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A Not So Healthy Obsession: Could You Be Orthorexic?

A Not So Healthy Obsession: Could You Be Orthorexic?

Selection of green health foods on grey table background.

Orthorexic-CarolynO'Neil0217By Carolyn O’Neil MS, RD

Can you be too obsessed with eating a healthy diet? While most Americans struggle daily with efforts to follow nutrition advice outlined by the U.S. Dietary Guidelines—such as eating fewer total calories and more vegetables; there’s a mindful minority who take healthy eating habits a bit too seriously. The excessive preoccupation with avoiding foods perceived to be unhealthy has been classified as an eating disorder called orthorexia nervosa. The term orthorexia comes from the Greek words for “right” and “appetite.” Coined by physician Steven Bratman, orthorexia nervosa is not officially recognized by the American Psychiatric Association but is getting more attention from nutrition professionals who observe this behavior in clients. “They are afraid of food,” says registered dietitian Jim White, spokesperson for the Academy of Nutrition and Dietetics. White says, “I’m concerned because they’re so obsessive. They’ll eat nothing that comes in a box or has more than five ingredients.” Types of foods and drinks avoided might include those containing sugar, fat, gluten, wheat, meat, or dairy.

Unintended Consequences

What divides a commitment to healthy eating and orthorexia is the extreme limitation in food selection. While it’s a good thing to choose carrots over cookies at snack time, there are potential downsides to cutting out whole food groups from your diet. Going “gluten free” may mean avoiding enriched whole grains that contain folic acid, an important nutrient for women of childbearing years because it helps reduce the incidence of neural tube birth defects such as spina bifida.

Vegans, who shun all animal products, may be at risk of a vitamin B12 deficiency unless their diets are planned very carefully.

Avoiding dairy can cut out a key source of calcium and vitamin D. Then there’s the mental strain of orthorexia with its demands to obsessively police food choices.

Who’s Orthorexic? 

Behavioral issues associated with orthorexia include the following: Do you look down on others who don’t eat this way? Do you skip foods once enjoyed in order to eat the “right” foods? Does your diet make it difficult to eat anywhere but at home, distancing you from family and friends? Do you feel guilt or self-loathing when you stray from your diet rules?

Real Measures of Health

Rather than focusing on a checklist of foods to avoid, White guides clients to eat a wide variety of healthful foods. From there, he gauges the physical and mental conditions that develop with healthy eating habits. “We rate energy level, mood, quality of sleep and stress levels,” White says. “After three months (of eating a well-balanced diet) they’ll see changes and listen to what works for the long run.”

To learn more about the difference between a healthy appreciation of good foods and obsessing over food choices, enlist the help of a registered dietitian nutritionist to find the best eating plans customized to your lifestyle, fitness goals and taste preferences.

Carolyn O’Neil is a registered dietitian, cookbook author, journalist, and blogger. Learn more at 


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