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  • Writer's pictureDr. Kelli Malkasian, PsyD, CEDS

Can Healthy Eating Go Too Far?

Clean Eating. Health-Conscious. Sustainable. Vegan/Vegetarian. Organic. Paleo. Keto. The list goes on and on to describe different focuses or categories of what our culture has determined to be healthy eating patterns. The attention to different factors of food is ever-changing and highly marketed by different organizations and industries that seek to profit heavily from the obsession with health, which is often misunderstood to also be a pursuit of thinness.

While anyone would argue that being informed about nutrition and understanding food sourcing is important, it is possible to become obsessed and controlled by this obsession. This is called Orthorexia. Orthorexia is problematic, dangerous, and obsessive relationship with proper or “healthful” eating. The obsession with food can look different depending on the focus or factors of food considered most important to the individual. The obsessions are based on the irrational belief that food labeled as being “healthy” is the only acceptable food they will allow themselves to eat.

The presentation of orthorexia varies from person to person. One person with orthorexia may only eat a few foods deemed clean or pure including sweet potato and quinoa, whereas another person who is also obsessed with clean or pure foods may only consume organic cauliflower and chicken due to their organic label and lower sugar content. Others may follow the Keto diet rigidly and believes that they cannot falter from this regimen.

So, what is the difference between utilizing a diet and orthorexia? Orthorexia is an eating disorder and the level of distress, obsession, and rigidity are far greater than that of just your average dieter or “health-conscious” person. Also, a person with orthorexia is usually under immense distress if acceptable foods are not available and may engage in bizarre behaviors to be able to follow their strict rules. NEDA highlighted several characteristics to consider when identifying if a person may be struggling with orthorexia.

  • Compulsive checking of ingredient lists and nutritional labels

  • An increase in concern about the health of ingredients

  • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)

  • An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’

  • Unusual interest in the health of what others are eating

  • Spending hours per day thinking about what food might be served at upcoming events

  • Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available

  • Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram

  • Body image concerns may or may not be present

Though this disorder is based on the idea of health, it is extremely unhealthy and can result in devastating medical consequences, such as severe vitamin or nutrient deficiencies, anxiety, depression, seizures, bone loss, muscle loss, cardiovascular problems, etc. Much like anorexia, the intensity of restriction and obsession with food becomes greater and greater until it controls the person’s life.

One of the most difficult parts of identifying and treating this disorder is that it is highly positively reinforced in our culture. People suffering and struggling with orthorexia often receive immense positive feedback for being healthy, “good,” disciplined, smart eaters, clean eaters, etc. If the orthorexia also results in weight loss, this too can be positively reinforced in our very weight-obsessed and thin-ideal culture. It is often very difficult to convince someone with orthorexia that what they are doing is hurting them. Sadly, many doctors, therapists, or nutritionists may not even catch on to what is going on due to the immense influence of the diet and health food industries.

However, treatment is possible. Working with a skilled team consisting of an eating disorder specialized therapist, dietitian a medical professional can help those struggling with orthorexia to recover and develop a better and truly healthy relationship with food. It may seem strange to be encouraged to eat foods labeled by most as unhealthy, but the rigidity of never allowing oneself to have them is far worse on the body and the mind.

For more information on orthorexia and treatment options, please see the below resources.

Local South Florida Resources:

National Resources:

For information on how to book an appointment with me please visit my website here.


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