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How to notice symptoms of orthorexia

How to notice symptoms of orthorexia

The symptoms of orthorexia are characterised with an obsession with healthy eating or “pure” foods. Whilst this may sound like a good way to be eating, in the case of someone with orthorexia is it taken to extreme levels. Orthorexia symptoms can start of from someone going on health kick. Unlike anorexia nervosa, bulimia nervosa and binge eating disorder, orthorexia isn’t categorised as a clinical eating disorder. This can diminish the danger. So let’s highlight that it is still a serious condition that can impact your mental health, physical health and wellbeing.

The name Orthorexia Nervosa actually comes from the Greek word for “right” or “correct”. Although the term was first described back in 1997, it has become more well-known in recent years.

orthorexia what is it?

Knowing what the symptoms of orthorexia are can help someone who is reaching out for help or who needs help and support. You may notice some of these symptoms of orthorexia in loved ones or in yourself. If this is the case then please do seek help from your GP first or the BEAT helpline.

Differences between othorexia and healthy eating

What counts as a “pure” food will differ from one person to the next. Additionally, following a healthy, balanced diet doesn’t necessarily indicate orthorexia either. For example, going gluten free or vegan may be a sign of restriction in one person, but a legitimate choice for ethical or medical reasons for someone else. Instead, it is the degree to which these food rules impact your life, and the impact on your mental health that are more relevant.

Orthorexia may cause the range of acceptable foods to become increasingly limited over time. These feelings and fears around food are often less about the food, and more about coping mechanisms and a means to find control. So even if food choices start off appearing to be healthy, food choices can become so restrictive that it ends up being detrimental to health.

The 5 warning signs of Orthorexia

Food Obsession

Orthorexia has a level of Food Obsession?. This can take over life. Maybe the person is tracking, counting, weighing and measuring everything. They may be unable to eat out or eat anything without scrutinising the label. This isn’t just an interest in nutrition but an obsession. It can take hours of planning and preparation for someone suffering from Orthorexia.

Extreme food rules and dietary rules.


If you suffer from Orthorexia you may have rules about what foods can and cannot be eaten. This may mean that foods with certain levels of salt, fat or sugar may not be acceptable. Additives or artificial flavours in foods may lead to anxiety. Often foods that are ultra processed (cereal bars, cakes, biscuits) may be excluded from the diet. Instead there can be a focus on natural foods all made from scratch.

Anxiety, mood swings and emotional distress

Breaking food rules or eating foods that are not on the acceptable list can lead to emotional distress. Feelings of guilt, anxiety, overwhelm and stress can be common. This can feel so very hard to deal with and reinforces the idea that eating these foods is unnecessary.

Viewing food as good vs bad

Orthorexia can lead to strict black and white categories around foods. Good foods are commonly pure, viewed as unprocessed, made from scratch, organic, with as few ingredients as possible. Bad foods are classed as those with additives, artificial colourings, foods that are higher in fat, salt and sugar and are more processed.

Affects social eating

As you can imagine having these foods rules can lead to a large affect on social eating. People suffering from Orthorexia may find it super hard to eat out, to have meals cooked for them or to choose a snack from a coffee shop for example.

Is orthorexia bad?

Both mental health and physical health can be affected by orthorexia nervosa. It can lead to intense fear or stress around foods and situations that feel out of a person’s control. It can impact relationship and lead to a poor quality of life.

Due to the restrictive nature of the condition, physical health can be impacted too. Without a varied and balanced diet, there is a risk of nutrient deficiencies, leading to health conditions such as anaemia, weakened immune system and poor bone health, to name a few. If someones calorie intake is too low (this can especially happen with overexercising), unhealthy weight loss can also occur, further damaging the body. This is why it is so important to seek out help as all of this can be reversed with treatment.

Orthorexia vs anorexia

Orthorexia and anorexia can be linked, with one condition potentially leading to the other. Here there are some differences. Where orthorexia involves a focus on only eating foods that fit that are “clean” or “healthy”, anorexia can involve restriction of a greater range of foods. Although restriction of calories can be seen in orthorexia, at least initially the focus tends to be on the perceived quality of food rather than quantity. In anorexia nervosa the focus can be specifically on calories and/or exercise.

What are orthorexia symptoms?

  • Cutting out foods or food groups
  • Fear of foods that don’t fit into a set of rules or beliefs
  • Reduced concentration
  • Judging other’s food and lifestyle choices
  • Food obsession
  • Feelings of guilt around food
  • Impacted relationships or difficulty joining social occasions
  • Depression or low mood
  • Low energy
  • Muscle weakness
  • Being unwell more often than normal

Orthorexia quiz

Wondering if you have Orthorexia? This quiz is not meant to diagnose or scare you, but rather make you think about your relationship with food.

Answer each question with : (0) Rarely or never (1) Occasionally (2) Frequently (3) Constantly and add your scores up at the end.

1. How often do you think about the healthiness, purity or wholeness of the foods you eat?

2. Have you cut out entire food groups from your diet (e.g. carbohydrates, fats) to make your diet healthier?

3. Do you feel anxious or guilty if you eat certain foods that you deem to be unhealthy.

4. Have you ever skipped social occasions or eating out because you were afraid of there not being suitable food that was healthy enough?

5. Do you spend hours of the day thinking, planning and researching healthy food?

6. Do you feel others eat less healthily than you and your diet is higher quality than theirs?

7. Has your eating negatively affected your relationships or social life?

8. Can you find it hard to eat anything but food you have prepared yourself?

9. Do you believe that certain foods are “clean” or “pure,” and others are “bad” or “dirty”?

10. Has the way you eat ever led to you feeling physically or emotionally unwell?

Interpretation of scores:

0-9 points: You have very low risk of having orthorexia nervosa.

10-18 points: You have a moderate risk of having orthorexia nervosa. 19-30 points: You have a high risk of having orthorexia nervosa.

Note: This quiz is not meant to diagnose orthorexia nervosa, and it is important to seek professional help if you suspect that you may be suffering from this condition.

Treatment and support

Getting support from a professional is so important and a key part of recovery. This involves breaking those food rules and starting to reintegrate all foods back into your diet. Which can feel terrifying, which is why working with someone who can guide you, helps.

A specialist dietitian or therapist can help to build a recovery plan. Everyone is individual and so recovery can look different from one person to the next. Feelings of anxiety, guilt and shame can come up. It is key to have some psychological support as well as the nutrition support too. As a dietitian I may give nutrition education, help you work through that list of fear foods and food rules. We may use breathing techniques and work on things like core beliefs to help too. Remember you cannot compare yourself to anyone else in recovery. Everyone’s recovery process is unique, and takes its own timeframe.

Getting help

Need support? Get in touch for dietitian-led consultation, or find free advice from Beat.

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