What is Orthorexia nervosa?

From Banting to the Paleo diet, gluten-free to vegan lifestyles, we live in a society that has been swept by a healthy-living and weight loss craze. While maintaining a healthy lifestyle is always a good idea, could some people be taking it too far?

Moneybags journalist, Danielle van Wyk explores the disorder, Orthorexia nervosa.

“Today, society seems to cycle and recycle through a myriad of diets made popular by the media as they hook onto the latest advice from health related professionals, in our attempts to achieve the perfect body.

“The advice we receive can be confusing but can also be used to help justify one’s own extreme practices. Eat carbs and then cut them out; fats cause heart attacks and then suddenly they are good for us,” maintains clinical psychologist, Liane Lurie.

While an individual never starts with an obsession, in this case with losing weight, this can develop quickly once they are privy to the effects of dietary restrictions.

This is then worsened by the barrage of messages, which focus on the labelling and mislabelling of certain food as either good or bad, healthy or unhealthy, adds Lurie.

What is Orthorexia nervosa?

According to The National Eating Disorders Association (NEDA), “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.’”

“It is not a diagnosable eating disorder, although the behaviours described by Orthorexia, such as obsession with healthy food to the point of eliminating foods, can be warning signs for eating disorders,” says Lauren Smoller, director of helpline services at NEDA.

How does it affect you?

Since this disorder is not an indicatively diagnosable one, because on the surface it appears the individual is leading a healthy life, it goes fairly undetected in the first stage.

“Initially it may not appear that they are starving themselves but as their diet becomes progressively more restrictive severe weight loss and other medical conditions may result. The individual may attempt to justify their healthy eating obsession on the basis of some cause, as if this has become inextricably linked to their identity,” states Lurie.

She goes on to explain that victims are often more concerned with the notion of feeling impure as a result of what they ingest than they are with the goal of losing weight. However, one cause can become confused with the other especially with adolescents and their developing brains.

“These actions over time may interfere with the person’s engagement in social activities, as these generally centre on food. The person may become extremely anxious about eating foods in another person’s home if they do not know the exact ingredients that went into preparation,” adds Lurie.

Another affect Smollar highlights is that of malnutrition which often sets in as the individual starves their body entirely of certain food groups.

What are the symptoms?

Like with any condition there are indicators that are often missed by those around the individual, this is especially the case with eating disorders as the individual is able to mask the affects for a while, before people start noticing the physical effects first.

“The individual may become progressively more anxious as they seek perfection. Their need for control becomes stronger. The sphere of their lives become smaller and smaller as they choose control of food over spending quality time with friends and loved ones. Others may distance themselves from them due to a lack of understanding or experiencing them as being ‘extreme’ in their behaviour and outlook,” reveals Lurie.

According to Timberline Knolls residential treatment centre, some of the other common indicators include:

-Individuals exhibit an obsessive anxiety about their food choices and health concerns such as asthma, low mood, digestive problems, anxiety or allergies.

-There is often an increase in their interest and consumption of herbal remedies, supplements and or probiotics.

-Individuals experience a drastic reduction in opinion around acceptable food choices and options, eventually they may consume fewer than 10 foods.

-They experience or exhibit an irrational concern around food preparation techniques, especially the washing or sterilization of utensils.

In recent times there has certainly been a lot more media coverage in educating the public about identifying these behavioural traits as a problem, adds Smollar. “Since people cannot be diagnosed specifically with Orthorexia, it is difficult to track if the behaviours themselves are on the rise, or if more people are simply aware that these behaviours are cause for concern.”


Research and clinical practice have proven through the years, time and time again, that extreme eating disorders and conditions are never about food alone.

“With any eating related disorder, the individual has to recognize that there is some kind of issue and that their lives have become unmanageable as a result,” explains Lurie.

She further explains that approaching a friend or family member can always be tricky and perceived as somewhat of an attack. However, if you remain quiet, you may unwittingly be enabling the person’s destructive behaviour.

“Try and approach the situation in a loving and non-judgmental way, expressing your concern and wanting to offer support.  The level of weight loss and associated anxiety may often necessitate the immediate involvement of health professionals, particularly if the individual’s behaviour is placing their health and wellbeing at risk,” suggests Lurie.

Just like with any other eating disordered condition or behaviour, it is always recommended that the individual seek professional help. And because these conditions are less about food and more about the mental control or issues experienced, this help usually entails extensive therapy.

“The therapy may work on helping the person to expand their sense of self from food or the control of food to other domains. The therapist will need to work slowly and in a manner, which is unthreatening to the patient. Working in conjunction with a dietician is useful in helping the individual experiment with foods they previously may have feared, while dealing with the associated emotions,” Lurie elaborates.

Maintaining a healthy lifestyle in a world that has become ‘carb-sessed’ with fast food living, is difficult but necessary. The key to this, however, as with everything in life, is balance.