Orthorexia - Hidden in Plain Sight
- Olivia Kidd
- Sep 6
- 3 min read
Many articles written about orthorexia nervosa are titled “The Obsession with Healthy Eating” or “When Clean Eating Goes Too Far”, but the thing that is most overlooked about this disorder is that it’s hidden in plain sight. The very reason for this is that the behaviours associated with orthorexia are normalized by so many. This means that we usually don’t see anything wrong with the “healthy eating” mindset until it has spiralled into a full-blown eating disorder.
Orthorexia Nervosa, while not formally acknowledged in the DSM-5-TR, is characterized by a focus on healthy eating, so much so that it becomes restrictive. People with orthorexia may not eat foods that they consider more processed or unhealthy. This limits the kinds of food they will eat, possibly resulting in malnutrition, physical health problems, and mental distress.
Moreover, orthorexia is about the nutritional quality of the food and therefore its health implications, rather than portion sizes. An individual with this illness may have rules about when they eat certain foods and what foods make up a meal. They might also spend additional time planning and preparing meals, as well as researching or thinking about food (Koven & Abry, 2015). Imagine all of the things you have to do in a day, and then factoring in several hours to consider what you will be eating. It can be extremely tiring and frustrating, but it feels necessary to achieve good health.
The desire to be healthy, however, is not harmless. The nutritional deficiencies that result can lead to osteopenia (loss of bone density), anemia, bradycardia, and other health issues. What’s more, is that this illness can be socially isolating. After all, eating is a social activity; therefore it becomes difficult for one to adhere to their dietary rules when friends suggest going out for the day, grabbing some ice cream, or eating at a restaurant (Koven & Abry, 2015). The wellness industry also takes advantage of our desire to live a healthy life by promoting products, ingredients, and regimens. For instance, the promotion of a gluten-free diet for those who do not experience gluten intolerance. Plus, social media further supports these ideas with constantly changing trends and advice from creators (Gortat et al., 2021).
There’s also been research on the potential relationship between obsessive-compulsive personality disorder (OCPD) and orthorexia nervosa. Individuals with OCPD exert a need for control, perfection, and rigidity. It’s therefore possible that they would feel compelled to achieve “perfect” health, or the ideal figure, putting them at risk for developing orthorexia. It was also discovered that people with orthorexia had greater metacognitive activities, which essentially means that they think more about their own thought processes. This could include planning and assessing. It was overall concluded that the overactive metacognitive processes could lead someone to be more focused on the quality of their eating (Kılıçaslan, 2025).
The rise of orthorexia nervosa calls for a reassessment of how we approach conversations around food, and more importantly, what we do with the slew of information that circulates in the media. It’s overwhelming, and becoming increasingly complicated to figure out what to eat, and you’re not alone in feeling this way. It’s a good reminder that sometimes the healthiest choice for you is not what’s trending or what your friend is doing, but instead what will best support your needs and allow you to live a fulfilled life. Also, keep in mind that striving for perfection can often make things feel far from it.
References
Gortat, M., Samardakiewicz, M., & Perzyński, A. (2021). Orthorexia nervosa – a distorted approach to healthy eating. Psychiatria Polska, 55(2), 421-433.
Kılıçaslan, A. K. (2025, May 2). Orthorexia in obsessive–compulsive personality disorder: the impact of perfectionism and metacognition. BMC Psychiatry, 25.
Koven, N. S., & Abry, A. W. (2015, February 18). The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric Disease and Treatment, 11, 385-394. https://doi.org/10.2147/NDT.S61665
