Eating Pure or Pure Anxiety? Understanding Orthorexia
By Amanda LaMela
Have you found the rules for healthy eating have become more complicated (and anxiety-inducing) than ever? If "clean eating" feels more like walking a nutritional tightrope than nurturing your body, the pursuit of wellness might be devolving into an unhealthy obsession. In an era flooded with contradictory health advice, influencer fear-mongering, and idolized aesthetics, it's easy to slip from conscientious eating into rigid, rule-bound routines that do more harm than good. But where exactly does a genuine desire to improve health cross the line into orthorexia - and how can you tell the difference between dedication and disorder?
What is Orthorexia?
Orthorexia remains a somewhat controversial concept. Many researchers use the term ‘orthorexia nervosa’ to describe a preoccupation with food purity and the associated restrictive behaviors surrounding consumption. Experts continue debating whether orthorexia nervosa warrants its own diagnosis or if it's simply a variant of existing eating disorders. It hasn't yet been officially included in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), primarily because research into diagnostic criteria, prevalence, and distinctness is ongoing. However, it's acknowledged by many eating disorder specialists as a serious issue deserving attention.
On the surface, someone developing orthorexia nervosa might start with good intentions: “I want to eat healthier to feel better.” But over time, the intention to eat healthily becomes an unhealthy obsession. For many, orthorexia isn’t really about nutrition. It’s about control. Striving for a perfect, “clean” diet can create a sense of order in a chaotic world. Focusing on perfecting one’s diet can be a coping mechanism to deal with stress, anxiety, or uncertainty. In these cases, orthorexia shares similarities with obsessive-compulsive disorder, given the intrusive thoughts and compulsive behaviors around food purity. In other cases, someone who has suffered from anorexia nervosa in the past might channel those restrictive impulses into a socially praised “clean eating” routine instead. But while perfectionism drives them to stick to ever-stricter rules, it never feels “perfect” enough. There’s always another ingredient to cut out or a cleaner method to try.
Another psychological driver is health anxiety. We live in a time where we’re bombarded with warnings about toxins, chemicals, and diseases. It’s easy to become overly fearful about food choices. For someone vulnerable, reading that processed sugar is “poison” or that gluten causes every known illness might spark an extreme need to avoid those things entirely. Orthorexia often starts with the genuine desire to prevent illness or improve health, but it becomes a problem when that desire goes into overdrive.
It doesn’t help that society often praises (and even idolizes) the behaviors that orthorexia entails. Whether the desired aesthetic is ‘clean girl,’ ‘that girl,’ ‘crunchy,’ or ‘scrunchy,’ many of these sought-after personas focus on rigorous meal prep, food purity, and organic everything. This positive reinforcement can make it harder to recognize when healthy habits have morphed into an obsession.
Finding Balance
If you suspect that you or someone you love is grappling with orthorexia, take heart -recovery is possible. It might feel daunting to loosen the grip on those food rules, but with support and the right strategies, you can rebuild a healthier relationship with eating.
Acknowledge the Issue (with Compassion).
The first step is recognizing that your eating habits and thoughts have become excessive and are impacting your life. Be honest with yourself: do you feel anxious or guilty about food? Is the quest for “healthiness” actually making you unhappy or unwell? Acknowledging this is a brave and positive step. Remind yourself that no one is perfect, and needing help doesn’t make you weak. It simply means you care about your well-being and realize something needs to change.
Take a critical look at the media you consume.
The multi-billion dollar wellness industry has a massive hand in orthorexia’s rise. In recent years, countless “health gurus,” bloggers, and supplement companies have built careers on convincing us that our foods are full of dangers (and that they have the solution). There is a big difference in tone between ‘Five Healthy Comfort Food Alternatives’ and ‘Is Oat Milk DESTROYING Your LIFE?’
Persuasive influencers may tell you that your fatigue or bloating is due to all the ‘chemicals’ in your diet, generating anxiety about normal foods. Once you’re fearful and convinced you’re doing everything “wrong,” they swoop in with something to sell. This dynamic creates a cycle of dependency and heightened fear. You start believing you must have the $50 organic powders, cleansing teas, and gut-healing supplements, or your health will suffer. Whenever you consume advice about nutrition or wellness, consider the source’s attitude, motivations, and background.
Strengthen your social support and share your concerns with people you trust.
People with orthorexia may begin to withdraw from social situations that involve food. Dining out at restaurants, eating at a friend’s house, or attending parties becomes a source of anxiety because you can’t control how the food is prepared. To cope, you might bring your own food everywhere or just avoid eating with others altogether. Over time, this can isolate you and strain relationships – friends and family may feel hurt or confused that you won’t partake in meals with them.
Recovery from any disordered eating is a journey, usually with ups and downs. You don’t need to do it alone. Open up to someone you trust about what you’re going through, whether that be a therapist, friend, parent, partner, or support group. You might be surprised how relieving it is to admit, “I’m struggling with how I eat. I think I’ve taken healthy eating too far.”
Challenge black-and-white thinking.
When your sense of virtue and identity is rooted in what you are not doing, deviating from that impossible standard can feel like a moral failing. Start unlearning the idea that foods are strictly “good” or “harmful.” In reality, all foods can fit into a balanced diet. Practice reframing your thoughts. You might even make a list of foods you’ve banned and slowly allow yourself to eat one occasionally, noticing nothing terrible happens. This can be scary at first. But over time, it retrains your brain to see food more neutrally. Moderation truly is key. Your body can handle a less-than-perfect meal. In fact, flexibility is healthy.
Keep in mind the bigger picture.
Health is not just about food. Mental health, social connection, movement, enjoyment, and flexibility are vital to our well-being. Orthorexia may trick you into thinking that perfect eating is the gateway to a perfect life, but in reality, it slams your world shut. Real, sustainable wellness comes with achieving balance and enjoying life’s many flavors.
If you’re struggling with potential orthorexia, or disordered eating in general, it might be important to reach out to a therapist. We’re here to help. You can can book appointment with Amanda or any of our clinicians by contacting us here and listing the therapist you’d like to work with, or simply make an appointment below. We look forward to working with you!
Resources
Hanras, E., Boujut, E., Barrada, J. R., & Dorard, G. (2024). Differentiating healthy orthorexia from orthorexia nervosa: sociodemographic, psychological and dietary characteristics in a French sample. Public Health Nutrition, 27, e255-. https://doi.org/10.1017/S1368980024002374
Missbach, B., Dunn, T. M., & König, J. S. (2017). We need new tools to assess Orthorexia Nervosa. A commentary on “Prevalence of Orthorexia Nervosa among College Students Based on Bratman’s Test and Associated Tendencies.” Appetite, 108, 521–524. https://doi.org/10.1016/j.appet.2016.07.010
Valente, M., Cesuroglu, T., Labrie, N., & Syurina, E. V. (2022). “When Are We Going to Hold Orthorexia to the Same Standard as Anorexia and Bulimia?” Exploring the Medicalization Process of Orthorexia Nervosa on Twitter. Health Communication, 37(7), 872–879. https://doi.org/10.1080/10410236.2021.1875558
