Orthorexia – Causes, Symptoms & Treatment


Orthorexia is one of the eating disorders, but is neither known nor frequently diagnosed as such. Those affected have a strong desire to always eat as healthily as possible.

What is orthorexia?

The term orthorexia is derived from the Greek words “orthos” and “orexis” for “right” and “appetite”. In contrast to other eating disorders , orthorexia does not focus on the quantity of food, but rather on its quality. Those affected only eat foods that they consider healthy. The pronounced preoccupation with food and the study of nutritional values ​​are also part of the clinical picture. All of these orthorexic behaviors are compulsive in nature .


Similar to anorexia nervosa, the main cause of orthorexia is a pronounced need for control. It mostly affects young women with a higher level of education, who are often perfectionists. Many people suffering from orthorexia compensate for a perceived loss of control in another area of ​​life by having more control over their diet. This increases their self-esteem and takes away many of their everyday fears.

A strict diet with the goal of weight loss is often the starting point for orthorexia, since during this period those affected find pleasure in being able to control and shape the body.

Symptoms, Ailments & Signs

Orthorexia sufferers have a compulsive focus on good quality food. Unhealthy things are avoided completely if possible. As a result, the thoughts of those affected revolve for several hours a day not only about different foods and the planning of their meals, but also about how they can avoid eating supposedly unhealthy foods.

When choosing their food, those affected usually study nutritional value tables or check the vitamin and mineral content of the same using tables from books or the Internet. They are always on the lookout for new foods that are even more nutritionally valuable and do everything they can to get them. This can take absurd forms, such as ordering from selected sources, for example in special online shops.

Not only the calorie content and the distribution of macronutrients play a role. Even with the micronutrients of the food is not the end for those affected. Especially when food is in the media, because it has been classified as carcinogenic or has an above-average level of pollutants such as pesticides, orthorexia patients consistently avoid it.

While eating, those affected always think carefully about the nutritional values ​​of the food they choose and often also about how they can make their meals even healthier. So they can no longer enjoy the meal in a relaxed manner.

Diagnosis & disease progression

Orthorexia often goes unnoticed, as many doctors dismiss the particularly strong tendency to eat healthily as a temporary fad. Also, some doctors don’t see orthorexia as an eating disorder in its own right, but rather as a common obsessive-compulsive disorder. Since the classification of orthorexia does not yet follow any fixed criteria, it is difficult to diagnose.

The consequences of orthorexia occur on both a physical and psychological level. Due to the severe restriction of the “allowed” foods, it is not uncommon for severe malnutrition and underweight to occur . This can be accompanied by various complaints such as listlessness , sleep disorders , concentration disorders or reduced performance and resilience.

The psyche can also suffer greatly from orthorexia. In addition to the general lack of pleasure in eating, those affected often distance themselves from their environment. Thoughts can revolve around food intake for several hours a day. In the case of severe forms of orthorexia, eating together informally can no longer take place unless those affected have extensively checked the food options on offer beforehand or even brought their own food.

People suffering from orthorexia often try to convert their fellow human beings to their supposedly healthier diet. The insight that their eating behavior is already pathological is missing. Such behavioral patterns can lead to the patient’s self-induced isolation.


Orthorexia has a negative effect on the psyche and also on the body. As a rule, patients suffer from an eating disorder due to orthorexia. This eating disorder has a very negative impact on the patient’s quality of life and can also lead to significant social discomfort. In most cases, this leads to malnutrition and further to deficiency symptoms. These can lead to other symptoms.

Orthorexia also often leads to severe weight loss. In severe cases, those affected may also lose consciousness. The psychological symptoms sometimes lead to personality disorders or obsessive-compulsive disorder. Depression or other mental upsets can also occur as a result of this disease. In serious cases, those affected are dependent on treatment in a closed clinic.

Disturbances in concentration or states of anxiety can also occur as a result of orthorexia. Treatment is usually with a psychologist. In outpatient cases, however, inpatient treatment is necessary. There are no complications. However, not every treatment is successful. In many cases, the treatment only takes effect after a very long period of time.

When should you go to the doctor?

The normal interest in healthy eating has no disease value. Not even a strong, one-sided interest that should be used professionally. It becomes difficult when those affected obsessively pay attention to the health value of food. Many orthorexics impose strict rules on what to eat and what not to eat.

The distinguishing factor between orthorexia and mildly disturbed behavior is the pathologization of interests. In the case of pathological traits and an obsession, the sufferer should see a doctor for their eating disorder. Alternatively, he could turn to a contact point specializing in eating disorders, where people with eating disorders receive psychological support.

The discussions about orthorexia nervosa are controversial because the transitions between a strong interest and pathological features are often fluid. Vegans or Paleo fans also show a certain consistency in their eating habits. Some develop strong proselytizing willingness to fight. But it doesn’t have to have an illness value.

However, the disease value is given if the person concerned suffers from his own behavior and still cannot stop it. In this case, it can be assumed that the excessive interest in healthy eating overshadows other psychological problems. Whether orthorexia is actually an eating disorder or a compulsive or addictive strategy to distract oneself from other problems must be assessed individually by a medical professional.

Treatment & Therapy

The aim of orthorexia therapy is to restore a normal and relaxed relationship with food to those affected. During psychotherapy , those affected learn to reintegrate supposedly unhealthy foods into their everyday lives that they avoided during the course of the eating disorder. Food should no longer be selected solely on the basis of its nutritional value or other health aspects. Accompanying this, the sometimes hours-long fixation of thoughts about food and food intake should be relaxed.

If the orthorexia has led to malnutrition and the associated underweight, another goal is to gain weight to within the range of normal weight. In some cases, it is also necessary to bring those affected back to eating carefree in company.

Outlook & Forecast

The disease known as “orthorexia nervosa” has not yet been officially recognized as an eating disorder. In the US, however, experts consider people obsessed with healthy eating to be disturbed and mentally ill. They have abandoned a healthy relationship with food in favor of an obsessively unhealthy relationship with its perceived health benefits.

It is not entirely clear whether orthorexia is an obsessive -compulsive disorder or an eating disorder. After all, those affected only eat healthy foods. Only the compulsive occupation with it for hours is not healthy. Food is often selected according to strict criteria that others cannot understand.

The problem, however, is that the lack of classification of orthorexia as an eating disorder or obsessive-compulsive disorder also limits the treatment options. Neither the therapeutic approaches for eating disorders nor those for obsessive-compulsive disorders are fully applicable. Orthorexia can also be combined with other eating disorders in those affected. An orthorectic can also suffer from bulimia or anorexia . In this case, the treatment options are slightly larger.

However, the prospects of recovery depend on the cooperation of those affected. In the case of anorexics or bulimics, the awareness of the disease is often very low. Therefore, only some of those affected can be helped. As long as those affected understand the causes and the clinical significance of orthorexia, the prognosis for a cure is uncertain.


Orthorexia is difficult to prevent, not only because it often sets in insidiously and is still not recognized as a clinical picture. It is important to be aware that a balanced diet does not consist exclusively of healthy food and that enjoyment also plays a role. A healthy self-confidence, not only with regard to eating habits, as well as critically questioning health-related reports about different foods can help prevent orthorexia.


In most cases, those affected with orthorexia have only a few and only limited measures or options for aftercare available, so that in the case of this disease, a quick diagnosis and subsequent treatment must take place first and foremost. It is also not possible to heal on its own, so that the person affected is usually dependent on a visit to a doctor for this disease.

Psychotherapy is usually necessary for orthorexia. Above all, the patient’s parents, relatives and friends must support the patient during treatment and point out the symptoms and symptoms of the disease. The triggering of the disease should be avoided as far as possible so that a relapse does not occur even after complete healing.

In general, a doctor can also prescribe a nutrition plan for the patient, which must be followed in any case. Loving and intensive conversations with one’s own family are also very important in order to prevent depression or other psychological problems. Contact with other people affected by orthorexia is often very useful, as this leads to an exchange of information, which can make everyday life easier for the person affected.

You can do that yourself

If there is a suspicion that a person is suffering from orthorexia nervosa, a doctor’s visit is recommended. Since the clinical picture is not precisely defined, a specialist must assess whether the person concerned actually suffers from an eating disorder.

If an eating disorder is present, the obsessive behavior must be reduced. This is achieved through behavioral therapy and a change in the usual routines. For example, the patient may use notes to catch themselves over-preoccupied with food. Friends and family can also play this role. In addition, literature, documentation, and other material that encourages obsessive behavior should be discarded.

Meanwhile, it is important to find the cause of the orthorexia nervosa. The pathological condition is often based on an inferiority complex . These must be worked through as part of therapy. In any case, the patient should contact a psychologist and talk to him about his problem. First of all, those affected can seek advice in forums or in self-help groups. The most important step is to recognize the preoccupation with food quality. Then the decision can be made to break through the behavioral structures in a targeted manner.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.