There’s been growing discussion over the term Orthorexia – what is it? Is it a diagnosable eating disorder? Is it serious? How is eating healthy an eating disorder? Does it require treatment? We’re here to answer those questions and more!

Orthorexia is a condition marked by an extreme fixation over the quality and purity of food. It commonly results in highly inflexible eating patterns, with individuals creating rigid “food rules” which usually consists of segmenting foods that they will eat to categories “good” and “healthy” foods and “bad” foods which are avoided. While some people struggling with eating disorders may focus on limiting the quantity of food with which they consume, people who struggle with Orthorexia typically are far more concerned with the quality of the food.

Individuals with Orthorexia generally will only consume organic, raw and pure foods. A lot of people struggling with this disorder will only eat foods that are local, “farm to table” or become obsessed with “eating clean,” and/or exercise routines. Often times, entire food groups like sugar, meat, dairy and carbohydrates are avoided. A defining feature of Orthorexia is that people struggling will opt NOT to eat if the only food available are those deemed as “impure” or processed. These rigid food rules and behaviors can often result in an unbalanced diet and inadequate caloric intake. Many cases can lead to malnutrition, accompanied by a variety of potential medical and psychological side effects.

Although Orthorexia is not an “official” eating disorder, meaning that it is not described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it can be as serious as other eating disorders and does require appropriate consultation. As its understanding has evolved in recent years, specialized eating disorder treatment providers are equipped to handle most cases of Orthorexia.

Now let’s dive a bit deeper:

Orthorexia is different from “healthy eating” or dieting. Based on its definition, you might think: “I know someone with Orthorexia!” Yes, millions of people diet, strive to be healthy or label foods as “good” or “bad.” What is important to note however, is that just because someone chooses a certain lifestyle for themselves that includes eating in a certain way, it does not mean that they have Orthorexia.

Two key identifiers of Orthorexia versus “healthy eating” is the intensity to which the inflexible eating patterns are enforced, and more so, what happens when someone strays from them. In terms of the diet, does the “good” versus “bad” classification seem arbitrary? Are they cutting out entire food groups without a consultation from a professional? Are they compulsive in their “healthy” eating habits? Do they become highly uncomfortable when “prohibited” foods are nearby? Are they losing weight and critical energy sources because of it? Answering yes to most of these questions can be a cause for concern.

What happens when a diet or exercise rule are broken? If emotional turmoil, distress, shame or means of “self-punishment” – restriction, purging or excessive exercise – results, it could be a case of orthorexia.

The root of the issue is unlike most eating disorders: Conditions like anorexia and bulimia are often driven by a fear of gaining weight, poor body image or dissatisfaction with one’s appearance. While those can play into some cases of Orthorexia, it mostly stems from fears certain foods can cause harm, sickness or disease. Individuals are more focused on the quality of food, instead of quantity.

Orthorexia involves distorted thinking: Individuals with anorexia generally think restricting their food intake is in their best interest, they can reduce weight and feel better about themselves. Orthorexia, too, can also be based on unfounded views. Someone thinks abstaining from a wide range of food types or a more balanced diet can promote their overall health, while in reality, it’s likely causing quite the opposite effect.

The risks are real: Sure, millions have rigid diets, but orthorexia can result in a wide range of health risks, some very serious. A lack of a balanced diet can result in malnutrition and weight loss. Many cases also involve emotional distress, anxiety, depression, and even social withdrawal from friends and family.

While Orthorexia may not be an official eating disorder clinically-speaking, it does warrant serious attention, and in many cases, treatment. Most of today’s specialized providers of eating disorder care can diagnose, provide the right level of support and guide one towards recovery. This includes us.

If you know someone who might be impacted by Orthorexia, we’re here to help!


Michael McDonough is the director of communications at Walden Behavioral Care. Prior to joining Walden in February of 2016, he was the Marketing Communications Manager for the Greater Boston Chamber of Commerce, elevating the organization’s brand awareness and increasing membership acquisition through digital and traditional marketing strategies. He also carries nearly ten years of public relations experience working with dozens of corporate and non-profit organizations.

Michael is a graduate of Syracuse University, where he obtained a Bachelor of Arts in both broadcast journalism and psychology. He is an avid runner, having completed five marathons (including four Boston Marathons). 


*This blog post does not necessarily represent the views of Walden and its management. The Walden Blog is meant to represent a broad variety of opinions relating to eating disorders and their treatment. Comments are welcome, but respect for the opinions of others is encouraged.