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Those who have an "unhealthy obsession" with otherwise healthy eating may be suffering from "orthorexia nervosa," a term which literally means "fixation on righteous eating." (NEDA.) Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become solely concerned with the quality of the food they put in their bodies, refining and restricting their diets according to their personal understanding of which foods are truly 'pure'. They become consumed with what and how much to eat, and how to deal with "slip-ups."

An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be "good," rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics' diets and they sometimes feel superior to others, especially in regard to food intake.

Eventually food choices become so restrictive, in both variety and calories, that health is compromised — an ironic twist for a person so completely dedicated to healthy eating. Eventually, the obsession with healthy eating can crowd out other activities and interests, impair relationships, and become physically dangerous. The focus may turn into a fixation so extreme that it can lead to severe malnutrition or even death.

Orthorexia differs from other eating disorders, such as anorexia nervosa and bulimia nervosa, where people focus on the quantity of food eaten rather than the quality of the food.

Are You Telling Me it is Unhealthy to Follow a Healthy Diet?

Following a healthy diet does not mean you are orthorexic, and nothing is wrong with eating healthfully.


  • it is taking up an inordinate amount of time and attention in your life;
  • deviating from that diet is met with guilt and self-loathing
  • it is used to avoid life issues and leaves you separate and alone.

Orthorexia: The Dirty Downside of "Clean" Eating

Vegetarian, vegan, low-carb, raw, paleo — all claim to be the "ideal" diet, and adherents preach the benefits with the conviction of religious converts. But the current obsession with "clean" or "healthy" eating can have very unhealthy consequences. Mirasol clinicians gathered to talk about the roots of orthorexia, how it differs from anorexia, and the red flags that help health professionals and family members distinguish between selective or "picky eating" and an eating disorder.

Download Audio: M4A

Signs and Symptoms

Orthorexia nervosa is characterized by:

  • an obsession with avoiding foods perceived to be unhealthy
  • symptoms that are consistant with obsessive compulsive disorder.
  • an exaggerated concern with healthy eating patterns.

Here is a little quiz that might help a person decide if they are orthorexic:

  • Do you spend more than 3 hours a day thinking about healthy foods?
  • When you eat the way you're supposed to, do you feel in total control?
  • Are you planning tomorrow's menu today?
  • Has the quality of your life decreased as the quality of your diet increased?
  • Have you become stricter with yourself?
  • Does your self-esteem get a boost from eating healthy?
  • Do you look down on others who don't eat this way?
  • Do you skip foods you once enjoyed in order to eat the "right" foods?
  • Does your diet make it difficult for you to eat anywhere but at home, distancing yourself from family and friends?
  • Do you feel guilt or self-loathing when you stray from your diet?

If yes was answered to two or more questions, you may have a mild case of orthorexia.

Causes of Orthorexia

An obsession for healthy foods could come from a number of sources such as family habits, societal trends, economic problems, recent illness, or even just hearing something negative about a food type or group, which then leads them to ultimately eliminate the food or foods from their diet.

Orthorexia appears to be motivated by health. There are underlying motivations however, which can include:

  • safety from poor health
  • compulsion for complete control
  • escape from fears
  • wanting to be thin
  • improving self-esteem
  • searching for spirituality through food
  • using food to create an identity

What Is The Treatment for Orthorexia?

Treatment begins with a safe and supportive environment that is found only in a small, holistic treatment center such as Mirasol. The staff at Mirasol is caring and compassionate and understand the difficulties that the client is facing and help the client delve into the underlying issues that contribute to orthorexic thoughts and beheaviors.

Orthorexia is generally treated with psychotherapy, medication, or preferably with neurofeedback.

  • Psychotherapy: A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively.
  • Dialectical Behavioral Therapy (DBT) is used extensively in treatment of anxiety disorders. DBT combines behavioral, cognitive, and meditative therapies to help a woman heal.
  • Medication: Doctors also may prescribe medication to help treat orthorexia. The most commonly prescribed medications for orthorexia are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
  • Neurofeedback: Neurofeedback is a form of biofeedback designed to help people alter their brain waves in ways that can have a profound effect on their behavior, mood, and thinking. Neurofeedback provides information about the type and intensity of brain waves being generated. A 2003 study describes how neurofeedback was used to reduce OCD symptoms by 89% as measured by the internationally-recognised OCD test, the Padua Inventory. OCD had not returned more than 12 months after the Neurofeedback training. It is postulated that orthorexia is a type of OCD.
  • In an age dominated by pharmaceutical approaches to treating the brain, neurofeedback has emerged as a bold new nonchemical alternative-one that is surging in popularity among patients frustrated by the limitations and side effects of anti-depressants, stimulants, and other drugs.
(Hammond, D. C. (2003). QEEG-guided neurofeedback in the treatment of obsessive compulsive disorder. Journal of Neurotherapy, 7(2), 25-52.)

At Mirasol medications are very carefully prescribed and generally only for short periods of time.

FREE Eating Disorder Support Group!

FREE weekly eating disorder support group for adults struggling with food issues, staffed by therapists from Mirasol Eating Disorder Recovery Centers. Thursdays from 5:30-6:45 pm at 3116 N Swan in Tucson. For more information, call 520-546-3200.

"Mirasol is light years ahead of any other program in the country."