Everyone eats differently because they have different nutritional needs. Physical activity, age, and sex are just a few things that impact what you need to eat. Eating “healthy” looks different for everyone. Eating healthy is great! But, if it becomes a race to perfection, thoughts about food can consume your life. People who have orthorexia experience obsessive thoughts about food and feel that they must eat “perfectly”.
What is orthorexia?
Orthorexia is a form of disordered eating where a person obsesses over eating “perfectly” healthy. Eating healthy isn’t harmful, but when someone has orthorexia, they fear foods they think are “unhealthy” causing them to feel distress and anxiety. To avoid feeling like this, they may avoid or restrict what foods they allow themselves to eat to the point where they may not be getting enough nutrition for their body. They may feel that if they don’t eat perfectly, they will become unhealthy. In the mind of a person with orthorexia, being unhealthy or not perfect may feel like the end of the world. A vicious cycle of distress happens when they feel they must plan food ahead of time to avoid negative emotions, even though they are already stressed.
What can orthorexia look like from the outside?
- Looking at the nutritional information on all or most foods
- Visible distress around unfamiliar foods, unplanned activities including food, or eating food that you think is unhealthy
- Excess exercise
What can orthorexia feel like on the inside?
- Rigid self-made routines and rules for eating
- Urge to eat “perfectly” or else you don’t feel good about yourself
- Distress when you don’t eat perfectly
- Mentally planning out what to eat
- Feeling like thinking about food has taken over your thoughts
- Overall feeling like you need to control everything that you eat
Healthy eating vs orthorexia: What’s the difference?
Healthy Eating
Eating healthy means you are getting the proper amount of nutrition for your body in all the food groups: carbohydrates, fats, proteins, vegetables, fruit, and dairy; and that you are getting all of the vitamins and minerals needed. Healthy eating is balanced and varied so you can enjoy different foods, including desserts. There are many ways to eat healthy, depending on personal needs. Eating healthy is something to be mindful of but not obsessed over.
Healthy Eating vs. Orthorexia
In orthorexia, obsessive thoughts about food crowd the mind, along with worry and other negative feelings. Eating with orthorexia is different from healthy eating because people with this condition feel like they have to follow self made food rules. If they don’t they feel distressed, even feeling bad about themselves as a person. Orthorexic eating is not actually healthy because obsessing over food leads to unnecessary stress.
Who is more likely to develop orthorexia?
Young people
Young people, like teens, are more at risk for developing disordered eating habits like orthorexia for a variety of reasons. In this life stage many rapid changes are happening with development. Teens become more independent and try to make sense of their lives. They may take advice from people or sources that are not backed by science or aren’t what they personally need. With widespread access to social media, teens can be influenced by content creators who promote unrealistic ideas of health. Teens develop their own eating habits and if they are influenced by inaccurate data, it can be harmful to their development and mental health.
Perfectionists
Perfectionists constantly chase their self-made standards that are always rising. They are often very hard on themselves and find it difficult to feel proud of themselves because they are always trying to be “better”. Perfectionists often feel this self criticism in all parts of their lives. This could be school, sports, extracurriculars, social life, and sometimes eating and health. In orthorexia, there is perfectionism in eating.
People with obsessive compulsive disorder (OCD)
OCD is a mental health condition where people have obsessive thoughts that are satisfied by compulsive actions. A common obsessive thought in OCD is the fear of getting sick or feeling contaminated. Often, the compulsive action for this thought is to excessively wash hands. This is similar to thoughts with orthorexia. People with orthorexia have obsessive thoughts, striving for perfect health. The paired compulsive actions, eating what they think is perfect, is the response. Many people believe that orthorexia is a more specific version of OCD, since it focuses on a specific thought cycle.
People with diagnosed eating disorders (EDs) or disordered eating behaviors
EDs are mental health conditions that also impact a person’s physical health. Disordered eating behaviors/habits aren’t diagnosed mental health conditions, but if a person is experiencing these behaviors, they can be more at risk to develop an ED. Orthorexia isn’t an official ED on its own, but it features disordered eating habits that are harmful and put the person experiencing them more at risk for developing an ED.
How is orthorexia like other forms of disordered eating?
Orthorexia is similar to other restrictive forms of disordered eating, such as anorexia nervosa. Both can involve cutting out foods, feeling pressure to eat “perfectly,” and obsessive thoughts about food. This kind of restriction can lead to serious health consequences, especially for teens whose bodies need energy and nutrients for growth and development. However, the motivations may differ: people with orthorexia are often focused on achieving “perfect” health, while anorexia is more often driven by fear of weight gain and/or a desire for a certain body size.
How Anorexia and Orthorexia Relate
Because these conditions can share patterns like restriction, perfectionism, and a need for control, people with eating disorders such as anorexia may be at higher risk for developing orthorexia and vice versa.
What problems can orthorexia cause?
Physical health
When orthorexia includes restricting food intake, there won’t be enough energy for the body to properly function. Some issues that arise from this include:
- Feeling more tired than normal
- Delayed puberty
- Irregular or no periods
- Weaker bones
- Unhealthy weight loss
- Dangerous nutrient deficiencies including electrolyte imbalances, vitamin deficiencies, and mineral depletion
Mental health
- Constant worry about eating and food in general
- High levels of anxiety can interfere with other parts of life, when you have this focus it can take away from other parts of life
- Feeling like you are not good enough/ not being happy with yourself
Social health
- Turning down hanging out with friends out of the fear of unpredicted food
- Comparing your eating habits to others’
- Pushing away those that love you because you are so worried about food
What should you do if this sounds familiar?
If you recognize these disordered eating habits in yourself, or think you might have orthorexia, you can talk with your health care provider or a mental health professional that specializes in EDs. If your thoughts are often taken over by food and eating, this can be harmful to your well-being. You can change your relationship with food to fuel your life instead of consuming your life with proper treatment and support. Don’t try to diagnose or treat yourself, instead reach out for help from a qualified professional.
For immediate support, here are some ED and mental health-related hotlines:
- National Alliance for Eating Disorders 24/7 Hotline Crisis Help- 1-866-662-1235
- National Alliance on Mental Illness (NAMI) Helpline M-F 10am-10pm ET 800-950-6264 or text “NAMI” to 62640 or email
- Suicide and Crisis hotline- 988
Click on these links to learn more about orthorexia:
- Orthorexia: Symptoms, Risks & Treatment | NEDA
- How to Better Understand the Confusing, Counterintuitive World of Orthorexia – National Alliance for Eating Disorders
Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.