Understanding Orthorexia: The Overlooked Eating Disorder
In a culture that idealizes clean eating, self-discipline, and wellness, it’s easy to overlook when a desire to be healthy begins to cause harm.
Orthorexia is a lesser-known but increasingly common form of disordered eating that often starts from a well-intentioned place, yet can gradually consume a person’s energy, identity, and peace of mind.
As a therapist and someone who has personally navigated orthorexia in my own life, I know how sneaky and seductive it can be. I experienced a sense of control, safety, and pride that came with following strict food rules and fitness regimens, but also the exhaustion and anxiety that crept in beneath the surface. It took time, reflection, and self-education to reconnect with my body and reclaim the parts of myself that had been pushed aside in the name of “health.” I still have to periodically connect and check in with my own parts that contributed to my orthorexia. Remember that healing is not linear.
What Is Orthorexia? A Closer Look at the Obsession with Healthy Eating
Orthorexia, or orthorexia nervosa, was first named by physician Dr. Steven Bratman in 1997. Unlike anorexia or bulimia, which often focus on food quantity and weight, orthorexia centers on the quality or purity of food. The pursuit of health becomes so rigid and consuming that it begins to harm physical and emotional well-being. It’s also important to note that orthorexia and exercise addiction often show up hand in hand.
While it’s not currently a formal diagnosis in the DSM-5, orthorexia is increasingly recognized by clinicians as a serious form of disordered eating. It often begins when a part of someone longs to feel better—more in control, more virtuous, less anxious—and finds reassurance in following certain food rules. However, over time, those rules can harden into rigid beliefs, and other aspects of the self—such as spontaneity, connection, or joy—begin to be pushed aside.
How Orthorexia Manifests: Signs, Symptoms, and Lived Experiences
For many people, orthorexia doesn’t show up suddenly. Instead, it builds slowly through rules that feel protective or necessary. Over time, these rules can start to dominate internal space and daily life. Some signs that this might be happening include:
Avoiding meals with others or declining invitations because of anxiety about the food
Spending significant time researching or planning meals to ensure they meet strict standards
Feeling guilt, shame, or self-criticism after eating something “imperfect”
Believing that health or moral worth is tied to food purity
Experiencing inner conflict, stress, or self-punishment when breaking food rules
Feeling disconnected from one’s body, hunger cues, or natural pleasure in eating
These patterns often reflect the presence of protective inner voices—parts that believe they must control food to protect against shame, illness, or chaos. Even when someone intellectually knows their habits might be extreme, another part may insist that loosening control is unsafe.
Orthorexia vs. Anorexia and Bulimia: Key Differences and Overlaps
Though orthorexia shares features with other eating disorders, its focus and function can differ. Anorexia is often driven by a pursuit of thinness or control over body size, while bulimia involves cycles of binging and purging fueled by distress, shame, or attempts to regain control. In orthorexia, the primary focus is food quality—with an emphasis on “clean,” “pure,” or “perfect” eating. If a food does not meet your standards, you will not eat it, no matter how hungry you are. Does this sound familiar to you?
Some individuals with orthorexia may be overly concerned with their appearance. Or, some are less concerned with weight and more concerned with being right in their choices—often driven by parts that equate health with morality or safety. Still, there is significant overlap. People can experience orthorexia alongside body image concerns as well as traditional eating disorders. You may have orthorexia paired with body shame, engage in restrictive eating patterns, and exercise obsessively.
Orthorexia often involves inner patterns of perfectionism, fear, and rigidity
Strategies that are developed to manage deeper emotional burdens. Even if the external presentation seems health-oriented, there’s often a lot happening beneath the surface.
When Does Healthy Eating Cross the Line?
It’s not always easy to recognize when a well-meaning focus on health becomes harmful. Our culture tends to reward discipline and control—even when it causes suffering. If you’re wondering whether your relationship with food might be more stressful than supportive, here are some questions to gently explore:
Do I feel anxious or guilty when I eat something outside of my usual “safe” foods?
Is my eating flexible and responsive to what I want and need—or rigid and rule-based?
Do I avoid social events or feel isolated because of my food choices?
Is there a part of me that feels superior when I eat “perfectly,” and ashamed when I don’t?
Am I able to listen to my body’s cues, or have I learned to override them with rules?
Start working with an IFS-informed eating disorder therapist in Highland Park, Los Angeles, CA
Often, what begins as a sincere desire for health becomes a system of internal negotiations and pressures—where one part tries to manage fear or uncertainty through food, while others begin to lose their voice. Healing doesn’t mean giving up on health; it means learning to relate to food—and ourselves—with more flexibility, compassion, and trust.
If any of this resonates, I see you! Working with a therapist and a dietitian who understand the emotional and relational layers of disordered eating can help you reconnect with a more peaceful, embodied way of eating.
It’s possible to let go of harsh food rules without letting go of your values.
You can build a relationship with your body and eating that feels authentic, energized, and free.
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At Therapy on Fig, we provide therapy services tailored to the unique needs of couples and individuals. We offer Neurodivergent Affirming Therapy, IFS Therapy, Grief and Loss therapy , Therapy for Empaths, Trauma Therapy, Couples Therapy, and Teen Therapy. Whether you're seeking support for a specific issue or looking to strengthen your relationship overall, our therapists are here to help. Reach out today to learn more about our services!
Gabriella Elise Giorgio is a Registered Associate Marriage and Family Therapist (AMFT 140682), supervised by Sharon Yu. As a highly sensitive person and a mother, she helps individuals recover from childhood attachment injuries, couples navigate significant life changes, and those who struggle with disordered eating. Reach out to learn more about our experienced therapists.