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Do you or someone you know have an excessive focus on eating extremely healthy food? Here we explain what orthorexia is and how to seek help.

What is orthorexia?

Orthorexia is a term used to describe an unhealthy focus on eating extremely healthy food. The problem behaviour involves being centered on the quality of the food. People with orthorexia are obsessed with eating foods that they consider clean or extremely healthy and may avoid large groups of foods that they perceive as unhealthy or unclean. This obsession can lead to significant nutritional deficiencies, social isolation, and a severely reduced quality of life.

Is orthorexia a diagnosis?

Orthorexia first came to attention as a condition in the 1990s by Dr. Steven Bratman. Although it is not officially recognised as its own diagnosis in the major diagnostic manuals such as DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) or ICD-10 (International Classification of Diseases), awareness and discussion of the condition has increased.

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What causes orthorexia?

Orthorexia stems from various factors, including psychological traits like perfectionism and the desire for control. Social influences, such as society’s emphasis on health and idealised images on social media, contribute to its development. Personal experiences with food and diet, as well as environmental factors valuing a healthy lifestyle, also play significant roles. Additionally, biological factors, like genetic predisposition, can play a part.

Orthorexia is a complex condition that affects both physical and emotional health, and treatment should address the underlying causes, often through psychotherapy and nutritional counselling.


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What are the symptoms of orthorexia?

People with orthorexia exhibit an obsession with food quality and spend an inordinate amount of time thinking about and preparing food that they consider healthy. They limit their diet to a very small group of ‘allowed’ foods and avoid foods considered unhealthy or ‘unclean’, which can lead to social isolation as they avoid social situations involving food. Feelings of anxiety, guilt or stress arise if they deviate from their strict diet, and physical problems such as nutritional deficiencies may occur due to the restricted diet.

The obsession with healthy food can reduce quality of life as other interests and activities are neglected. They strongly defend their dietary choices and have difficulty accepting other points of view or scientific evidence that contradicts their beliefs. This extremely health-conscious attitude can result in ill health when it leads to restrictive eating habits, emotional distress and social isolation, making it important to seek professional help if these symptoms affect you or someone you know.


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Treatment of orthorexia

Treatment for orthorexia aims to restore a healthy relationship with food and to address the psychological aspects behind the problem. Psychotherapy, such as cognitive behavioural therapy (CBT), helps individuals identify and change the thought patterns that contribute to unhealthy behaviors, while acceptance and commitment therapy (ACT) and compassion-focused therapy (CFT) focus on accepting thoughts and feelings and promoting self-compassion.

Nutritional counselling is central to developing a balanced diet plan that covers all nutritional needs without being restrictive. For people whose orthorexia has led to nutritional deficiencies or other medical problems, medical supervision may be necessary. Support groups and possibly family therapy can also offer valuable support and guidance during the recovery process. The treatment process is often long-term and requires an individualised plan that addresses both nutrition and psychological needs to promote a healthy relationship with food and body image.


12 common questions about orthorexia

What is orthorexia?

Orthorexia is a term used to describe an unhealthy focus on eating extremely healthy foods.

Is orthorexia a diagnosis?

Orthorexia is not officially recognised as a separate diagnosis in the major diagnostic manuals such as DSM-5 or ICD-10 but awareness and discussion of the condition is ongoing.

What causes orthorexia?

Orthorexia is due to a combination of factors including perfectionism and the need for control, social and cultural influences from society, personal experiences related to food and diet, and environmental factors where a healthy lifestyle is highly valued also have an impact. Biological factors such as genetic predisposition may also play a role.

What are the symptoms of orthorexia?

Individuals with orthorexia show an obsession with eating only foods they consider healthy, leading to strict dietary restrictions and social isolation. This fixation causes nutritional deficiencies, anxiety about dietary deviations and a significant negative impact on quality of life.

How can orthorexia be treated?

Orthorexia can be treated with different methods such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT). Nutritional counselling is key, while other medical problems may require medical supervision.

What is CBT?

Cognitive behavioural therapy (CBT) is an evidence-based form of psychotherapy that aims to change negative thought patterns, emotions, and behaviours that contribute to mental illness.

Is orthorexia an eating disorder?

Orthorexia is not a formal diagnosis but could fall into the category of anorexia and bulimia, with a different expression. Orthorexia as an eating disorder is still a matter of scientific debate.

Are you addicted to exercise when you have orthorexia?

No, you don’t have to be addicted to exercise, the problem is mainly focused on food and its content.

I have a strong need to check that my food is healthy and it is affecting my life, what should I do?

If you feel that you have a behaviour that leads to problems, you can seek treatment to get more help to break the pattern.

My partner has a strong obsession with healthy food, what can I do?

If someone close to you has a problem that you think may be related to orthorexia, you can bring it up with them. If they don’t want to change, it’s difficult but you can refer them to a health professional for more support.

Can you get therapy online?

Lavendla offers online sessions with its psychologists and therapists via video conference.

Where can I seek help?

If you want to seek therapy, we recommend that you contact a licensed psychologist or therapist. You can book a first appointment with one of our therapists here at Lavendla. We make the difficult easier.

Treatment with cognitive behavioural therapy

Treatment approaches can differ between different schools of therapy. This is what a treatment can look like with Cognitive Behavioural Therapy (CBT), a method that can be used for many different problem areas and conditions:

Understanding and assessment

The first step is to understand the problem and realise you can seek help for it. A licensed psychologist can help with an assessment situation based on discussions about your lifestyle and background. Assessment forms may require completion.

Psychoeducation and objectives

You will learn about the problem and how it affects you both physically and mentally. It is important to understand what is happening in your body, thoughts and feelings. It also involves setting goals for treatment.

Tools to change behaviours and patterns

Identifying and changing patterns of thinking linked to the problem helps develop a more nuanced picture and increase your ability to manage emotions, thoughts, and change behaviours. Together with your therapist, you will explore situations and learn how to deal with them. Homework will be given for practicing between sessions.

Follow-up and evaluation of progress

You will have support from your psychologist throughout the process. At the conclusion of the treatment, you’ll receive a plan outlining how to continue practising and maintain your progress in the long-term. Feel free to book an initial online session with one of Lavendla’s licensed psychologists or therapists to see how they can help you.


Written by Dominic Wardall

Dominic is a Cape Town-based copywriter and editor with extensive background and studies in psychology. Dominic is a central part of the articles written on Lavendla.