When it comes to health, you can have too much of a good thing.
Orthorexia is an obsession with eating healthy food. For people who develop the eating disorder, the intention to eat nutritious food turns into a fixation. Instead of generally striving to eat more healthy foods, people with orthorexia cut out entire food groups they feel aren't healthy, which can result in nutritional deficiencies, mental health challenges, and social isolation.
The signs of orthorexia can also be very difficult to identify, says Sadi Fox, PhD, a licensed psychotherapist who has been working with people with eating disorders for 10 years. Since eating healthy is generally perceived as a good thing, people with orthorexia might be praised for their disorder, not know they have a problem, and not end up getting the help they need—which is the case for some patients who work with Fox. 'A lot of people are just like, ‘Whoa, I didn't even realise how deep [into my eating disorder] I was,’' she says.
People with orthorexia might make food choices based on different approaches they see on social media, but that doesn’t necessarily mean it’s backed by science, says Fox. Narrowing down the foods you eat, especially based on misinformation, is a 'slippery slope' for other disordered behaviours, she adds.
Most importantly, orthorexia can often go unnoticed. Since eating healthy is a good thing, behaviours related to orthorexia can often be encouraged. It’s important to know the signs and symptoms—and even more important to turn to experts when it comes to determining what goes into a well-balanced diet.
Orthorexia is not officially recognised in the
DSM-5 (the handbook for diagnosing mental disorders), but it’s an eating disorder that has risen significantly over the past few years, according to the experts who treat it. Without formal diagnostic criteria, it’s challenging to determine exactly how many people in the UK struggle with orthorexia, but
BEAT estimate that 1.25m people are struggling with an eating disorder (anorexia, bulimia or EDNOS -
eating disorder not otherwise specified).
Prevalence of orthorexia varies across countries and populations, ranging from 6.9% in the Italian population to 88.7% in Brazil, per a 2021 review in the
International journal of environmental research and public health. Other studies suggest orthorexia might be more common in
Instagram users (49% prevalence)
nutrition students (72% prevalence), and
populations that exercise (55% prevalence). Plus, athletes and endurance athletes (runners especially) have higher symptom severity when it comes to orthorexia, according to a 2023 study in
Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity.
