What is Orthorexia — and is it on the rise?

In recent years, many people have become familiar with recognised eating disorders such as anorexia nervosa and bulimia. A newer concept gaining attention — both in clinical research and popular media — is orthorexia nervosa, an unhealthy fixation on eating “pure” or “healthy” foods.

Although not yet a formal diagnosis in major clinical manuals like the DSM-5 or ICD-11, orthorexia is increasingly discussed by clinicians and researchers as a distinct pattern of disordered eating that can have serious physical and psychological consequences.

What is orthorexia?

The term “orthorexia nervosa” was coined in 1997 by the American physician Dr Steven Bratman from the Greek orthos (“correct” or “right”) and orexia (“appetite”). Unlike other eating disorders that focus primarily on quantity of food or body weight, orthorexia centres on quality — an obsessive pursuit of foods perceived to be healthy, pure or “clean”. This can involve rigid dietary rules, excessive avoidance of entire food groups and intense anxiety about food preparation or sourcing.

Key features can include:

• Rigid food rules and black-and-white thinking about “good” vs “bad” foods

• Preoccupation with ingredients, sourcing, purity and nutritional quality

• Emotional distress when dietary rules are broken

• Social impairment, such as avoiding meals with others to control food intake

• Health consequences such as nutritional deficiencies or unintended weight loss
  

While eating healthily can be positive, in orthorexia the behaviour becomes compulsive, consuming a person’s thoughts and daily life in ways that resemble more widely recognised eating disorders.

How orthorexia differs from healthy eating

It can be hard to draw a clear line between “being health conscious” and orthorexia, but clinicians look for loss of flexibility and significant distress in daily functioning.

Criteria that may point towards orthorexia rather than a normal healthy diet include:

• Time spent planning, purchasing and preparing food interferes with work, studies or relationships

• Guilt or anxiety when deviating from self-imposed food rules

• Negative physical effects, such as fatigue or malnutrition, despite the intent to be healthy
  

In contrast, balanced healthy eating typically:

• Allows for variety and flexibility

• Does not dominate social life or cause severe anxiety

• Supports physical and emotional well-being
  

Is orthorexia on the rise?

There is evidence that interest in healthy eating has grown markedly in recent decades, driven by social media trends, wellness culture and increased public health messaging. But whether true orthorexia — as a clinical phenomenon — is increasing is more complex.

Research findings

• Several studies report higher scores on orthorexia questionnaires among young adults, athletes and health-focussed populations.

• Clinical research suggests that orthorexia traits may co-occur with anxiety disorders, obsessive–compulsive tendencies and other eating disorders.

• Social media platforms, with their focus on “clean eating” and idealised lifestyles, are often cited as cultural contributors, though causation is difficult to establish.

However, large-scale, long-term data tracking orthorexia prevalence in the general population are limited, in part because it is not yet a formal diagnosis with standardised diagnostic criteria. This makes it hard to say definitively whether the condition is truly increasing, or whether greater awareness and measurement tools are simply bringing attention to a problem that has long existed.

Why it matters

Even without formal diagnostic status, orthorexia can have real consequences:

• Physical health issues, including vitamin and mineral deficiencies

• Social isolation, as individuals may avoid eating with family or friends

• Emotional distress, including anxiety, guilt and loss of control

• Overlap with other disorders, sometimes masking or co-occurring with anorexia, bulimia or obsessive–compulsive disorder
  

For people whose eating patterns are harming their quality of life, early recognition and support are important. Healthcare practitioners often approach orthorexia with multidisciplinary care, including dietitians, psychologists and psychiatrists.

Getting balanced help

If someone suspects they may be struggling with orthorexia, signs to watch for include:

• Eating patterns that lead to nutritional deficiencies

• Severe anxiety around food choices

• Withdrawal from social events due to rigid food rules

• Diet behaviour that feels compulsive or uncontrollable
  

Support can include:

• Cognitive behavioural therapy (CBT) to address rigid thinking

• Nutritional rehabilitation to restore a balanced diet

• Psychological support to manage anxiety and perfectionism
  

A deeper conversation

Orthorexia sits at the intersection of well-intentioned health behaviours and disordered eating. While healthy eating is beneficial, when it becomes rigid, anxiety-driven and socially isolating, it may be harmful.

Although research is ongoing and the condition remains outside formal diagnostic manuals, growing clinical interest and public awareness reflect a deeper conversation about how cultural norms around food and health can sometimes lead to unintended harm.

Recognising the signs and supporting those affected can help ensure that “healthy eating” remains just that — healthy.