Orthorexia Nervosa:

When Eating Healthy Becomes a Fixation

You probably know at least one of them.

Your friend or colleague who sticks to their healthy eating plan regardless of what is going on in their life. Friends and acquaintances often speak admiringly of their solid willpower while out with their mutual friends (many times while munching on pizza and beer themselves).

Sometimes we look up to them, maybe we’re a little confused by their rock solid willpower, but we admire them just the same.


It may be hard to believe, but they may be struggling with a very difficult eating fixation. It’s difficult to identify because they are “eating healthy” but it is there.

They are rigid in their food and become righteously indignant when their choices are questioned.

This is not healthy behavior.

Steven Bratman, MD, MHP came up with the term Orthorexia Nervosa in 1996 as he worked with some “diet-obsessed” clients. This “health food eating disorder,” gets its name from the Greek word ortho, meaning straight, proper or correct.

The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5), which psychiatrists use to diagnose mental disorders, does not include Orthorexia Nervosa. It currently lists anorexia nervosa, bulimia nervosa, binge-eating disorder, “other specified feeding or eating disorder” and “unspecified feeding or eating disorder”. I believe a therapist would most likely diagnose a person with this type of eating fixation with one of the last two categories.

I think they should add Orthorexia Nervosa to the DSM, but who’s listening to me?

These are all examples of specific diets.

  • Clean Eating
  • Paleo
  • Vegetarian
  • Green Smoothies
  • No gluten
  • No Dairy
  • Raw foods?

Can ANY specific diet become problematic?

The short answer is yes. In 2005, researchers developed the ORTO-15 questionnaire to help identify a tendency toward the pathological eating behavior Orthorexia Nervosa.

Some of the questions include:

  • Does the thought about food worry you for more than three hours a day?
  • Do you allow yourself any eating transgressions?
  • Do you think your mood affects your eating behavior?
  • Do you think the conviction to eat only health food increases self-esteem?

How can you know if your healthy eating crosses the line between typical healthy eating and Orthorexia Nervosa?

The best way to spot the condition in your own life is when eating “healthily” causes significant distress or negative consequences in your life.

Some real life examples of this may include:

  • Feeling like a failure for eating a forbidden food (bread, dairy, cookies)
  • Only eating at home (or alone)
  • Avoiding events with food (social gatherings, out with friends, etc)
  • Weighing every morsel
  • Constantly thinking of your next meal/food choice

But most importantly, when your eating rules impact your relationships with friends or family, dictate your mood, or cause significant distress in ANY way.

Eating should not be that hard.

You know what? Being HEALTHY means a LOT more than eating a special diet and exercising. You need to control your stress, improve your sleep, manage your negative self-talk, … and more. But the most important piece is to LOVE yourself regardless of your weight.

In my 90-Day Health Intensive, I help my clients figure out their own, unique HEALTHY LIVING PLAN!

Sign up for my NO COST 30-Minute Discovery Session and lets figure out what may be holding you back from living your healthiest AND happiest life! (hint: it may not have anything to do with your weight)

If you share this blog on any social media platform, I will add an additional 15 minutes to your session! (That’s a $94 value)

Sooooooo, what are you waiting for? Share this blog below.. and lets schedule a time to chat!
I’ll pour the coffee….



Twin Cities Life Coaching is passionate about self-care. If we don't take care of ourselves first, how do we expect to care well for others in our lives?

Think of the oxygen mask in an airplane. The instructions given to you before taking flight insist that if there is a change in cabin pressure, we are to put on our own mask BEFORE we assist others with theirs.

Our hectic, over-scheduled, over-worked lives push us to meet everyone else's needs and deadlines before our own. We have it backwards and need to take an airplane oxygen mask approach instead.

Take care of yourself first, and the rest will follow.

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