Understanding Orthorexia Nervosa

Learn how an obsession with healthy eating can harm physical and mental health

A woman pours a green smoothie from a blender into a mason jar, representing unhealthy eating habits.

Learn how an obsession with healthy eating can harm physical and mental health

We’ve all heard the saying, “Too much of a good thing.” Turns out the adage applies to health, too. 

The term “orthorexia nervosa” was coined by a physician in the late ’90s to describe what happens when healthy eating is taken to the extreme. A fixation on healthy food, a tendency to stick to restrictive diets and labeling certain foods or food groups as “bad” or “dangerous” — to be avoided at all costs — can backfire and lead to a host of unhealthy consequences.

What is orthorexia?

Orthorexia nervosa is not yet recognized as an official medical or psychological condition with formal diagnostic and treatment criteria. However, a growing number of doctors, dietitians and other health experts consider orthorexia to be an eating disorder. Like anorexia nervosa and other eating disorders that cause constant worries about food, orthorexia involves an obsessive focus on healthy eating and behaviors that disrupt daily life.

“There’s no one right answer for a diet — but there are wrong answers,” says Vikki Lane, MD, internal medicine physician at Scripps Clinic Carmel Valley.

Misinformation can lead to malnutrition

Dr. Lane says there is a lot of misinformation in the marketplace. For instance, gluten-free diets have become prolific in recent years. That’s not to say everyone who cuts out gluten is on a slippery slope to disordered eating. But going gluten-free by choice isn’t as beneficial as some may claim—cutting out wheat and other grains can lead to deficiencies in fiber and nutrients, which are important to digestive and overall health.

“A number of patients think they have to follow a gluten-free diet, and if you have celiac disease or a true gluten sensitivity issue then yes,” Dr. Lane says. “But there are a number of people who think it’s healthier when it’s actually not.”

Cleanses, juicing and fasts may also become problematic and can deprive participants of important nutrients. Physical symptoms stemming from these deficiencies include bloating, swelling in parts of the body, nausea, blood sugar spikes, irritability and mood changes. 

“Unfortunately, there are a lot of extreme diets out there that people do follow, with negative effects,” Dr. Lane adds.

Signs of orthorexia

People with orthorexia nervosa may experience the following symptoms or behaviors:

  • Obsessively checking ingredient lists and nutrition labels
  • Restricting foods to a narrow group considered clean, pure or healthy
  • Eliminating whole food groups, such as cutting out all sugar, carbs or dairy
  • Feeling anxiety, shame or fear when breaking self-imposed food restrictions
  • Worrying about what food might be served at upcoming events
  • Feeling distressed when healthy or “safe” foods aren’t available

Dr. Lane says there’s a difference between a fixation on healthy eating and desperation to lose weight. People who are overweight may turn to extreme diets as a last resort, but orthorexia is different; a person’s mental health suffers when healthy eating becomes an obsession and interferes with other parts of their life.

In any case, balance is key. If you’re considering making any major changes to your diet, run it by your doctor or a registered dietitian first.

Cover of San Diego Health Magazine

This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.

Related tags: