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Do you or someone you know have a strong focus on eating extremely healthy food? Here we explain what orthorexia is and how you can get help to stop the behavior.

What is orthorexia?

Orthorexia is a term used to describe an unhealthy focus on eating extremely healthy food. The problem behavior 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 in Ireland and internationally.

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What causes orthorexia?

Orthorexia is due to a combination of factors including psychological traits such as perfectionism and the need for control, social and cultural influences from society’s focus on health and idealised representations on social media. Personal experiences related to food and diet, as well as environmental factors where a healthy lifestyle is highly valued also have an impact. Biological factors such as genetic predisposition may also play a role.

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


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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 behavioral 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 counseling 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 and answers 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 Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT). Nutritional counseling is key and other medical problems may require medical supervision.

What is CBT?

Cognitive-behavioral therapy (CBT) is an evidence-based form of psychotherapy that aims to change negative thought patterns, emotions and behaviors 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, although it has a different expression. Whether orthorexia is 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 behavior 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?

It is possible to get treatment online, at Lavendla all our psychologists and therapists work digitally.

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 hard things easier.

Treatment with cognitive behavioral therapy

Treatment approaches can differ between different schools of therapy. This is what a treatment can look like with Cognitive Behavioral Therapy (CBT), which is 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 that it is okay to seek help for it. A licensed psychologist can help you assess your situation based on your life situation. You can also fill in assessment forms.

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 behaviors and patterns

This works on identifying and changing patterns of thinking that are linked to the problem. This will help you develop a more nuanced picture and increase your ability to manage emotions, thoughts and change behaviors. Together with your therapist, you will explore situations and learn how to deal with them. You will also be given homework to practice between sessions.

Follow up and evaluate progress

You will have support from your psychologist throughout the process. At the end of the treatment, you will also receive a plan to continue practicing and maintain your progress over time. Feel free to book a first session with one of our licensed psychologists or therapists to see how we can help you.

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Written by Ellen Lindgren

Licensed psychologist

Ellen is a licensed psychologist and has experience mainly in clinical psychology where she has worked with various conditions such as stress, anxiety, depression, insomnia, crises and trauma in primary care and psychiatry. She has also worked with research while studying in the US and with affective disorders and insomnia at Karolinska Institutet, Sweden.