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When Diet Culture Goes Too Far

In July 2019, we posted a blog called “the Toxicity of Diet Culture.” Lately, I’ve been thinking about a quote that led to the research for this blog. Christy Harrison, the host of the podcast, Food Psych, said that “Diet culture is a system of beliefs that worships thinness and equates it to health and moral virtue, which means you can spend your whole life thinking you’re irreparably broken just because you don’t look like the impossibly thin ‘ideal.’” It made me think about what happens when someone takes that kind of lifestyle to the extreme, particularly if they are genetically susceptible to mental illness. I thought that there would have to be an eating disorder associated with it. It turns out that my suspicions were correct, and the condition is called orthorexia.

What Is orthorexia?

Officially, orthorexia nervosa isn’t an eating disorder at all. At least, not yet. The American Psychiatric Association has yet to recognize orthorexia as a disease officially. This is unsurprising, though. Researchers only coined the term in 1997, and formal criteria didn’t follow until almost 20 years later. However, more and more eating disorder specialists see cases that they feel fit the bill. The primary difference between orthorexia and an eating disorder like anorexia is a question of intent and extent. Someone suffering from anorexia restricts food to lose weight.

In contrast, a person struggling with orthorexia does it to feel healthy or natural. They may obsessively cut out foods with artificial colors or flavors, high in saturated fats or refined sugar, or other ingredients they may consider unhealthy. Paradoxically, their quest for health leads them into a very unhealthy situation.

A Question of Extent

I am willing to bet that some of you have started to mutter under your breath angrily. Something like, “Well, what am I supposed to do? Just go out and eat nothing but McDonald’s for the rest of my life?” And I’ll admit, I was a little skeptical when I was doing the research for this blog. But remember that qualifier of the extent I mentioned earlier. While there’s nothing wrong with wanting to eat healthier, the disordered eating that characterizes orthorexia starts to interfere with life. But where do health-conscious eating end and orthorexia start? Again, it might be best to go to the source. In this case, that means Steven Bratman, the man who coined the term “orthorexia.”

Signs of orthorexia

Bratman created the following list to help individuals determine whether they might be developing orthorexia:

  • I spend so much of my life thinking about, choosing, and preparing healthy food that it interferes with other dimensions of my life, such as love, creativity, family, friendship, work, and school.
  • When I eat any food I regard to be unhealthy, I feel anxious, guilty, impure, unclean and/or defiled; even to be near such foods disturbs me, and I feel judgmental of others who eat such foods.
  • My personal sense of peace, happiness, joy, safety, and self-esteem is excessively dependent on the purity and rightness of what I eat.
  • Sometimes I would like to relax my self-imposed “good food” rules for a special occasion, such as a wedding or a meal with family or friends, but I find that I cannot. (Note: If you have a medical condition in which it is unsafe for you to make ANY exception to your diet, then this item does not apply.)
  • Over time, I have steadily eliminated more foods and expanded my list of food rules in an attempt to maintain or enhance health benefits; sometimes, I may take an existing food theory and add to it with beliefs of my own.
  • Following my theory of healthy eating has caused me to lose more weight than most people would say is good for me or has caused other signs of malnutrition such as hair loss, loss of menstruation or skin problems.

If any of these statements apply to you, you could be developing or suffering from orthorexia.

Effects of orthorexia

Whether the American Psychiatric Association considers orthorexia a bona fide eating disorder or not, the consequences of orthorexia are very real. The isolation from others, depression, and frustration associated with obsession are all possible results of orthorexia. In severe cases, so are dry skin, hair loss, loss of menstruation, and other effects of malnutrition that Steven Bratman mentioned. These effects are all the more likely when they occur with addiction, trauma, or another co-occurring disorder.

Ocean Recovery has been treating eating disorders, addiction, and co-occurring disorders since 2002. If you or someone you love suffers, please seek medical attention and consider Ocean Recovery for holistic, evidence-based residential treatment. Our admissions staff is standing by to answer any questions and help you start building your foundation for hope.


Ocean Recovery has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations for our references. We avoid using tertiary references as our sources. You can learn more about how we source our references by reading our editorial policy.

1. Dunn TM, Bratman S. On orthorexia nervosa: A review of the literature and proposed diagnostic criteria. Eat Behav. 2016;21:11-17. doi:10.1016/j.eatbeh.2015.12.006

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Last medically reviewed August 1, 2022.