How Orthorexia and Today’s Diet Culture can Impact Recovery

Do you choose only foods labeled “clean” or “all natural”?  Or, have you skipped out on a meal with friends because the menu wasn’t “healthy”? Have you found that your mind is consumed by food constantly?  Whether it be a preoccupation with your next meal, or perhaps the countless health influencers you follow on your Instagram feed?

While there is no harm in choosing nutritious foods or engaging in eating habits that promote our body’s basic functions, it can turn harmful when the rigidity of these choices become so extreme, a person’s mental and physical well-being is compromised. When the choice of food is driven solely by “purity” over pleasure, an eating disorder may be present.

This eating disorder is what is known as Orthorexia Nervosa (ON).

What is Orthorexia?

Orthorexia is a term coined in the 1990’s by Dr. Steven Bratman to describe a way of eating that fixates on the “health” or quality of food to the point that it causes disruption in one’s life. In nearly 30 years, Orthorexia has yet to be recognized as a diagnosable eating disorder by the Diagnostic and Statistical Manual for Mental Disorders 5th Edition (DSM-V) due to the difficulty in differentiating between what is considered healthy eating practices or disordered eating behaviors. Understandably so, when our society and diet culture praise restriction and deem rigidity as “self-discipline.” Regardless of diagnostic criteria, whenever thoughts or behaviors around food start controlling aspects of your life, you deserve help.

Signs of Orthorexia

As with any eating disorder, no one person will fit perfectly in a diagnostic “box.” However, according to the National Eating Disorder Association (NEDA), Orthorexia can be characterized by some, if not all, of the following (1):

  • Compulsive checking of ingredient lists and nutritional labels
  • Heightened concern over the quality or health benefits of ingredients/foods
  • Eliminating specific foods or entire food groups if not deemed “healthy”
  • Inability to eat or increased distress when eating foods not considered “pure,” “clean,” or “healthy”
  • Unusual interest in what others are eating and feelings of judgement towards others who do not eat similarly as you
  • Preoccupation and hours spent thinking about food (worry about next meal, how meals are prepared, reading blogs or books about nutrition, etc.)
  • Stress or anxiety is present when “safe” foods are not available or you are unable to prepare them yourself
  • Obsessive following of “wellness”/”health” content
  • Body image concerns may or may not be present

Orthorexia can easily go unnoticed as diet culture deems several of the above mentioned behaviors as simply “living a healthy lifestyle.”

Is it Orthorexia or Another Eating Disorder?

Another reason why Orthorexia has yet to be incorporated into the DSM-V is that it shares several of the same behavioral and psychological traits as other diagnosable eating disorders such as Anorexia Nervosa and Bulimia Nervosa. In a study conducted on university students, findings indicated that 17% of participants were at risk for Orthorexia Nervosa and demonstrated common eating disorder traits such as a drive for thinness, body dissatisfaction, perfectionism, asceticism, and impulsiveness(2).

Diet Culture & Eating Disorders

Diet culture is sneaky. It tells us there is a “right” and “wrong” way to eat. It normalizes eating disorder behaviors like restriction or excessive exercise. It tells us that a thin body is the epitome of health. From your social media to grocery store aisles, and even in casual conversation with friends about the latest “superfood” or fad-diet, these toxic messages creep in. All messages that our logical brain knows to be untrue but when it is constantly reinforced in every aspect of our lives, it can be difficult to navigate.

Orthorexia & Eating Disorder Recovery

As a result of these messages and societal expectations, it is understandable that differentiating between an eating disorder and being health conscious can be confusing. If not careful, Orthorexia may serve as a mask for resurfacing eating disorder behaviors during any stage of recovery.

In a study conducted on eating disorder patients 3 years out of treatment, 58% demonstrated Orthorexia Nervosa behaviors. This study hypothesized that eating disorder patients in recovery were able to maintain some level of control over their food and live with a more minimized eating disorder by doing so in the name of “health.” (3)

The goal of any eating disorder recovery is to establish flexibility. To find the joy and pleasure in eating again. To honor both your taste buds and your health. No one food or single meal is going to have a detrimental impact on your health. However, sticking to rigid rules, deeming foods “good” or “bad,” and depriving yourself of the satisfying experiences food can bring us can and will be detrimental.

When the line between health and eating disorder gets blurry, take a step back and ask yourself: Does this satisfy ME or my eating disorder? What is my motivation behind this food choice or behavior?

There is not one definition of health. Nutrition and recovery can coexist. Make every choice with the intention to honor YOU. Your health. Your values. Your recovery.


  1. National Eating Disorder Association. (2021). Orthorexia. Retrieved from
  2. Parra-Fernandez, M.L., Rodriguez-Cano, T., Oneiva-Zafra, M.D., Perez-Haro, M.J., Casero-Alsano, V., Fernandez-Martinez, E., & Notario-Pacheco, B. (2018). Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behavior disorders. BMC Psychiatry, 18(364), 1-8.
  3. Segura-Garcia, C., Ramacciotti, C., Rania, M., Alio, M., Caroleo, M., Bruni, A., Gazzarrini, D., Sinopoli, F., & De Fazio, P. (2015). The prevalence of orthorexia nervosa among eating disorder patients after treatment. Eating and Weight Disorders, 20, 161-166.