Orthorexia: When the Focus on Eating Well Becomes a Problem

Eating well is one of the foundations of physical and mental health. For some people, however, the pursuit of a "perfect" diet turns into a constant preoccupation that limits their social life and can even harm their health. This pattern is known as orthorexia. Understanding where healthy care ends and obsession begins helps people recognise the problem in time.

What is orthorexia?

The term comes from the Greek orthos (correct) and orexis (appetite) and began to be used in the late 1990s to describe an excessive fixation on eating only foods considered healthy or "pure". Unlike other eating disorders, the focus is not on the amount of food or on body weight, but on the quality of foods and how they are produced and prepared.

Orthorexia is not yet recognised as a separate diagnosis in the main classification manuals for mental disorders, and researchers are still discussing criteria to define it. Even so, it is described in the scientific literature and health professionals encounter it in clinical practice, sometimes alongside other eating disorders, anxiety or obsessive-compulsive traits. It can also be linked to an excessive focus on exercise and body shape.

Healthy eating or obsession: the differences

Choosing fresh foods, cooking at home, preferring organic produce or following a vegetarian or vegan diet are not, in themselves, signs of illness. Likewise, dietary restrictions for religious, cultural or ethical reasons, or on medical advice, are legitimate choices. The difference lies in the rigidity, the distress and the impact on a person's life.

Some signs that the concern may have gone too far:

• Spending many hours a day thinking about food, planning meals or researching ingredients.
• Gradually cutting out entire food groups without medical reason, until the list of "allowed" foods becomes very short.
• Feeling intense guilt, anxiety or shame after eating something that breaks self-imposed rules.
• Avoiding dinners with friends, parties or family meals because of not being able to control what will be served.
• Always bringing one's own food or refusing utensils that have touched foods considered unsuitable.
• Judging one's own worth, or that of others, according to what they eat.
• Losing weight unintentionally or showing signs of nutritional deficiencies, such as persistent tiredness.

This behaviour often starts gradually, with apparently positive changes, and intensifies as more rules pile up. Contradictory nutrition information and food trends that come and go, such as cutting out gluten or lactose without need or "detox" diets, can feed this cycle.

Health risks

When restriction is severe, deficiencies in protein, vitamins and minerals can develop, along with loss of muscle mass and, in more serious cases, malnutrition. Emotionally and socially, orthorexia can lead to isolation, constant anxiety and family conflict. Because the person tends to see their behaviour as healthy and even virtuous, they often do not recognise that there is a problem, and family members or friends are frequently the first to notice.

How to seek help

If you recognise yourself in the signs above, or are worried about someone close to you, the first step is to speak to a family doctor, who can assess the situation and refer to the appropriate professionals. The approach is usually multidisciplinary and may include:

• Psychological support: to work on rigid beliefs about food, the anxiety that comes with them and the relationship with one's body.
• Nutritional support: to reintroduce foods gradually and safely and correct any deficiencies.
• Medical and psychiatric assessment: to rule out or treat other associated conditions, such as anxiety disorders, depression or obsessive-compulsive disorder.

If you want to support someone close to you, it helps more to express concern calmly and without judgement, focusing on their wellbeing and the impact on daily life, rather than arguing about food rules or trying to impose changes.

In summary

Orthorexia describes an obsessive concern with the quality and "purity" of food, leading to ever-tighter restrictions, distress and isolation. A healthy diet should be varied, flexible and compatible with social life. When food rules start to cause anxiety or limit everyday life, it is worth seeking professional help. This article is for information only and does not replace advice from a health professional.