Orthorexia: When Healthy Eating Becomes Harmful in Eating Disorder Recovery
Orthorexia: When Healthy Eating Becomes Harmful in Eating Disorder Recovery
Written by Lily Thrope
“But I’m Just Trying to Be Healthy”
Orthorexia often begins with a desire to feel better, have more energy, or “take care” of one’s body. Unlike other eating disorders, it is frequently praised, by friends, family, and even healthcare providers. This is one of the trickiest disordered eating patterns to notice because it can be so easily written off as a version of super health.
Often this structured way of eating can be touted as positive when there is actually a much darker and sadder experience under it all. The behaviors associated with orthorexia are often framed as discipline or wellness, many people don’t realize there is a problem until their world has become significantly restricted. On the outside it can look like someone making good choices for their health, but the internal experience is much less enjoyable. It can feel rigid, rules based and punishing.
Orthorexia is not about health itself. It is about control, fear, and rigidity disguised as self-care.
What Is Orthorexia?
Orthorexia is characterized by an obsessive focus on food quality, purity, or perceived healthfulness that leads to:
Restrictive eating
Fear based eating
Over exercising
Heightened anxiety
Social isolation
Impairment in daily functioning
While orthorexia is not currently a formal DSM diagnosis, it is widely recognized by eating disorder professionals due to its prevalence and impact. Disordered eating deserves understanding and treatment.
How Orthorexia Differs From “Healthy Eating”
Caring about nutrition is not inherently disordered. The difference lies in flexibility, impact, and emotional cost. Often orthorexia comes with some negative self beliefs and an idea that if you follow these rules you are “good” and if you don’t you are “bad.” There is a built in sense of morality and punishment for choosing health promoting behaviors. Using control to avoid difficult feelings can look like a nice strategy, but wreaks havoc on a person's relationship to themselves.
Healthy eating tends to involve:
Flexibility
Enjoyment
Adaptability to context
Curiosity rather than fear
Balance, Comfort, Trust
Gentle Nutrition
Orthorexia often involves:
Rigid food rules
Moral judgment of food choices
Anxiety or guilt when rules are broken
Avoidance of social eating
Self-worth tied to eating “correctly”
Compensatory exercise or restriction of food
When food rules become more important than nourishment, connection, or quality of life, something has shifted and you might be experiencing orthorexia or disordered eating.
Common Signs of Orthorexia
Orthorexia can look different from person to person, but common signs include:
Increasing Restriction Over Time
Foods are gradually eliminated due to concerns about:
Ingredients
Processing
Sugar, fat, or carbohydrates
“Inflammation” or “toxins”
What begins as a short list often expands until very few foods feel “safe.”
Anxiety Around Food Choices
People with orthorexia may experience:
Panic when preferred foods aren’t available
Distress when meals are unplanned
Preoccupation with researching food rules
Difficulty enjoying food due to fear of consequences
Moralization of Food
Food choices may be labeled as “good,” “clean,” or “pure,” while other foods are seen as “bad” or “toxic.” This moral framework often extends to self-judgment and low self-esteem.
Social Withdrawal
Eating in restaurants, attending events, traveling, or sharing meals may feel overwhelming or impossible due to fear of losing control.
Why Orthorexia Is So Often Missed
Orthorexia is frequently overlooked because:
The behaviors align with diet culture ideals
Restriction is socially rewarded
Weight loss may be praised
The individual appears disciplined or “healthy”
In some cases, orthorexic behaviors are encouraged by wellness spaces or even medical professionals, reinforcing the belief that there is no problem.
Orthorexia and Diet Culture
Diet culture provides fertile ground for orthorexia by promoting:
Fear-based nutrition messaging
Food purity ideals
The belief that health is earned through control
Constant self-monitoring
When health becomes a moral obligation rather than a support system, rigidity often follows.
The Impact on Mental and Physical Health
Despite appearing health-driven, orthorexia can lead to:
Nutritional deficiencies
Chronic stress and anxiety
Disordered digestion
Hormonal disruption
Social isolation
Reduced quality of life
Mood changes
The stress of maintaining rigid food rules can be just as harmful as the restriction itself.
Orthorexia and Eating Disorder Crossover
Orthorexia may exist on its own or overlap with other eating disorders such as anorexia, bulimia, or binge-restrict cycles. It can also be a socially acceptable entry point into more severe eating disorder behaviors.
It is important for more medical providers to understand eating disorders, orthorexia and disordered eating so there can be early recognition and connection to support. Working with a team of trained eating disorder doctors, therapists, psychiatrists and dietitians can make a huge difference for a person struggling with an eating disorder.
Recovery From Orthorexia
Recovery does not mean abandoning health or nutrition. It means redefining them and learning to care for yourself from a more compassionate and understanding place. Less restrictive and controlling and more open and loving.
Recovery often involves:
Gradually increasing food flexibility
Reducing fear-based food rules
Addressing underlying anxiety or perfectionism
Rebuilding trust in the body
Learning to tolerate uncertainty
Reconnecting with pleasure and satisfaction in eating
This process is often emotional and requires time and dedicated support teams. Support teams can include eating disorder specialized doctors, therapists, dietitians and psychiatrists. There are also many options of care treatment centers for eating disorders which can be very helpful.
How Therapy Helps
An eating disorder therapist can help by:
Identifying orthorexic patterns
Exploring where food rules came from
Challenging moralized food beliefs
Supporting exposure to feared foods
Addressing anxiety, control, and self-worth
Integrating nutrition support when appropriate
Therapy is not about forcing someone to eat in ways that feel unsafe, it’s about expanding safety itself. Helping a person feel more emotionally safe, regulated and confident in the face of emotions can lead to less of a need for control. Often eating disorder behaviors can be a temporary band aid to avoid feeling certain things. As one recovers, they will gain the tools to navigate big emotions and experience less of a need to engage with eating disorder behaviors. Therapy is also essential in working through the connections of body image and self worth which are also usually connected to eating disorder behaviors.
A More Sustainable View of Health
True health supports:
Flexibility
Adequate nourishment
Emotional wellbeing
Social connection
Respect for body diversity
Health is not fragile, and it does not require constant vigilance. Health can be pursued by anyone and does not have to be a strict definition. Your individual definition of health might look different from your friends and that is ok. We all have different emotional, physical and psychological needs.
Orthorexia thrives in a culture that confuses control with care. If eating feels stressful, rigid, or fear-driven, even in the name of health, it deserves attention.
You do not have to choose between health and freedom. Recovery allows room for both. Thrope Therapy in New York offers personalized support. Schedule a free 15-minute consultation today or email us at hello@thropetherapy.com with questions or to learn more.
