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Orthorexia – Understanding This Eating Disorder



Orthorexia is an obsessive focus on healthy eating. In many cases, a change to the diet can be considered positive. However, some eating behaviors can quickly become out of control if someone becomes overly fixated on self-imposed food rules.

Some might find this counterintuitive, so allow me to explain.

Children and teens who show signs of this form of disordered eating may develop obsessive concerns about eating the most “pure, perfect or healthful” foods to the point that it impacts their everyday life. For instance, your daughter turns down an opportunity to go out to eat with her friends. She does this because she is worried that she will not be able to follow her strict dietary guidelines. If this occurs, it is a good time to ask some questions.

For most kids, opting to eat in a healthier manner is in general a good choice. It’s only when these restrictions are taken to extreme that this could be a cause for concern.


The side effects of orthorexia can mimic more well-known eating disorders, such as anorexia or bulimia. The symptoms are serious, chronic, and go beyond a lifestyle choice. Maintaining an obsession with healthy food may cause a serious reduction in calories. This is because “acceptable” foods might not be available. If dietary restrictions are too severe, malnutrition can result. Malnutrition and weight loss for children and teens is highly concerning because this is a period of time when they should be growing. When too few calories are consumed, this cannot occur properly. Losing weight can lead to a slower metabolism, stunted growth, delayed puberty, irritability, hair loss, dry skin, absent menstrual cycles, and changes in body temperature.


So how can parents be on the lookout for orthorexia? Children who have more of a rigid or perfectionist type of personality or who are naturally anxious, may be more likely to gravitate toward this type of behavior. Eating disorders do have a genetic component. So, if a parent has had one, his or her child is more likely to develop one as well.

Here are some behavior changes that could be signs of orthorexia:

  • Increased avoidance of particular foods in the absence of a true food allergy
  • Eliminating an entire food group
  • Refusal to eat any processed food
  • The amount of “acceptable” food choices decreases so much that once-loved foods become off limits
  • It becomes difficult to go out to eat or socialize when a meal is involved
  • Obsessive concern with food choices and their relationship with health conditions such as, digestive problems, mood, anxiety or allergies
  • Guilt, shame or irritability when unable to follow self-imposed dietary restrictions
  • Avoids food made by others
  • Isolation from others who do not share same view on foods
  • Spending excessive time in grocery stores or online reviewing food labels and ingredients


In general, making healthy dietary modifications can be a good choice for the majority of children and teens. However, if your child tends to have rigid or perfectionist tendencies and is starting to obsessively modify his or her diet, I recommend speaking to a registered dietitian (RD). Look for one who has specialized training in eating disorders/disordered eating. An RD can provide guidance on the importance of including all foods in the diet, help reverse irrational thoughts about food, and assist in re-learning how to trust the body’s internal hunger and fullness cues. If you are out of town, follow this link to find an eating disorders specialist near you. 


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