Orthorexia: Taking healthy eating too far


By Rachel Dewey, Iowa State Dietetic Intern and Lizzie Kasparek, MS, RD, CSSD, LN Sports Dietitian

Nutrition and physical activity are important parts of a healthy lifestyle, but a growing trend of obsessive healthy eating has medical professionals worried. The hashtag #eatclean has 51 million posts on Instagram. Eating well and exercising are, of course, healthy habits to have, but there is a point where healthy behaviors can become unhealthy. When individuals become overly-fixated on only eating healthy foods, and restricting foods they consider unhealthy, this can negatively impact them in several ways.

Bowl of oatmeal porridge with banana and caramel sauce on rustic table, hot and healthy breakfast every day, diet food

Orthorexia is the term for a disordered pattern of eating where individuals have become obsessed about eating healthy foods and the quality and ingredients of the foods they include in their diets. They have restrictive diets and ritualized patterns of eating, including certain “clean,” “pure” and “healthy” foods, and rigidly avoiding any “unhealthy” foods, which can lead to nutrient deficiencies, medical complications and a poor quality of life.

With the rise of social media accounts promoting clean and healthy eating, it can be difficult to recognize when healthy habits are taken too far, to the point of being disordered. Although orthorexia isn’t currently recognized as a clinical eating disorder, it can still cause a great amount of distress for individuals , who create so many rules concerning what foods are healthy and what foods are not that more and more mental energy is needed to plan their diet for that day. One study found sufferers of orthorexia could spend upwards of 3 hours daily determining what, how much and when to eat. When food takes up that much of a person’s day, it decreases their ability to be spontaneous, to spend time on relationships, and their overall quality of life. Making sure “clean foods” will be available at family events, on trips, at work or at celebrations limits enjoyment and sometimes causes individuals to skip some social situations all together in order to ensure they can eat according to their rules.

In addition to the psychological stress of needing to adhere to strict food rules, orthorexia can cause other health issues. Some people may experience nutrient deficiencies or malnutrition from cutting out food groups or restricting the overall variety and/or amounts of foods eaten.


From the National Eating Disorder Association

  • Compulsive checking of ingredient lists and nutritional labels
  • An increase in concern about the health of ingredients
  • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
  • An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
  • Unusual interest in the health of what others are eating
  • Spending hours per day thinking about what food might be served at upcoming events
  • Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
  • Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
  • Body image concerns may or may not be present

What can you do?

  • Work with a psychologist or therapist who has experience with eating disorders.
  • Unfollow social media that makes you feel guilty or overly concerned with health.
  • Remember moderation is key, don’t exclude treats from your diet.
  • Eat a colorful well balanced plate, including grains, fat, protein, fruits, vegetables and dairy.
  • Be flexible and try new foods.


Koven, Nancy, and Alexandra Abry. “The Clinical Basis of Orthorexia Nervosa: Emerging Perspectives.” Neuropsychiatric Disease and Treatment, 2015, p. 385., doi:10.2147/ndt.s61665.

Olejniczak, Dominik, et al. “Analysis Concerning Nutritional Behaviors in the Context of the Risk of Orthorexia.” Neuropsychiatric Disease and Treatment, Volume 13, 2017, pp. 543–550., doi:10.2147/ndt.s129660.

“Orthorexia.” National Eating Disorders Association, 22 Feb. 2018, www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia.