When a healthy diet becomes unhealthy

Man juicing in a kitchen
Man juicing in a kitchen

You may be suffering from orthorexia nervosa (ON), a preoccupation with eating only healthy foods and avoiding everything even vaguely unhealthy or harmful – and spending a large amount of time is devoted to planning, purchasing, preparing and consuming meals.

What is Orthorexia Nervosa?

ON was first identified and labelled in 1997 by Steven Bratman, an alternative medical practitioner, when he started to notice this health-obsessed eating behaviour in his patients. ON is not yet a recognised disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it is similar to other eating disorders.

Read: Are food cravings controlling you?

The difference is that people with ON focuses on food quality rather than quantity. The individual becomes obsessed with dietary purity as well as self-punishment when slipups are made, like very strict eating, fasting and exercise regimes.

There is limited research investigating the prevalence of Orthorexia Nervosa; however preliminary research has shown prevalence rates of 6.9% for the general population and, interestingly, 35–58% are in high risk groups such as health professionals.

When healthy eating becomes disordered

This disorder may start innocently enough with an individual simply wanting to enhance their health through nutrition. It then moves from being a healthy eating habit to a disorder when the individual becomes obsessed with eating what they believe are health foods, and go so far as to isolate themselves socially or fast if the food on offer does not meet their strict criteria.

Read: Eating disorders up risk of pregnancy complications

This definitely does not mean that you should not take care to optimise your diet nutritionally. It rather implicates that your eating habits should not take up an unreasonable amount of time; deviating from your eating regime should not leave you feeling guilty, and your eating habits should not isolate you socially.

Ironically, individuals suffering from Orthorexia Nervosa can become malnourished owing to their stringent food rules and thus limiting an intake of a wide range of foods and nutrients. 

Do you suffer from Orthorexia Nervosa?

Are you worried that you may suffer from Orthorexia Nervosa?  The more of the following questions that you answer “yes” to, the more likely you are suffering from this disorder.

  • Do you spend more than 3 hours a day thinking about your diet?
  • Do you plan your meals several days ahead?
  • Is the nutritional value of your meal more important than the pleasure of eating it?
  • Has the quality of your life decreased as the quality of your diet has increased?
  • Have you become stricter with yourself lately?
  • Does your self-esteem get a boost from eating healthily?
  • Have you given up foods you used to enjoy in order to eat the “right” foods
  • Does your diet make it difficult for you to eat out, distancing you from family and friends?
  • Do you feel guilty when you stray from your diet?
  • Do you feel at peace with yourself and in total control when you eat healthily?

Recovering from Orthorexia Nervosa

As with all eating disorders, part of the recovery is acknowledging that there is a problem – and then identifying what caused the obsession.  Rather than encouraging unhealthy eating habits, the individual should become less rigid and more flexible about their eating.  It is recommended that a health practitioner who specialises in eating disorders is approached for assistance.

With the public’s increasing interest in healthy foods and a heightened awareness of food origin and processing it is easy to understand how a healthy interest can easily turn into an obsession.  As with most things in life, a balanced approach should be applied to eating, and the focus should be on nourishment and enjoyment, not on unreasonable restrictions and rules.

Read more:
Eating disorders affect fertility
Men with eating disorders underdiagnosed
Smart family, eating disorder risk


1. https://www.nationaleatingdisorders.org/search/node/orthorexia

2. Schebendach JE & Roth J. 2015.  Nutrition in Eating Disorders: Krause’s Food & Nutrition Care Process.  Ed by Mahan, LK and Raymond JL.  14th edition.  Canada, pp.407.

3. Dietitians of Canada. Mental Health Disorders - Eating Disorders: Orthorexia Nervosa.  In: Practice-based Evidence in Nutrition [PEN]. 2015 October 8 [cited 2016 July 16]. Available from: http://www.pennutrition.com/KnowledgePathway.aspx?kpid=23951&trid=23981&trcatid=38 . Access only by subscription. 

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