Orthorexia: When Eating Healthy Turns Ugly


By Joy Stephenson-Laws, JD, Founder

It’s that time of year again when we focus on positive changes we want to make in our lives. This is commonly referred to as New Year’s resolutions. One popular type of resolution is a lifestyle change that is likely to make us healthier - like eating healthier.

And no reasonable person will dispute the fact that eating healthily is critical for good health. But did you know that you can overdo it and eat “too healthily?” Being unhealthy because you only eat healthy foods sounds like quite the oxymoron. But there is a behavior called ‘orthorexia,’ and it literally means a “fixation on righteous eating.”

The word ‘orthorexia’ was coined in 1996 by a doctor named Steven Bratman. He explained that healthy eating doesn’t become ‘orthorexia’ until a tipping point is reached and enthusiasm transforms into obsession.

Orthorexics may only eat organic fruits and vegetables.

Charlotte Andersen shared her story of overcoming orthorexia. At one point, her diet was so restrictive that she only ate five food items: apples, cashew nuts, green leaves, artichokes and pomegranates.  

Andersen recalls first just eliminating dairy from her diet, which is perfectly healthy to do as long as all the essential nutrients - protein, carbohydrates, water, minerals, vitamins and fats - are all consumed. But she soon found herself eliminating practically everything.

And what’s particularly interesting about orthorexia is that it is not always about being thin, eating less and losing weight, as is the case with disorders like anorexia.

“Orthorexic individuals are typically concerned by the quality, as opposed to the quantity, of food in one’s diet,...” says the National Institutes for Health (NIH).

“I wasn't concerned with calories or even really with my weight or appearance; for me it was all about food purity,” Andersen said.

This obsession with food purity often is about whether vegetables have been exposed to pesticides, if dairy products came from cows who were given hormones, if nutrients in food were lost through cooking, if artificial flavors or preservatives were added to food, if food was packaged in potentially plastic-derived carcinogenic compounds and more. Some orthorexics also constantly scrutinize the quality of food labels, doubting that they provide enough information to help determine if a food is actually healthy.

And since we live in a society where fast and processed foods are readily available, delicious tasting and addictive, you can see why a person could fall down the rabbit hole of orthorexia.

Some orthorexics follow strict food rituals. For example, they may believe that maximal digestion of one food type occurs a certain amount of time after ingestion of another food type. When they are not eating, they may spend their time constantly researching and cataloguing food, measuring and weighing food and planning their future meals.

According to the National Eating Disorders Association (NEDA), underlying motivations for being orthorexic include safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food and using food to create an identity.

“With regard to the consequences of this extreme style of eating, orthorexic individuals may experience nutritional deficiencies due to omission of entire food groups, and, although long-term empirical studies are lacking, there is anecdotal evidence that this kind of dietary extremism can lead to the same medical complications that one sees with severe anorexia,” says the NIH.

Some of these medical complications that result from orthorexia include:

  • Osteopenia. A condition in which bone density is lower than normal (often a precursor to osteoporosis). This is often caused due to a lack of consuming enough calcium and vitamin D.
  • Anemia. When the blood does not have enough healthy red blood cells. This is usually caused by an iron deficiency but can also be caused by low levels of vitamin B12 and folate.
  • Hyponatremia. When the level of sodium in the blood is too low. Having balanced sodium in the body is critical for maintaining healthy blood pressure. Sodium is also needed for nerves, muscles and other body tissues to work properly.
  • Metabolic Acidosis. When too much acid accumulates in the body. This often occurs due to a lack of thiamine (vitamin B1). It is a condition that starts in the kidneys, and symptoms may include an increased heart rate and shallow breathing.
  • Pancytopenia. A condition in which a person’s body has too few red blood cells, white blood cells and platelets. Red blood cells carry oxygen throughout your body, white blood cells are critical for immunity and fighting off infections and platelets allow your blood to form clots. You can develop this condition from a lack of vitamin B12 and folate.
  • Bradycardia. A condition in which an individual has a slow heart rate, a heart rate of less than 60 beats per minute. If severe or prolonged, this condition could lead to heart failure. This may be caused by a lack of B vitamins and protein.

So while it is important to make ‘healthy’ resolutions, it is also important not to practice unhealthy behaviors to be healthy. Make wise eating decisions, and include foods in your diet which provide you with the right amounts of all the necessary nutrients to keep you healthy.  

Finally, any resolution to be healthy should necessarily include periodic testing to ensure that your nutrients are balanced. Eating healthily does not ensure that your body is absorbing adequate nutrients from the foods you eat to remain healthy. And if you discover you have nutrient deficiencies and imbalances, work with a competent healthcare professional to tweak your diet, take good quality supplements or even consider the use of liposomal technology.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.


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