When Healthy Goes Too Far: Meet Orthorexia


Lets play a little game of association here. When you hear the word healthy, what comes to your mind?

The “healthy” is a loaded word these days. Gluten-free, toned thighs, 12 pack abs, dairy-free, nut-free, paleo, keto, whole 30, long flowing locks, youthful-ageless skin, ________ insert any other #trendingnow thing.

Recently there has been an increase in interest in eating healthy, which is AWESOME don’t get us wrong. We love that people are thinking about food. We love thinking about food.

But is there a such a thing as being too healthy?

We think so. There is this little thing called “Diet Culture.” This culture of dieting, cleansing, clean eating, detoxing, macro-counting, etc. has hijacked and kidnapped some of our favorite foods and is now holding them as hostage.

At Evolve, we believe that food so much more than fuel. Food is our culture. It is social. It is experiential. It brings us joy, pleasure, oh yeah… and energy. Let’s think about it like this: When you think of the smell your mom’s cookies (or any other favorite childhood food), what does it remind you of? Coming home from school, Christmas, your birthday? Okay so now you have a location. What do they taste like? What do they feel like? These emotions about food are deep-rooted, and Diet Culture doesn’t just tell us to eat cookies less often. Instead it tries to convince us that cookies are dirty, scandalous, worthy of guilt and shame. And that’s just wrong.

When was the last time was that you were at the grocery store and you didn’t see a magazine spouting “lose 10 pounds in 5 days!”, “3 Day Detox”, “Slim and Happy”, “Top Ten Clean Eats You Have to Try”… or something along those lines. This obsession with “detoxing”, “cleansing”, and “clean eating” has warped the relationship that many people have with food in a way that makes us seriously concerned.


Let me introduce you to Clean Eating’s evil twin, Orthorexia. Orthorexia means a fixation on righteous eating. Orthorexia is not currently recognized as a clinical eating disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it is recognized as a disordered eating behavior. Eating disorders are diagnoses such as anorexia nervosa or bulimia nervosa, both of which are highly restrictive, weight and body- image focused and often have purging behaviors. Orthorexia is when healthy eating is taken to an extreme, when it starts to affect your normal life and ability to adapt to your circumstances.

Instead of restricting quantity (anorexia), orthorexia is overly restricting quality. Orthorexia is extreme “healthy eating”. So what are some of the signs and symptoms?

  • Rigidity: Sure, we all have our quirks. I don’t eat candy often, but that doesn’t mean I won’t get down on a Heath Bar every now and again. It not because it is “bad” it is because I prefer French fries. However, someone who may have orthorexic tendencies will struggle with flexibility around food. Anything that is deemed to be “bad” or be deemed “unhealthy” based on whatever rules that person has created will be avoided at all costs. Do you often go hungry eating out in public because you may not know exactly what is in the food that is offered, or where it comes from?

  • Fixation on quality: Yes, you should have quality food if you can afford it and if it is available. You can do whatever you want with your wallet and your mouth. But when someone absolutely won’t eat something because it is not organic, whole, raw/vegan, or any other label, we may have a problem. Please note, I am not referring to those who have a actual allergies or intolerances.

  • Eliminating entire food groups: Often times it starts with going vegetarian, and then vegan. You have now eliminated some KEY nutrients if you aren’t supplementing. Then, you eliminate gluten because you read in Women’s Health that it was the devil. Sugar is next, because it makes you fat right? Then, you eliminate nuts because, well those do too. White foods? No thanks. Then it’s the carbs, because gross. Can someone say BLOAT? All of the sudden… you have nothing left. (Again, if you have an allergy or intolerance I am not talking about you. If you are choosing to be vegan or vegetarian for environmental or other religious beliefs I am still not talking about you).

  • Emotional turmoil: Individuals with orthorexia often experience a a large emotional response when you they are confronted with eating something on their “no” list, such as anxiety, depression, or distress. If you have these or any other negative emotional experience around food, we need to get to the bottom of that. How do we do that? With a mental health professional and a Registered Dietitian. Simply eliminating foods is not the answer.

  • Typically not driven by body image: Orthorexia is often motivated by health, familial history, poor health, control, escape from fears, improving self-esteem, searching for spirituality through food, using food to create an identity. Although orthorexia may sound similar other eating disorder behaviors, eating disorders are commonly associated with body image.

  • Self-identity: Many people identify themselves by their culture and how their culture relates to food. Individuals with orthorexia instead conflate their self-identity with their righteous food choices. This can be why a sense of emotional turmoil is felt when eating something on the “no” list -- it challenges their sense of self-identity. Using food and a false sense of healthy eating to define self identity has the potential to cause harm to one’s self and others.

Why its good to be dirty

“Clean” eating sounds really sparkly and glittery. Clean things are good and hygienic. Of course we want to be clean people. But, the opposite of clean is dirty. Is dirty the best way to explain your moms cookies? Not exactly.

The difficulty we have with “clean eating” is that there is a good list, and bad list. You shouldn’t feel guilt when enjoying a childhood recipe or your favorite flavor of ice cream. When we live within these boxes of “yes” and “no” there is little room for maybe, and little flexibility to indulge in certain foods for reasons other than health. Remember, we should find joy in food, not just view food through a lense of “good” or “bad.”

At EVOLVE, we believe that everyone should generally find a way of eating that is about feel and enjoyment, along with health, rather than some abstract idea of “eating clean.” For example, I love a beautiful salad that is rich in color, locally sourced from my farmers market. Based on this you may think I am a “clean eater”. Yes, I do limit my processed foods and eat vegetables, whole grains, and lean proteins at most meals. BUT, this is NOT because of health alone, or because I must be clean. I do this because these foods make me feel better. I am able to recover well from my workouts. I have more energy to focus on my work and I truly enjoy these types of food.

Want to know what else I enjoy? Pizza, chocolate mousse, creme brulee, salted caramel ice cream, greasy street tacos from street cars, and Pad See Ew and anything from a steamy dim sum cart. These foods bring me joy. They remind me of family, friends, and momentus periods in my life. Do I eat these everyday? No, because then I would not be able to do the things that I love. It is all about balance.

I know that it may seem like a gray area, but that’s life. Embrace the gray area, and take a closer look at your intentions around food.

Some reading this may completely disagree, and that is fine. But if you are reading this and want to let the food reins go a little bit, then reach out. When working with individuals that have orthorexia or orthorexic tendencies, we usually start by unravelling false food beliefs, getting to the bottom of any real gastrointestinal or other food-related health concerns with evidence-based treatments, and then adding back in foods that bring joy. If you want to explore this path, find a Registered Dietitian that you trust and a mental health professional. Often, if you find one, that person can help direct you to the other. Having a truly healthy relationship with food doesn't look like eating only brightly colored vegetables. It looks like eating when your hungry, eating in community, finding joy in the food that you eat, eating vegetables, fruits, whole grains, proteins and cookies!

Concerned or confused about food? We’re here to help. Click the button below to schedule a FREE 15-minute strategy session with our Registered Dietitian to develop a plan to meet your goals.