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Orthorexia – A Little Known Eating Disorder

By Emily Battaglia

In 1997, Steven Bratman, M.D., published an essay about a new kind of eating disorder. He coined the condition as “orthorexia nervosa.” Although orthorexia nervosa is not an official psychiatric diagnosis (it’s typically categorized as a variety of anorexia), Dr. Bratman’s disorder does possess unique attributes. The main difference between an orthorexic and an anorexic is the individual’s motivation. Dr. Bratman used the prefix “ortho” to mean right or true. Orthorexics don’t operate from a desire to be thin; instead, they strive to eat pure and healthy foods. While this condition may sound innocuous at first, it can have serious consequences. These health food addicts may obsess about eating the right foods to the point of social isolation, pathological obsession, and even starvation.

Specialized diets have achieved wider popularity in the United States in the last few years. Widely acclaimed regimens such as the Atkins diet (which allows little to no carbohydrates) have introduced self-imposed severe dietary restrictions to the mainstream, and made unusual or rigid dietary practices more socially acceptable than ever before. In addition, escalating obesity rates in the United States over the past two decades have created a backlash of healthy and socially-conscious eating in some areas.

Like people with anorexia or bulimia, orthorexics transfer their entire self-worth into their eating practices. People with these three conditions are pathologically fixated on food. Ironically, they begin by trying to control their eating, and in the end their eating ends up controlling them. Individuals with eating disorders think about food almost every minute of the day. Their schedules revolve around when, where, and what they will eat. Individuals with eating disorders constantly battle what they perceive as temptation, praising themselves for following the rules of their disorders, and haranguing themselves for lapses. Penitence for lapses usually involves even stricter and more extreme practices. Anorexics and orthorexics frequently experience feelings of superiority over others, viewing other people as undisciplined, gluttonous, and impure in their eating habits.

Whereas anorexics and bulimics are focused on the quantity of food they consume, orthorexics obsess over the quality. Many people begin alternative eating practices to address health problems. Commonly, allergies to wheat, corn, and soy can cause fatigue, digestive problems, allergic reactions, and even intensify asthma. Relief from physical symptoms and healing through dietary changes can motivate individuals to continue seeking new dietary improvements. However, some individuals become so fixated on dietary restrictions that other aspects of their lives begin to suffer. Many orthorexics will only eat food that they buy and prepare themselves. They take their own food wherever they go. They find it difficult to interact normally with others. As thoughts and ideas about food intrude on every interaction and relationship, they tend to withdraw socially. Paradoxically, as orthorexia escalates, the health of the individual often begins to suffer. Orthorexics can become so selective and stringent in their eating habits that they eventually opt to die of starvation rather than contaminate their bodies with any impurities.

Currently, scientists do not fully understand the root causes of eating disorders. Genetics are thought to play a role in the development of these disorders, in collaboration with situational factors such as stress and family dynamics. Eating disorders afflict females far more often than males, although recent research has shown an increase among males. As a psychological basis, it is thought that many eating disorders are developed out of a desire to exercise control. Young people, especially, may feel that they have no control over their lives—their bodies, relationships, and self-perceptions are undergoing great changes. Add in stress from school and sports, a tumultuous family life, or any number of other stressors, and a young person may feel entirely out of control. Orthorexics may seek out alternative diets as a way to exercise control over their lives, as well as a source of identity, purpose, and self-worth.

In 2004, scientists at the Universita degli Studi di Roma La Sapienza conducted a study orthorexia. The team drafted some diagnostic procedures and attempted to verify a prevalence rate for this disorder. The study found that 7% of 404 subjects suffered from orthorexia. Surprisingly, the study also found a higher prevalence among men and those with less education, both facts that contradict accepted knowledge about eating disorders.

Orthorexia has no universal menu. Food ideologies come in every variety imaginable, can conflict greatly with one another, and are all susceptible to orthorexia. In general, orthorexics tend to fixate on certain foods or ingredients as bad or impure. As more and more Americans embrace alternative eating practices, it can be difficult to draw a line between a sensitive eater and an orthorexic. According to Dr. Bratman, however, orthorexics display the three hallmarks of eating disorders: social isolation, cycling through emotional extremes, and obsession.


Bratman, Steven, M.D. Essay on Orthorexica. Yoga Journal. October 1997. Retrieved June 26, 2008 from

Donini LM, Marsili D, Graziani MP, Imbriale M, Cannella C. (2004/6). Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disorders. (2):151-7.

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