When clean eating goes too far: 5 warning signs your “diet” could lead to orthorexia

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A testimonial from a fitness coach about ridding toxins from your body in your Facebook feed. An Instagram story about how to make “clean” meals. An email with the latest diet trends. You likely see these daily, if not more, and the influx of them doesn’t seem to be slowing down.

“We’re being flooded with what’s ‘good’ and what’s ‘bad’ for someone to eat. This constant exposure to these ideas that are so focused on what can make your body better through what we should and shouldn’t eat, is not ‘good’ at all,” says Dr. Elizabeth Hamlin, medical director for the adult inpatient eating disorder program at Rogers–Oconomowoc.

She adds that many people already have a lot of anxiety about what’s going into their bodies, and having 24/7 access to this information can lead some to cross a threshold into orthorexia.

What is orthorexia?

Although it’s not formally recognized in the Diagnostic and Statistical Manual (DSM), orthorexia is defined as an obsession with proper or healthful eating. While being aware of and concerned with the nutritional quality of the food you eat isn’t a problem, it does become worrisome when a person is so fixated on so-called “healthy eating” that they actually damage their own well-being.¹

When someone has orthorexia, it’s not necessarily about their weight—even though it can start out as a desire to lose weight.

“It really takes on a life of its own about perceiving food as pure, clean, or good enough for their body. People with orthorexia put so much energy and time into what they are going to or not going to eat that little by little they start restricting what types of food they can eat. Eventually, this gets in the way of a person’s ability to function in everyday life,” says Dr. Hamlin.

5 signs you might have orthorexia

How can you tell if your diet is not just healthy eating? Dr. Hamlin says to consider your answers to these questions.

1. How do you psychologically feel about your daily diet? You should be concerned if your diet feels like it has become your identity and you can’t feel good about yourself unless you are following this diet.

2. Are you more judgmental of what others eat? Your diet may have crossed a line if you believe your friend isn’t as ‘good’ because they’re eating a food that you’ve deemed is ‘bad.’

3. Have your daily functioning and social interactions decreased? You find it difficult to eat with other people because you’re so focused on what you can and can’t eat. Food takes up all of your energy and thoughts, making it difficult to focus on anything else. This type of behavior is a red flag. 

4. Is the variety of food you eat shrinking and shrinking? For people with orthorexia, one food after another feels not good enough.

5. Are you able to adapt in different food environments? Often people will follow a diet and then there’s a big family event with food. When on a healthy diet, people can eat wherever they are and adapt. But for people with orthorexia, this type of environment is anxiety-inducing, creating thoughts like ‘The food is dirty, I can’t do this.’

Dr. Hamlin adds that those who tend to be perfectionists, have a history of eating disorders or obsessive compulsive disorder, or have low self-esteem are at higher risk for orthorexia.

What does orthorexia do to your body?

Orthorexia can have a devastating impact to a person’s body, creating significant medical complications. “As much as people think they’re getting everything they need from their ‘pure foods,’ they’re not,” says Dr. Hamlin. “This is especially true because, as orthorexia progresses, people begin eating fewer and fewer different foods.”

Examples of physical affects to the body:

• Cardiac abnormalities such as a very slow heart rate and cardiac rhythm disturbances
• Kidney problems
• Brittle nails
• Yellow skin
• Hair falling out

Treating orthorexia at Rogers

“We focus on expanding the variety of foods that someone can eat and feel okay,” Dr. Hamlin explains. “We can’t and don’t try to change the things that they like to eat or enjoy eating; everyone can have food preferences. We try to get the person back in charge of what they’re eating and not have the food in charge of them. We want people to be able to be flexible, so that they don’t derive their sense of worth from what’s on their plate.” 

Concerned that you or someone you know could be at risk for orthorexia or another eating disorder? Take our free, confidential Eating Disorder Quiz.

For admission information or a free screening, call 800-767-4411, or submit an online screening request.

¹National Eating Disorder Association