An unhealthy obsession with healthy eating: examining orthorexia

It’s not uncommon for people to start a new year with plans to become healthier – but is it possible to eat so healthily that it’s actually bad for you?

A growing number of dietitians and nutritionists are examining that question, and the possibility that an obsession with healthy eating could turn into a proposed eating disorder called orthorexia.

What is orthorexia?

Orthorexia nervosa is a term used to denote a harmful obsession with healthy eating.

It was first coined in 1997 by Dr. Steven Bratman in a paper he wrote for the October issue of Yoga Journal.

He says the term is derived from the Greek “ortho,” which means “right” or “correct,” and is intended as a parallel with anorexia nervosa.

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He further examined the idea in his book Health Food Junkies, published in 2004.

“There have always been recommendations regarding the healthiest foods to eat, but in recent decades the obsession over healthy eating seems to have escalated out of control,” says Bratman in the book.

“In more and more people it seems to be taking on the characteristics of an eating disorder like anorexia or bulimia. However, unlike these other eating disorders, orthorexia disguises itself as a virtue.”

Is orthorexia an eating disorder?

So far, orthorexia has not been recognized as a clinical eating disorder by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

In addition, there is a lack of clinical studies conducted on the subject.

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However, the latest publication of the DSM does contain an area dedicated to Feeding and Eating Disorders Not Elsewhere Classified (FED-NEC) and also Avoidant/Restrictive Food Intake Disorder (ARFID). It’s suggested orthorexia could possibly fall into one of those two categories.

READ MORE: Why you should care about changes to the DSM mental-health bible

“We need to do some more research to find out how often it’s a problem, versus just describing how some people are,” says Dr. Kristin von Ranson, associate professor, Department of Psychology at the University of Calgary.

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“Orthorexia hasn’t been studied, so it’s hard to know how much of a problem it is, or if it indeed is a problem for enough people for it to merit being studied.”

“I don’t mean to minimize it,” adds von Ranson. “I think there are people who probably do have extreme versions who need help, who should seek it.”

Von Ranson also suggests that it’s possible in some cases orthorexia could be an offshoot of another disorder, or could lead to other disorders.

“There are different ways to develop Anorexia nervosa, it’s not like it always looks the same,” says von Ranson. “It’s possible that in an extreme form, orthorexia might turn into anorexia.”

“Anorexia nervosa is primarily defined by a significant loss of weight – somebody who is quite underweight for their height and age and gender,” explains von Ranson. “So someone who started restricting their food intake to the point that they lost a great deal of weight, it’s possible they would actually meet the criteria for anorexia.”

Do I have orthorexia?

WebMD has a list of 10 questions they suggest individuals ask themselves when trying to identify orthorexic behavior.

  • Are you spending more than three hours a day thinking about healthy food?
  • Are you planning tomorrow’s menu today?
  • Is the virtue you feel about what you eat more important than the pleasure you receive from eating it?
  • Has the quality of your life decreased as the quality of your diet increased?
  • Have you become stricter with yourself?
  • Does your self-esteem get a boost from eating healthy? Do you look down on others who don’t eat this way?
  • Do you skip foods you once enjoyed in order to eat the “right” foods?
  • Does your diet make it difficult for you to eat anywhere but at home, distancing you from friends and family.
  • Do you feel guilt or self-loathing when you stray from your diet?
  • When you eat the way you’re supposed to, do you feel in total control?

It’s suggested that answering yes to two or three of these questions could indicate you are suffering from a mild case of orthorexia.

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“I definitely had some struggles with aiming for that perfect diet,” said registered dietitian Casey Berglund, who says she may have suffered from orthorexia in the past. “I thought it was just an intention to be healthy and eat well, to help myself manage my weight and do the exercises I wanted to do, but at one point it was a little bit of an obsession – constant thoughts about food.”

Need help?

The National Eating Disorder Information Centre (NEDIC) is a Canadian non-profit providing resources on eating disorders and weight preoccupation.

If you need help, call 1-866-NEDIC-20 (toll free) or visit for more information.

READ MORE: Binge-eating and bulimia have more in common than doctors realize

Eating Disorder Awareness Week is held from February 1-7th, 2015.

“Eating disorders are definitely stigmatized, like other mental disorders, and in some ways maybe it’s even worse,” suggests Von Ranson. “Very few people think that someone would cause depression themselves on purpose, but people do think eating disorders are a lifestyle choice.”

With files from Heather Yourex

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