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Orthorexia Nervosa: Can eating healthy become unhealthy?

Updated: Mar 25, 2020

Guys. We were listening to The Skinny Confidential and something got brought up about this obsession of eating healthy. This is a real condition known as, orthorexia nervosa. Yes, this exists! In a world full of addictions and an instagram page where everyone wants to look or be a model we never thought we would come to a place where being too healthy is a bad thing. So we thought we had to discuss this because we’re doctors and if we don’t stay up to date who will? Anyways, we’re doing this and we hope you love it!

You might be wondering what the hell is Orthorexia nervosa? It is a medical condition that involves obsessive behavior with respect to eating a healthy diet and optimal nutrition. It’s under the umbrella of anxiety disorders (like OCD) and it is frequently seen to be related to or occur with anorexia nervosa as well as other eating disorders (bulimia, etc.) It is not formally recognized by the DSM which is the psychiatric manual for all psychiatric conditions but it is something that in today’s society needs to be addressed.

Interestingly, enough the terminology was first created in 1997 and means obsessions with proper eating, orthos is derived from the greek word right. But, the issue is the fixation with the food not the eating healthy part.

What are the symptoms?

When you check nutrition labels compulsively, cut out all major food groups that you don’t think is healthy, wanting to know too much about what the person next to you is eating or obsessed with food and eating healthy at all times, among others. Most importantly it becomes a disorder when it affects your day to day functioning. When someone becomes distressed if only unhealthy options are available or cannot complete their tasks because they are preoccupied with these “healthy food” thoughts.

Risk factors include but are not limited to:

  1. Anxiety

  2. OCD

  3. Eating disorders

People who may be more affected: include healthcare workers, opera singers, ballerinas, symphony musicians and athletes.

Given the unknown nature of this no causes have yet to be established.

How do you diagnose it?

So far it’s been proposed that two major criteria be considered:

  1. Obsession with healthy eating (exaggerated emotional distress when it comes to food options)

    1. Compulsive behaviors or mental preoccupations with dietary choices

    2. Anxiety symptoms from breaking these self made rules

    3. Inappropriate dietary restrictions

  2. Behavior disrupting daily life or activities

    1. Causing additional or confounding medical issues

    2. Emotional dependence

This is a real thing and should be recognized because many side effects can occur one of which is malnutrition which can lead to vitamin deficiencies, poor bone health, early osteoporosis, change in bowel habits, issues with digestion, electrolyte imbalances, may or may not be associated with issues of body image as well as, other underlying undiagnosed psychiatric conditions.


No formal treatment option has been established at this time but it has been thought to be treated like you would other eating disorders or OCD. This includes pharmacologic management with antidepressants and psychotherapy or talk therapy. These treatments can be used together or separately depending on the case and the clinicians preference.

Psychotherapy subtypes/options offered:

1. Exposure and response prevention

2. Behavior modification

3. Cognitive restructuring

4. Relaxation training

However, it would be important to talk about healthy food options, coping as well as, stress relieving strategies, keeping a normal body weight, obtaining enough nutrients in their diet or through supplements, among others.

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Disclaimer: The Content on our podcast/website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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