Orthorexia: When Healthy Eating Turns Harmful | STACK Fitness

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Orthorexia: When Healthy Eating Turns Harmful

June 14, 2013 | Heather Mangieri

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A serious dedication to a healthy diet hardly seems like a bad thing.

But for some, the need to follow a "perfect diet" can actually become an unhealthy habit. Their fixation can develop into an obsession—to the point where healthy eating takes control of their lives.

If someone you know refuses to eat foods that aren't "clean," avoids eating out or refuses foods he or she once loved, s/he may be suffering from orthorexia nervosa (orthorexia).

What is orthorexia?

A form of disordered eating, orthorexia is characterized by an excessive focus on consuming only healthy foods. It was first discovered in 1997 by Dr. Steven Bratman, a Colorado physician, who noticed over time how certain patients become obsessed with the "perfect diet."

Orthorexia usually starts off innocently. A person changes his or her eating habits for a good reason, like losing weight or a medical diagnosis. In my athletes, I've noticed that it often starts with the knowledge that combining the right nutrients helps them obtain a competitive advantage.

Over time, the drive to be "healthier" and observe the "perfect diet" turns obsessive. Orthorexics become compulsive about calorie counting and meal planning. They overly stress about their foods' nutrient values and whether the foods are organic and free of pesticides; and they may avoid social gatherings around food.

For someone suffering from orthorexia, eating with friends and family, especially in restaurants, is an angst-ridden process. This is because the thought of eating "unpure" food causes an extreme amount of anxiety. They also tend to have strong opinions about how others eat.

What's wrong with orthorexia?

With obesity becoming a national epidemic, orthorexia may seem like a legitimate healthy eating behavior. But someone suffering from orthorexia doesn't enjoy a healthy relationship with food like a normal person does. The desire to eat a "structured," "perfect" diet is actually severely unhealthy. (See Are You at Risk for an Eating Disorder?)

As their focus on eating healthy foods intensifies, orthorexics have a reduced quality of life. Their desire for control  ultimately wears them down to the point where the need to plan daily meals becomes like a stressful workday.

If not treated professionally, orthorexia can have serious mental and physical health consequences. This is because sufferers often harbor misunderstandings about food and nutrition. They don't fear becoming "fat" like an anorexic, but the nature of their food restriction is similar.

Orthorexics eliminate entire food groups from their diets. And in their quest for the "ultimate" healthy diet, the process of elimination continues to the point of malnourishment. This happens in extreme cases of orthorexia when an individual eliminates critical nutrients (e.g., fats, proteins or carbohydrates) from their diet.

How you can tell if someone you know is suffering from orthorexia?

People suffering from orthorexia may:

  • Spend more than three hours a day thinking about healthy food
  • Plan meals more than 24 hours in advance
  • Criticize others who don't eat as they do
  • Skip "unhealthy" foods they once loved
  • Feel stress related to eating
  • Avoid social gatherings at restaurants or events where they can't prepare the food
  • Feel guilty if they are deterred from their healthy eating plan

People with orthorexia nervosa live lonely lives. They obsess about what they eat and how they obtain food, and they feel bad about themselves if they fail in their plans. (Learn more in Eating Disorder Warning Signs.)

Healthy eating is important, but stress should not be on the menu. Stress is just as harmful to the body (if not more harmful) as many foods. Healthy eating should feel good. To the sports dietitian, there are five characteristics of a healthy diet: variety, moderation, calorie control,  balance and adequacy.


Health Food Junkies: Orthorexia Nervosa: Overcoming the Obsession with Healthful Eating," by Dr. Steven Bratman, with David Knight. New York, Broadway Books, 2001.

Ed. Note: Please contact STACK Expert Heather Mangieri to learn more about orthorexia nervosa or if you think you may be suffering from this disorder.

Heather Mangieri
- Heather Mangieri is an award-winning expert in food and nutrition and a board certified specialist in sports dietetics. She owns Nutrition CheckUp, a nutrition...
Heather Mangieri
- Heather Mangieri is an award-winning expert in food and nutrition and a board certified specialist in sports dietetics. She owns Nutrition CheckUp, a nutrition...
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