What is orthorexia? When Healthy Eating Becomes Unhealthy
Most of us want to eat well. Food can be fuel, comfort, connection, joy. But when “healthy eating” becomes an all-consuming obsession, when you’re stressing over ingredients, rules, and whether your food is “pure enough”, that’s no longer about health. That’s orthorexia nervosa.
It’s not an official diagnosis in the DSM-5 yet, but research is catching up. And the reality? Orthorexia can look like you’re doing everything “right” on the outside, but inside, it’s exhausting, guilt-laden, and socially isolating.
What Even Is Orthorexia?
Orthorexia isn’t about chasing thinness (like anorexia often is). It’s about chasing purity or perfection. Think rigid food rules, cutting out food groups (carbs, dairy, “processed” anything), obsessively weighing foods to hit ‘macros’, or feeling anxious and guilty when you eat outside your “safe list.”
Sounds “healthy”? Nope. Research shows this kind of rigidity can lead to nutritional gaps, stress, and serious impacts on mental and physical health and social life (PubMed, 2018).
How Common Is It?
The numbers are a bit all over the place (thanks to different measuring tools), but here’s the gist:
Among university students in Australia, about 21% showed signs of orthorexia. When stricter criteria were applied (like impact on social or work life)? It dropped to around 6.5% (UNSW study, PubMed).
People in health-related fields (nutrition, medicine, fitness) show higher rates than the general population (Bond Uni review).
Folks who exercise a lot also have a higher prevalence of orthorexia traits (Journal of Eating Disorders, 2023).
So it’s not rare, but not everyone “eating clean” has orthorexia either. It’s about when the rules take over your life.
Why Does It Matter?
Because eating “too healthy” (ironically) can be really unhealthy.
🚫 Nutritional deficiencies (cutting whole food groups without medical need).
🚫 Social isolation (avoiding dinners, restaurants, travel).
🚫 Mental strain (constant guilt, anxiety, rigid routines).
🚫 Slippery slope into other eating disorders.
Health should feel flexible, nourishing, and connected, not a prison of food rules.
What Helps?
The good news? Orthorexia is treatable, and recovery is absolutely possible. Here’s what the evidence (and clinical wisdom) suggests:
Recovery usually works best when you’ve got a psychologist, a dietitian who understands eating disorders, and a GP or medical team if needed.
Multidisciplinary Care is Queen 👑
Working with a psychologist specialised in eating disorders.
A dietitian (with ED experience) to ensure nutritional adequacy, help expand variety, reduce fear and avoid food rules.
Medical monitoring for physical health (nutritional deficiencies, etc.)
Think of it like your personal pit crew for healing.
2. Therapeutic approaches
Cognitive Behavioural Therapy (CBT) to challenge rigid beliefs about food, perfectionism, all-or-nothing thinking.
Acceptance & Commitment Therapy (ACT) for increasing psychological flexibility, tolerating discomfort, letting go of rigid rules.
Behavioral experiments (e.g. eating “less than perfect”, introducing previously “forbidden” food for exposure).
3. Use of frameworks & models
RAVES™ (Regularity, Adequacy, Variety, Eating Socially, Spontaneity) can promote recovery by increasing variety, social eating, and flexibility.
4. Monitoring & gradual change
Start by identifying rigid or rule-based eating patterns.
Introduce flexibility gradually.
Nutritional adequacy first: ensuring enough energy, protein, fats, micronutrients.
Reintroducing variety: food groups, textures, social meals.
How This Can Be Part of Your Recovery
If this feels familiar, here are steps you might try:
Identify your food rules: write them down. Where did they come from (social media? health norms? family?)
Notice when they cause harm: do they lead to social withdrawal? Anxiety? Physical discomfort? Nutrient gaps?
Work with a psychologiost and dietitian: especially to safely expand food choices and reduce rigidity.
Small experiments: choose a “rule” to loosen (just one) and see what happens (e.g., eating out, or trying a previously “forbidden” food).
Build values & pleasure: not just nutrition or “purity,” but what food + eating means to you — enjoyment, connection, culture, joy.
Friendly Reminder
If you’re reading this and thinking, “uh oh, this is me,” take a breath. Orthorexia isn’t your fault — it’s often fuelled by a culture obsessed with clean eating and wellness.
But you don’t have to stay stuck there. With the right support, you can shift from food rules and fear into a way of eating that actually feels good.
Resources
Final Thought
Healthy eating is supposed to add to your life, not shrink it. If your food rules are stealing joy, flexibility, or connection, that’s your sign it’s time for support.
At recoverED Clinic, we offer online psychotherapy across Australia with a compassionate, evidence-based approach to eating disorders recovery. You don’t have to do it alone. Let’s find a path toward eating that feels nourishing, flexible, and emotionally freeing. Contact us to find out more.
