person struggling with orthorexia likely eats an extremely limited diet.

A Healthy Eating Obsession

Bowls of food for a balanced diet while avoiding orthorexiaIn the development and maintenance of orthorexia, untold hours are spent reading books or medical journals on healthy eating.  Also, scouring the internet for the latest research that validates their commitment to clean eating. If a study fails to reinforce their chosen lifestyle, it is eschewed as bad research.

An equal, or an even greater amount of time, is spent dissecting ingredient labels on food products. They are often convinced that deadly toxins, artificial chemicals or non-life-affirming materials lurk somewhere inside, just waiting to be discovered.

The committed orthorexic will unearth these items, then righteously return the food to the store shelf.

Avoiding Orthorexia Due to the Damage

This dedication to disordered eating eventually damages social relationships. An orthorexic rarely goes to restaurants. Even ordering a salad with no dressing can cause severe anxiety.

They do not know where the produce was harvested; if pesticides were involved in growing the lettuce; or if dye was injected into the tomatoes to make them appear more vibrantly red. If invited to a dinner party, they will come late, claiming to have already eaten.

They genuinely believe that the way they are conducting their lives is absolutely right; therefore, everyone else, by default, is wrong.

They will spend hours proselytizing to friends, hoping for converts. Outright lectures on the evils of junk food or refined food are the norm.

Anorexia and Orthorexia

Although orthorexia and anorexia are very different disorders, they are similar in certain regards. Anorexia results in weight loss due to the refusal of food, whereas orthorexia leads to diminished weight due to the refusal to consume anything but pure food. Ultimately, food becomes synonymous with fear.

Both conditions are highly restrictive, rigid, and defined by complicated rules. Prolonged anorexia or orthorexia can lead to anemia, cardiovascular breakdown, other glandular disorders, amenorrhea (discontinuation of the menstrual cycle), and death due to malnutrition.

Young women with anorexia are 12 times more likely to die than other women the same age that do not have anorexia. They also often share certain personality traits such as perfectionism and the need to control.

Interestingly, those with these disorders are often very proud of their behaviors. They perceive themselves as better than others because of the intense self-discipline required to live as they do.

Orthorexia and Exercise

Exercise benefitsThe concept of orthorexia continues to evolve. One significant change is the recent inclusion of obsessive exercise.

Research shows that most of the people with orthorexia are also exercise enthusiasts. For some, the exercising is just as important as eating.

However, it is important to keep in mind here that the term orthorexia itself refers to an obsession with diet and not with exercise.

The Line between Health & Obsession and Avoiding Orthorexia

The line between health and obsession is not always clear.  Here are some behaviors that may indicate you are struglling with orthorexia:

  • Consuming a nutritionally unbalanced diet due to concerns about “food purity.”
  • Preoccupied with how eating impure or unhealthy foods will affect physical or emotional health.
  • Rigidly avoiding any food you deem to be “unhealthy,” such as those containing fat, preservatives, additives or animal products.
  • Spending three or more hours per day reading about, acquiring, or preparing certain kinds of food you believe to be “pure.”
  • Feeling guilty if you eat foods, you believe to be “impure.”
  • Being intolerant of other’s food beliefs.
  • Spending an excessive proportion of your income on “pure” foods.

If these behaviors describe you or someone you know, seeking help from a professional is advised.


(n.d.). Retrieved from http://www.orthorexia.com/

Orthorexia. (2018, February 22). Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

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Timberline Knolls Residential Treatment Center provides quality, holistic care to women and adolescent girls ages 12 and older. We treat individuals struggling to overcome eating disorders, substance abuse, mood and anxiety disorders, trauma and post-traumatic-stress-disorder (PTSD), and co-occurring disorders. Our campus is located on 43 wooded acres just outside Chicago. This peaceful setting offers an ideal environment for women and girls to focus on recovery.

The opinions and views of our guest contributors are shared to provide a broad perspective of 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.

Reviewed & Updated on August 20, 2019, by Jacquelyn Ekern MS, LPC
Originally Published January 20, 2015, on EatingDisorderHope.com
Current version updated with statistics, recent research & video.