Orthorexia Is A Growing Diagnosis. Here’s How Experts Treat It.

Wanting to do what's best for your body is an extremely understandable impulse. Messages to eat whole foods and exercise are everywhere and are generally well intentioned. But in a world so marked by toxic diet culture, a desire to live a "healthy" life can quickly turn into a negative obsession. Experts now say this kind of obsession can actually be an eating disorder called orthorexia nervosa. As with other forms of disordered eating, treating orthorexia can require the help of a mental health professional and a solid support network.

"Orthorexia nervosa develops when healthy eating becomes an obsession or preoccupation that results in distress or anxiety over 'breaking' one’s self-imposed nutritional rules," says Dr. Elizabeth Barchi, M.D., sports medicine specialist at the NYU Langone Center for Women’s Sports Health. "This rigid adherence to a specific diet, or restriction of certain foods, can lead to nutritional imbalances and other negative health effects."

"Although there is no one specific treatment designed for orthorexia nervosa, seeking help from a multidisciplinary team is recommended," says Kristin Wilson, MA, LPC, vice president of clinical outreach for Newport Academy, a mental health rehabilitation facility for teens and young adults. This team will probably include a registered dietician and therapist, and together, they can come up with a plan that's unique to a patient's needs.

Some of the goals of treatment for orthorexia include working with your treatment team to "increase the variety of foods eaten, develop more flexible eating patterns, reduce anxiety around feared foods, and work on exposure and inclusion of those and all foods," says registered dietician Brenna O'Malley, founder of The Wellful.

Barchi says that being preoccupied with nutritional rules, extreme anxiety and distress over breaking these rules, and social friction or isolation resulting from these rules can all be signs of orthorexia nervosa. Orthorexia can lead to negative health impacts such as a compromised immune system, kidney failure, social isolation, heart disease, and cognitive difficulties from a lack of nutrition.

Orthorexia isn't yet in the DSM-5, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, because the dangers are similar to other eating disorders and doctors don't agree on the criteria for a diagnosis. But according to the National Eating Disorders Association, the term orthorexia came into use in 1998 as a way for physicians to refer to an obsession with healthy eating that winds up having a dangerous impact on a person's well-being. "Good nutrition and exercise are part of a healthy lifestyle," Barchi says. It only becomes unhealthy when "[it] becomes a preoccupation, a coping mechanism for a high-stress situation, or a compulsion (i.e., 'I have to workout or else the rest of my day is shot')."

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"Many clients’ orthorexic behavior started as an interest in health or nutrition and turned into an extreme fear of foods that don’t meet their ‘healthy’ or ‘clean’ standards," O'Malley tells Bustle. If you identify with that fear, O'Malley suggests asking yourself some important questions. "How much of your day is dictated by needing to follow your rules? How does it impact your social life? Can you make spontaneous plans with friends? Does the idea of having a day without these rules cause extreme anxiety or discomfort?" If you notice these patterns in yourself, the first step to treatment is often reaching out to a registered dietician or therapist. O'Malley says that many of these professionals offer free discovery calls to help you begin your recovery journey.

A combination of therapy is often needed to help decrease the anxiety, obsessive thoughts, and compulsive behaviors associated with orthorexia, Barchi tells Bustle. A person's mind-body connection can be improved by working with an experiential therapist, and a registered dietitian can help someone figure out how to maintain proper nutrition. "Ask yourself what you’d like your life to be like beyond an eating disorder or constantly thinking about food/exercise," O'Malley suggests.

If you're finding that trying to eat healthily is negatively impacting your social life, your energy levels, or your emotional health, Barchi recommends seeking help from a mental health professional to start building yourself a support network. "Healing your relationship with food requires healing your relationship with yourself, and that requires strength, insight, and above all, support," she tells Bustle. And you definitely deserve that support.

If you or someone you know has an eating disorder and needs help, call the National Eating Disorders Association Helpline at 1-800-931-2237, text 741741, or chat online with a Helpline volunteer here.


Dr. Elizabeth Barchi, M.D., sports medicine specialist at the NYU Langone Center for Women’s Sports Health

Kristin Wilson, MA, LPC, Vice President of Clinical Outreach for Newport Academy

Brenna O’Malley, RD, founder, The Wellful LLC