What is orthorexia and how does it differ from other eating disorders? Learn more about this condition with this page.

Orthorexia nervosa, commonly referred to as orthorexia, is an eating disorder based on obsessive healthy eating. Someone with orthorexia has taken a healthy diet to an unhealthy level. Unlike other common eating disorders, orthorexia is not about weight loss or food quantity. Instead, orthorexia revolves around the quality of food.

What Is Orthorexia?

Orthorexia has not yet been officially recognized in the Diagnostic and Statistical Manual, the handbook for mental health diagnosis. Despite not having an official set of diagnostic criteria, orthorexia is a potentially dangerous eating disorder. Answering, “What is orthorexia?” is complicated with this lack of set criteria. Several orthorexia definitions exist, each with minor differences. Families Empowered and Supporting Treatment for Eating Disorders, more commonly called FEAST, defines orthorexia as an obsession with eating healthy food and avoiding unhealthy food.

While orthorexia has only begun to be acknowledged by the larger medical community, the term was first coined in the late 90s. The word was created from the Greek root “orthos,” which means “right,” creating the orthorexia meaning of, “right appetite,” or, “right eating.”

Orthorexia vs. Anorexia

Orthorexia and anorexia may on the surface seem similar due to restriction and avoidance of certain foods. However, unlike anorexia, orthorexia does not indicate the restriction of all foods. In cases of orthorexia, the goal is not weight loss but to increase healthfulness. However, both disorders may lead to low body weight and malnutrition.

Signs and Symptoms of Orthorexia

Orthorexia symptoms are contained within two major criteria: an obsession with healthy eating and the disruption of daily life. Signs of orthorexia nervosa may include:

  • Consistent preoccupation with making healthy choices and obsession with achieving optimal health
  • Anxiety or shame about breaking self-imposed rules
  • Severe dietary restrictions that may consist of avoiding entire food groups or doing cleanses and fasts

Some common life disruptions caused by orthorexia include malnutrition, severely low body weight, distress or difficulty functioning due to an obsession with healthy eating, and self-worth being tied to complying with self-imposed rules.

Causes of Orthorexia

In many cases, a desire to eat healthily is positive, and most people want to maintain a healthy diet. Because of this, researchers have asked, “What causes orthorexia nervosa?” Specific orthorexia causes may be hard to identify because what causes orthorexia is a subtle shift where healthy practices are no longer beneficial. Possible risk factors for developing orthorexia include a history of eating disorders and having obsessive-compulsive tendencies. Many people with orthorexia appear to be perfectionists and need to feel in control of their lives.

Orthorexia Side Effects

If left untreated, orthorexia can start to mimic some of the same dangerous side effects of other eating disorders such as anorexia and bulimia. Some of the common side effects of orthorexia include the following:

Physical Effects

Consequences of orthorexia include medical complications like malnutrition and digestive issues. Someone with orthorexia may develop anemia, osteopenia or other conditions associated with poor nutrition. Chemical imbalances involving electrolytes and hormones are common among people with orthorexia. In some cases, these health effects may become life-threatening.

Psychological Effects

Additional orthorexia side effects include distress and frustration when self-imposed rules are broken. Someone with orthorexia may feel guilt and shame when not following strict standards for healthy eating. In extreme cases, someone may self-punish and implement purification cleanses and fasts if a rule is broken. The constant preoccupation of orthorexia may be linked to impaired brain functioning and decision-making skills.

Social Effects

Social effects of orthorexia include a need for control and the implementation of rigid patterns that prevent someone from participating in normal social activities, especially ones involving food. A person with orthorexia may experience social isolation due to their inability to be flexible with their self-imposed standards.

Diagnosing Orthorexia

Because there are no set guidelines for diagnosing orthorexia and no clear orthorexia nervosa test, it can be difficult to diagnose this condition. Some orthorexia quizzes and self-assessment tools are available that may help diagnose this condition.

However, an examination and assessment by a medical professional should be conducted before diagnosing this condition. A doctor may run tests to indicate if adverse health effects have occurred due to orthorexia. Someone is likely to be asked about their eating habits, beliefs about healthy eating and their health goals when being assessed for orthorexia.

Orthorexia Facts and Statistics

Orthorexia statistics are difficult to find as the differentiation between healthy eating and orthorexia is sometimes unclear. Another obstacle in identifying specific statistics is the lack of universal diagnostic criteria. While some orthorexia research reports incidence rates as high as 90 percent of the population, others which more stringently define orthorexia, report rates of one percent or less of the population.

Some important orthorexia nervosa facts to be aware of include:

  • Obsessive-compulsive traits such as perfectionism were more common in people who developed eating disorders than in those who did not
  • Approximately 97 percent of people hospitalized for an eating disorder were found to have a co-occurring condition
  • Among teenagers, those who dieted moderately were found to be five times more likely to develop an eating disorder. Those who dieted to the extreme were 18 times more likely to face eating disorders.
  • One-third of girls report dieting regardless of whether they are overweight

Orthorexia and Co-Occurring Disorders

Without concrete facts and statistics regarding orthorexia, it can be challenging to pinpoint common co-occurring disorders accurately. Orthorexia and exercise addiction may co-occur as both are initially healthy behaviors that become unhealthy when taken to an extreme. People with orthorexia may also be more likely to engage in substance use when they believe that certain substances may assist in meeting self-imposed health rules.

Treatment for Orthorexia

Orthorexia treatment may be delayed due to failure to diagnose the problem. After overcoming this hurdle associated with orthorexia recovery, treatment should include a multidisciplinary team that can address physical and mental health while implementing new, healthy beliefs about food. Seeking advice from medical professionals is advisable as physical consequences of orthorexia may not be visible. Overcoming orthorexia requires a person to unlearn false beliefs about health and nutrition while embracing valid nutritional information.

If you or a loved one has a drug or alcohol addiction and a co-occurring orthorexia issue, reach out to a representative at The Recovery Village today. The Recovery Village has treatment facilities across the country for substance use and co-occurring disorders. Call today and take the first step toward a lifetime of healing.

a woman in a black cardigan smiles at the camera.
Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
a woman with long black hair wearing a dress.
Medically Reviewed By – Denise-Marie Griswold, LCAS
Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more

Nationaleatingdisorders.org “Statistics and Research on Eating Disorders.” National Eating Disorder Association. Accessed February 11, 2019.

Nationaleatingdisorders.org “Orthorexia.” National Eating Disorder Association. Accessed February 11, 2019.

Koven, N. S., & Sebdonmatsu, R. “A neuropsychological evaluation of orthorexia nervosa.” Scientific Research, Published April 2013. Accessed February 11, 2019.

Cartwright, M. M. “Eating disorder emergencies: understandi[…]g disordered patient.” National Center of Biotechnology Information, Published December 2004. Accessed February 11, 2019.

Dunn, T. M., & Bratmam, S. “On orthorexia nervosa: A review of the l[…]diagnostic criteria.” Science Direct, Published April 2016. Accessed February 11, 2019.

Dunn, T. M., Gibbs, J., Whitney, N., & Starosta, A. “Prevalence of orthorexia nervosa is less[…]ta from a US sample.” National Center of Biotechnology Information, Published March 2017. Accessed February 11, 2019.

Koven, N. S., & Abry, A. W. “The clinical basis of orthorexia nervosa[…]erging perspectives.” National Center of Biotechnology Information, Published February 18, 2015. Accessed February 11, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.