Common Signs and Symptoms of Orthorexia Nervosa

By Megan Samuels, MSW, LMSW, Outreach Coordinator

What is Orthorexia?

Orthorexia Nervosa is an eating disorder that is characterized by an obsession to eat “clean” or so called “healthy foods”.  The diagnostic and statistical manual of mental disorders - fifth edition (DSM-5) does not formally recognize orthorexia nervosa as an eating disorder, however it has been on the rise for decades as new diets have evolved and that there has been more emphasis to eat “clean” or “healthy”.  Not having a diagnostic criteria can make it difficult for people to be diagnosed and treated with orthorexia nervosa.  

Similar to anorexia nervosa, orthorexia nervosa includes restriction of food groups, rigidity around food, potential weight loss, potential health impacts, and body image disturbance.  

Note: Just being orthorexia nervosa is not in the DSM-5, does not make it any less dangerous of an eating disorder.  Many people struggling with orthorexia nervosa suffer emotional, physical, and psychological consequences as a result of this disorder.  If you think you are struggling with orthorexia nervosa, you deserve help and treatment!

 Signs of Orthorexia Nervosa

• Not eating processed or already prepared foods.
• Spending a lot of time preparing and measuring foods.
• Not eating foods that they have not prepared themselves.
• Food rules.
• Potential weight loss or lab abnormalities.
• Obsession over eating “clean” or “healthy”.
• Having a hard time finding something to eat when going out to restaurants.  
• Believing that self worth is tied to being able to eat “clean” or “healthy”.

What does eating “clean” mean

Ultimately this is mainly a diet culture buzzword that has many definitions, however one definition of eating “clean” includes eating whole foods that are not processed or already prepared.  This can also include eating whole grain pasta or bread and organic fruits and vegetables.  The assumption is that other foods that are not “clean” are “dirty, “bad,” or “unhealthy” (which is totally false).

How do you know if you struggle with orthorexia nervosa?

If you experience any of the signs of orthorexia nervosa that are listed above, you may be struggling with orthorexia nervosa.  The first step is to talk to an eating disorder therapist or dietitian who specializes in the diagnosis and treatment of eating disorders.  
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There is often an overlap of orthorexia nervosa and obsessive compulsive disorder (OCD) because of the rigidity around food and the obsession with eating certain types of foods and having them be prepared in particular ways.  ​

So, how is this treated?

​Similar to other eating disorders, Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance Commitment Therapy (ACT), and Exposure Response Prevention (ERP) can help.  Medical interventions and monitoring may also be needed.

The therapists at The Eating Disorder Center have trainings in these therapeutic modalities to support the recovery journey for someone struggling with orthorexia nervosa.

You can read more about Dialectical Behavior Therapy as a treatment modality for eating disorders here.

*Disclaimer: The information is provided for educational and informational purposes only. It is not intended to be a substitute for your independent medical decision-making nor a recommendation or endorsement for any particular treatment plan, organization, provider, professional service, or product. The information may change without notice. You assume all responsibility and risk for any use of the information.

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The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in New York (NYC), Florida, and California. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com