What Is Orthorexia?

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Most research describes orthorexia nervosa as a pathological obsession with proper nutrition that is characterised by a restrictive diet, ritualised patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. 

Despite being tied with a desire to achieve optimum health, orthorexia may lead to nutritional deficiencies, medical complications, and poor quality of life. There has also recently been intense media interest in people whose highly restrictive ‘healthy’ diet leads to disordered eating. 

Dr Steven Bratman coined the term orthorexia in 1997. He used the term to describe people whose extreme diets – intended for health reasons – are in fact leading to malnutrition and/or impairment of daily functioning.

Causes of orthorexia

We now live in a society where the idealised healthy body is widely portrayed. Studies have also shown that many individuals with orthorexia also have obsessive-compulsive disorder.

Stacy Weeks, a nutrition coach at Red Yew, explains: ‘Orthorexia can begin as many things, but most commonly a benign interest in clean eating or self-improvement, looking at making healthier food choices, better lifestyle choices or both.

‘It can also occur in those who have had a prior history of other eating disorders, abstinence of sorts, refraining from eating foods that don’t fit the belief, or only engaging in activities or making rules that they think fit the ideology. The world of social media is filling us with filtered and altered images every day, made all the more prevalent by “influencers”, some actively changing their image they portray to the world, and others promoting products they either have little knowledge of, or are receiving for free. 

‘This influence, along with an influx of self-improvement literature, feeds the idea of a perfect life or image, which in turn, becomes, just one of many, triggers for the behaviour; an unending task to feel good enough.’

To have a fuller understanding of the causes of orthorexia, Stacy recommends Renee Mcgregors book Orthorexia and Dr Steve Bratmans works. In particular, Bratman’s work has always been her reference when looking for this eating condition with nutrition clients.

Symptoms of orthorexia

According to Timberline Knolls, a leading orthorexia treatment for females, here are some of the behavioural patterns to watch out for.

  • Spending an excessive amount of time planning meals 
  • Following an increasingly restrictive diet 
  • Eliminating entire categories of food from a diet 
  • Linking self-esteem with adherence to a diet 
  • Hiding or concealing food from others 
  • Refusing to eat with others, or avoiding food in public 
  • Being critical of others’ eating habits 
  • Feeling shame or guilt about failing to meet own dietary restrictions 
  • Obsessing over nutrition labels 
  • Significant weight changes 
  • Lower body temperature 
  • Sleep problems 

If you’re wondering whether you’re suffering from orthorexia, there’s actually a test that you can take to help you identify your situation. The Bratman Test can detect symptoms or indicators of orthorexia, an eating disorder characterised by the obsession, on a pathological degree, to eat healthily. This questionnaire consists of 10 questions that should be answered by yes or no.


There are currently no clinical treatments developed specifically for orthorexia, but many eating disorder experts agree that the treatment for orthorexia is similar to the treatment for other eating disorders.

Final thoughts

Research on orthorexia is still in its early stages. The lack of agreement on what orthorexia nervosa is and on how it can be diagnosed contributes to its non-recognition as a psychiatric disorder by the international psychiatric classifications such as DSM and ICD.  

Dennis Relojo-Howell is the founder of Psychreg.


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