In today’s world, healthy living and dietary habits are becoming increasingly popular.
However, for some individuals, the influence of these trends can turn into an obsession with clean eating.
Becoming excessively preoccupied with healthy eating patterns is known as Orthorexia Nervosa (ON).
Orthorexia Nervosa is a relatively new and not officially recognized eating disorder.
The term was first introduced to describe individuals who are obsessively focused on food quality, preparation, and consumption, strictly adhering to self-imposed dietary rules (Bratman, 1997).
This article will explore the definition of Orthorexia Nervosa, common symptoms, causes, health consequences, and treatment methods of ON.
What Is Orthorexia?
The term originates from the Greek words “orthos” (correct) and “orexis” (appetite).
This disorder is characterized by an extreme obsession with healthy eating and restricting one’s diet through rigid rules.
Unlike other eating disorders such as Anorexia Nervosa (AN), ON is not primarily concerned with weight loss, but with the “purity of food” (Arusoğlu et al., 2008).
The quality of food, nutritional content, and source of ingredients are of great importance to individuals with ON.
Although it is not yet officially recognized in diagnostic systems like the DSM (APA, 2013), ON is associated with psychological problems, nutrient deficiencies, social isolation, and decreased quality of life (Koven & Abry, 2015).
Common symptoms of Orthorexia Nervosa include:
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Consuming only organic, gluten-free, vegan, or raw foods
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Avoiding any foods that contain additives or preservatives
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Requiring food to be prepared in specific ways (e.g., cooked at certain temperatures)
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Excessive scheduling and rigid planning of mealtimes
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Avoiding eating out at restaurants
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Constantly criticizing others’ food choices or eating habits
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Feeling intense guilt after consuming “forbidden foods“
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Experiencing extreme stress and anxiety over minor dietary “mistakes”
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Feeling fatigued due to dietary restrictions
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Showing symptoms of anxiety or depression linked to eating habits
Causes of Orthorexia Nervosa
Sociocultural Factors
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In societies where obesity stigma is high, the risk of ON increases.
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Easy access to organic foods may contribute to ON.
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Media idealization of “clean eating” encourages dietary perfectionism.
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Positive reinforcement from others (e.g., “you eat so healthily”) can trigger ON.
Cognitive and Psychological Factors
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Overvaluation of body image (judging oneself primarily based on appearance) is a strong predictor of ON (Messer et al., 2022).
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Dieting behavior, especially among student populations, is a significant risk factor (Guglielmetti et al., 2022).
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Obsessive-compulsive traits and disordered eating attitudes are major psychological predictors (Arusoğlu et al., 2008).
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Perfectionism and obsessive personality traits play a key role in the development of ON (Horovitz & Argyrides, 2023).
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Higher socioeconomic status may contribute to ON development (Varga et al., 2013).
High-Risk Occupational Groups
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Health professionals
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Dietitians
These groups are considered to be at high risk for developing Orthorexia Nervosa (Varga et al., 2013).
Effects of Orthorexia Nervosa
Individuals showing ON symptoms report more physical complaints like dizziness and fatigue, and tend to use more supplements and alternative health practices compared to the general population (Oberle et al., 2019).
Weight loss in ON is typically a side effect of rigid healthy eating rules, rather than the goal itself.
In the long run, excessively restrictive eating can lead to serious health problems:
1. Physical Health Issues
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Deficiencies in vitamins and minerals such as iron, calcium, and B12
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Digestive problems (e.g., constipation, gut flora disruption)
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Weakened immune system
2. Psychological Effects
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Anxiety
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Depression
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Withdrawal from social environments
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Development of other eating disorders (e.g., bulimia nervosa, anorexia nervosa)
3. Social and Relational Problems
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Conflicts in family and friendship relationships
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Poor performance in school or work
Diagnosis and Treatment of Orthorexia Nervosa
Diagnosing ON clinically is challenging due to the lack of universally accepted diagnostic criteria.
Its overlap with Anorexia Nervosa (AN), Bulimia Nervosa (BN), Obsessive-Compulsive Disorder (OCD), and Generalized Anxiety Disorder (GAD) complicates differentiation.
However, ON differs from AN and BN in that it does not typically involve body image disturbance or compensatory behaviors such as purging or binge eating.
A comprehensive treatment approach for Orthorexia Nervosa is essential.
Current research supports the effectiveness of the following treatment options:
1. Psychotherapeutic Interventions
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Cognitive Behavioral Therapy (CBT): Restructuring rigid beliefs about healthy eating
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Exposure and Response Prevention (ERP): Controlled exposure to forbidden foods and managing anxiety (Zickgraf, 2020)
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Dialectical Behavior Therapy (DBT): Enhancing emotional regulation and cognitive flexibility
2. Pharmacological Support
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Antidepressants like Mirtazapine have shown positive effects, particularly in ON with comorbid Major Depressive Disorder (Lopes et al., 2020)
3. Nutritional Counseling
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Creating a balanced and flexible eating plan
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Educating individuals on the importance of dietary variety and nutritional balance
4. Social Support Systems
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Family Therapy: Creating a supportive family environment
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Support Groups: Promoting social connection and shared experiences
Conclusion
Orthorexia Nervosa is a growing and serious mental health condition that can develop under the guise of healthy eating behaviors.
Early intervention is critical for protecting both physical health and mental well-being.
Seeking help from a professional is the best option if you or someone you know is showing signs of ON.
Remember:
True health is about balanced eating, psychological flexibility, and meeting your body’s real needs-not about perfection.