What is orthorexia?
Orthorexia (orthorexia nervosa) is a still little-known eating disorder, characterized by an obsessive and pathological preoccupation with eating in a "healthy," "pure," or "clean" way. Unlike other eating disorders, the obsession is not about the quantity of food, but about its quality.
A person with orthorexia progressively eliminates entire food groups they consider "harmful," "toxic," or "processed," to the point that their diet becomes so restrictive that it puts their nutritional health at risk. Paradoxically, the obsession with eating "healthy" ends up causing emotional distress and nutritional deficiencies that are anything but healthy.
As a psychologist specialized in eating disorders, I see how the rise of "clean eating" culture and social media contribute to normalizing increasingly restrictive eating behaviors.
Symptoms of orthorexia
Relationship with food
- Progressive elimination of foods considered "impure": first processed foods, then gluten, dairy, sugar, fats, oil-based cooking, etc.
- Spending hours researching the origin, composition, and preparation methods of food
- Preparing food in very specific ways (cooking method, container, particular combinations)
- Bringing food from home anywhere to avoid eating "contaminated" food
- Obsessively reading labels and ingredients of every product
Emotional and social impact
- Intense guilt or disgust if they eat something "forbidden"
- Extreme anxiety in the face of uncertainty about food (restaurants, other people's homes, travel)
- Moral superiority: judging other people's food choices as "bad" or "irresponsible"
- Social isolation: avoiding dinners, parties, gatherings where food cannot be controlled
- Fused identity: the way of eating becomes the person's defining trait
The orthorexia paradox: "healthy" eating that makes you sick
Nutritional deficiencies
Eliminating entire food groups can lead to deficiencies in protein, iron, calcium, zinc, vitamin B12, essential fatty acids, and other fundamental nutrients. Ironically, the person who wants to take care of themselves through food ends up with a less nutritious diet than a varied conventional one.
The role of social media
Instagram, TikTok, and YouTube are full of content creators promoting increasingly restrictive diets as a "healthy lifestyle." Raw veganism, extreme intermittent fasting, elimination diets, and other trends can act as gateways to orthorexia, especially in vulnerable people with perfectionist or anxious traits.
Risk factors
- Perfectionism and need for control: food becomes the area in which to exert absolute control
- High anxiety: rigid food rules provide a temporary feeling of security
- Previous eating disorders: orthorexia can be a way of "reinventing" a previous eating disorder under a "healthy" guise
- Health professionals: nutritionists, athletes, and healthcare workers have a higher risk
- Social media exposure with content about "ideal" eating
Difference between healthy eating and orthorexia
The line is crossed when:
- Food generates more anxiety than pleasure
- The person feels morally superior because of how they eat
- Social relationships deteriorate because of dietary rigidity
- The person can't flex the rules even in special situations
- Physical health worsens despite eating "healthy" (fatigue, hair loss, amenorrhea, dry skin)
Treatment of orthorexia
Cognitive-behavioral therapy (CBT)
CBT helps identify and challenge rigid beliefs about food ("good vs. bad", "pure vs. toxic"), tolerate dietary uncertainty, and separate personal identity from how one eats. Specific fears are worked through gradual exposure to "forbidden" foods in a safe environment.
Nutritional rehabilitation
A registered dietitian specializing in eating disorders supports the gradual reintroduction of eliminated foods, ensuring the diet is nutritionally complete. The goal is not to eat "badly" but to eat in a varied, flexible way, free of fear.
EMDR if there is trauma or a prior eating disorder
When orthorexia masks a trauma or is the evolution of a previous eating disorder, EMDR makes it possible to address the experiences that fuel the need for control through food.
The first step is questioning yourself
If you ask yourself, "maybe my relationship with food isn't as healthy as I thought," that simple doubt is already an act of courage. I offer a free informational session where we can talk in complete confidentiality.