What is Orthorexia Nervosa?

The term orthorexia nervosa was coined by Dr. Steven Bratman in 1997 to describe situations when pursuing a healthy diet intensifies to the point of obsession and impaired daily functioning. Dr. Bratman has since noted orthorexia to be "an obsessive focus on 'healthy' eating, as defined by a dietary theory or set of beliefs" marked by emotional distress around food choices. More simply put, orthorexia represents a fixation with being "healthy." The concept has evolved beyond food choices and is now commonly found in association with excessive exercise. While orthorexia is not an officially recognized diagnosis in the DSM-V, it can have clinically significant mental and physical consequences worthy of professional support.

One complexity is that orthorexia often starts with intentions to care for oneself through food and exercise. It can be difficult to identify in our diet- and health-centric society, where individuals with orthorexia are frequently praised for being "health conscious." Diet culture permeates modern life, with the wellness industry estimated at 4 trillion dollars. Social media, governmental authorities, schools, healthcare institutions, and mainstream media inundate people with health messaging telling them what they "should" eat. This oversimplified approach to health may contribute to disordered eating behaviors like orthorexia.

Possible Signs of Orthorexia

Disordered eating and eating disorders exist along a spectrum, with differences in symptom frequency and intensity. Dr. Bratman notes that "Interest in healthy eating does not become pathological until obsessive thinking, compulsive behavior, self-punishment, and escalating restriction" emerge. Warning signs include:

  1. Fixating on food quality. Individuals often focus on perceived "purity," preferring organic, locally grown, or raw foods. They avoid GMOs and "overly processed" foods, using labels like "good/bad foods" or "clean ingredients" that add unhelpful morality to eating choices.
  2. Cutting out food groups. Entire food groups like carbohydrates, gluten, or dairy are eliminated based on purported health benefits or pseudoscientific evidence rather than medical necessity.
  3. Maintaining inflexible eating patterns and experiencing emotional distress. Individuals create rigid food rules and experience intense guilt, shame, or fear when rules are broken. This inflexibility indicates quality of life has been impacted.
  4. Experiencing social isolation. Fear around eating out may lead to avoiding social gatherings. People may spend disproportionate time thinking about, shopping for, and preparing food, pushing other interests aside and encouraging others to adopt similar restrictive patterns.
  5. Obsessively focusing on health status. Constant worry about illness and health anxiety may accompany excessive emphasis on diet and exercise at the expense of mental health, social connections, and other life aspects.

A Note on "Health"

Research demonstrates that social determinants of health — including income, stable housing, and food security — play larger roles in wellbeing than individual lifestyle factors. Additionally, "health" definitions vary per person, and not everyone has the opportunity or desire to pursue conventional health measures.

How to Move Forward

Orthorexia presents complexities and manifests differently across individuals. Any food, body, or movement-related stressors warrant professional support. Those with concerns deserve assistance, and help is available.

If you would like support, reach out to us at Woven Nutrition to schedule an appointment.