What is Orthorexia, its causes, symptoms and treatment?

Orthorexia is an eating behaviour disorder that consists of an obsession with healthy Food. People who suffer from this pathology feel obliged to follow a restrictive diet that, depending on the case, can exclude meat, fats, foods without organic labelling, and additives. In addition, it can lead to nutritional deficiencies and alter mental health.

“The orthorexic does not replace the foods he rejects with others that can provide him with the same nutritional supplements. This translates into anaemia, vitamin or trace element deficiencies or lack of energy.

This pathology is not included in the official psychiatric classifications, but psychiatrists and psychologists recognise its existence and treat it in their consultations, especially those dedicated to eating disorders.


The factors behind orthorexia are unclear, but it has been observed that it usually manifests itself in people with obsessive and perfectionist behaviours. This last feature is shared with subjects suffering from anorexia, bulimia or other eating behaviour disorders (ED). In fact, in some cases, orthorexia is part of the restrictive symptomatology of these pathologies. 

Psychiatrists and psychologists frequently observe that excessive preoccupation with healthy Food has to do with malaise or a personal difficulty that is tried to alleviate by controlling other aspects of life.


The main symptom is excessive concern about everything ingested.

Patients spend a great number of hours a day planning and preparing meals.

They are often so strict that they even feel guilty when they break it and punish themselves with even more rigid diets and fasts. Similarly, they eliminate certain foods from their diet, including meats and fats and other substances such as sugar.

Unlike other eating disorders, orthorexics are usually very open people regarding spreading their eating rules and do not refrain from being proud of them in front of other people.

In the same way, they look down on those who do not follow dietary rules so that the patient may be forced into social isolation.

Orthorexia usually begins with healthy lifestyle habits that become obsessive and can cause patients to lose weight. In addition, they may lose the ability to eat intuitively. That is, they stop knowing when they are hungry or full. 


To avoid becoming obsessed with healthy eating, specialists recommend following these tips:

  • Follow a healthy diet that includes the amount and variety of foods the body needs to function properly. 
  • Focusing on children’s education through advice such as respecting oneself and others and educating with non-stereotyped models of beauty and conduct is important. 

 “Food has a nutritional component: calories, carbohydrates, proteins, vitamins, and minerals. But it also has a very powerful social component -particularly in Mediterranean cultures- and is a pleasure; that’s why gastronomy exists “.



there is a fine line between an interest in healthy Food and an obsession with it. It must be remembered that the key to diagnosing any mental illness is that the disorder causes physical, social, and emotional harm to the patient.

To detect orthorexia, specialists include questions in the clinical interview aimed at clarifying the existence of pathological behaviour, such as the following:

  • Do you care more about the healthy characteristics of what you eat than the pleasure of eating it?
  • Do you spend more than three hours a day thinking about healthy Food?
  • Do you feel superior to other people who don’t eat like you?
  • Do you feel guilty if you skip the diet you have decided to follow?


The treatment of people suffering from orthorexia is based on psychological and pharmacological therapy, depending on the case. “The treatment is based on addressing what underlies this pathological attitude. Hence, it relies primarily on psychotherapy. “At some point, depending on the affective or anxiety consequences of the affected person, stress or anxiety regulator can be administered.

In many cases, the disorder is approached in a multidisciplinary way, with a team of professionals that includes a psychiatrist, a psychologist and a dietician-nutritionist. Nutritional education is essential for the patient to return to his intuition: he should eat when he is hungry and stop when he feels satisfied.

It is recommended that all the discarded nutrients be incorporated little by little and that a healthy diet be continued in which sufficient quantities of all the food groups are ingested. 

Orthorexics are not concerned about the amount they eat but more about the quality of Food, as they believe that a healthy diet taken to the extreme can cure certain diseases.

Advanced orthorexia can pose a health hazard, especially by causing hyponatremia (low sodium levels), metabolic acidosis (when the body produces too much acid or when the kidneys are not removing enough acid from the body), and pancytopenia (in which the patient has low levels of red blood cells, white blood cells, and platelets).

As for the psychological and social consequences, psychologist, psychotherapist, and care coordinator points out that those who suffer from this pathology come to “spend a lot of time thinking about what they are going to eat, do the shopping, cook food, etc.”, which implies “an increase in obsessive thinking about Food, causing the person to focus on their Food and isolate themselves and lose social contact “. Avoiding gatherings with family and friends due to distrust of what they are going to eat also encourages “the person to isolate himself, leading to the development of suspicious and paranoid ideas.” Finally, this isolation “generates feelings of sadness, emptiness and vital dissatisfaction.