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Orthorexia: Can Healthy Eating Become Unhealthy?


Orthorexia is a term used to describe a dietary pattern in which an individual restricts intake to include only “healthy” foods, such as vegetables or organic foods, but in doing so develops significant problems, such as an obsession with food and severe weight loss. While it is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, some psychiatrists are beginning to study orthorexia and offer treatment to patients.

What is orthorexia nervosa?

People with eating disorders have severe disturbances in their eating behaviors and related thoughts and emotions. They typically become obsessed with food and their body weight, though people with orthorexia are usually more concerned with healthy eating than with being thin.1


Orthorexia often starts as a genuine attempt to live a more healthful life, but then becomes out of control. The term “orthorexia nervosa” is interpreted as “fixation on righteous eating.”1

Veganism and clean eating have seen a surge in popularity in recent years. Many people enjoy these diets and feel that it benefits their health. The decisions to eat food that is closest to its natural state and/or not to eat animal products are not inherently problematic choices or cause for alarm. Being mindful about what we consume is a great way to live a healthy life—it is when the need to eat “good” foods becomes “extreme, obsessive, psychologically limiting and sometimes physically dangerous” that it is disruptive to an otherwise healthy life.2

Why is orthorexia not in the DSM-5?

There has only been limited research on orthorexia, and it is not known precisely what its characteristics are. As Tim Walsh, M.D., an expert in eating disorders, states, we do not know how many people are affected, whether those affected are mostly men or women, at what age it begins, the likely complications or other information that would help this term be a useful diagnosis for treatment.

A major reason for the lack of knowledge is that sound diagnostic criteria for orthorexia have not been agreed upon. Furthermore, Walsh says, a focus on eating “healthy” foods is a common symptom of anorexia nervosa and avoidant/restrictive food intake disorder, both of which are described in DSM-5. For example, there is no reason to believe that individuals with anorexia nervosa who focus on eating “healthy” foods have another disorder.

Due to this lack of information, orthorexia is not included in DSM-5. Substantial research will be needed before it becomes clear how useful the term is for clinicians and patients.

Who is at risk?

In many cases, eating disorders occur together with other psychiatric disorders like anxiety, panic disorder, obsessive compulsive disorder and alcohol and drug abuse problems. New evidence suggests that heredity may play a part in why certain people develop eating disorders, but these disorders also afflict many people who have no prior family history.

If you or someone you know has an eating disorder, there is help available. Talk to your doctor about the treatment options that are best for you. Learn more about eating disorders and their treatment.



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