Orthorexia: An Unhealthy Obsession with Healthy Foods

In the spirit of sharing information during National Eating Disorders Awareness Week, I’d like to give parents a heads up on a nationwide trend that I’ve also been encountering in our Eating Disorders Clinic.

It’s called orthorexia, and it is an unhealthy obsession with maintaining a perfect diet, rather than a healthy weight and lifestyle.

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

Children and teens who show signs of this eating disorder have obsessive concerns about eating foods that are clean, unprocessed, organic, pesticide and preservative free, low in fat, sugar or salt – to the point that it impacts their everyday activities. For instance, if your daughter turns down an opportunity to go out to eat with her friends because she is worried that she will not be able to follow her strict dietary guidelines, this is a good time to ask some questions.

I would like to clarify that for most children and teens (and even adults), opting to eat in a healthier manner, adopting some of the changes I just described, is in general a good choice. It’s only when these restrictions are taken to extreme that this could be a cause for concern.

What’s troubling about orthorexia is that the side effects can mimic the 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 because “acceptable” food might not be available and 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, 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 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 in the past, his or her child is more likely to develop one as well.

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

  • Increased avoidance of particular foods, claiming food allergies as the cause, without a medical diagnosis
  • The amount of “acceptable” choices decreases so much that he may be willing to eat less than 10 foods
  • Obsessive concern with food choices and their relationship with health conditions such as asthma, digestive problems, low mood, anxiety or allergies, without medical advice
  • Feels guilty when he/she is unable to follow self-imposed dietary restrictions
  • Avoids food made by others
  • Isolation from others who do not share his/her same view on foods
  • Spending excessive time in grocery stores or online reviewing food labels and ingredients

With more than a third of the U.S. population being overweight, making healthy dietary modifications is a good choice for the majority of children and teens. However, if your child or teen tends to have rigid or perfectionist tendencies and is starting to obsessively modify his or her diet, I recommend speaking with him/her about balance and moderation. Explain that there are healthy “everyday” foods , and there are “sometimes” foods, which we should eat on occasion. And it’s okay to eat these “sometimes” foods periodically because there is room for all foods to fit into a healthy diet.

If you have concerns about your child’s eating habits, please speak with your child’s doctor about it. He or she may need to be seen by a Registered Dietitian for basic nutrition education or, it may be recommended your child be seen by an Eating Disorder Program where the medical, psychological and nutritional aspects of disordered eating can be addressed.

Laurie Dunham, MS, RD, LD

About the Author: Laurie Dunham, MS, RD, LD

Laurie Dunham, MS, RD, LD has worked as a Registered Dietitian at Cincinnati Children’s for 14 years. She lives in West Chester with her husband and two children. In her spare time she enjoys reading and being active with her family and friends.

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Comments

  1. Amy February 24, 11:03
    Great post - thank you so much!
  2. […] In reaction to childhood obesity (which I discussed in an earlier post) there’s a brand spanking new eating disorder amongst teens: An unhealthy obsession with healthy foods. Interesting. Orthorexia: An Unhealthy Obsession with Healthy Foods | Cincinnati Children’s Blog. […]
  3. Heather Zwingler February 24, 19:38
    Enjoyed your article Laur! Heather
  4. Donna Hughes February 25, 10:48
    Great article Laurie. Uncle Gene and I both enjoyed reading it. Super job. Aunt Donna
  5. Holly Kane February 26, 13:21
    Great information Laurie. I am going to share this with Nia and Faith's health teachers at school.
  6. St. Elizabeth Healthcare April 14, 13:53
    We need to keep encouraging kids to eat healthy but make sure not to push it too far. Healthy eating is getting a balanced diet and kids need to be educated on what that entails.
    • Barbara thepenier May 20, 08:39
      Stay away from the "diet" word......folks with an ED call it FOOD!
  7. jan zarczynski May 21, 09:33
    Very timely article. This trend is growing among young teens whose longterm course is unknown at this time. Due to the 'healthy' veneer their obsessive/compulsive pattern has, they get confusing feedback, especially in the earlier stages of this sad and serious abnormal behavior. They may get positive feedback at first which challenges parents and practitioners from being able to help in their recovery. I actually wonder what recovery means for them. Going to 'junk food' which includes just about anything now, including milk and dairy products. Time to tackle this. Orthorexia is to anorexia what cutting is to suicide. They seem an alternate problem, however they are rooted very similarly. thanks.
  8. […] http://cincinnatichildrensblog.org/healthy-living/orthorexia-an-unhealthy-obsession-with-healthy-foo… […]
  9. Lizzy Mac June 26, 16:02
    Wow! This post is eye opening. My teenage daughter has a couple of friends who will only eat "healthy" food, not that they have a problem (at least that I'm aware of), but I totally thought in my head, "I wonder if all the hype about healthy, organic, natural eating could cause a child to obsess over it to the point of an ED." I thought I was making it up. Glad I stumbled upon this article today.
  10. Rex Crouch June 30, 02:24
    #ThanksMichelleObama
  11. Concerned Husband July 23, 14:11
    How would I talk to my wife about this condition if I believe that she has many of these warning signs?
    • Laurie Dunham, MS, RD, LD
      Laurie Dunham, MS, RD, LD Author July 27, 14:16
      Talking to a loved one about disordered eating is a difficult, but important step. I encourage you to share your concern in a supportive, calm manner and provide examples of the types of behaviors that worry you. Carve out time when you are both able to sit down and focus on the discussion at hand. She may respond well, but be prepared for her to not receive the information in the way in which it was intended. Have some resources ready for her if she is open to treatment. Physicians, therapists and registered dietitians trained in treating individuals with eating disorders would be the best place to begin. The National Eating Disorders Association has an array of information on this very topic on their website. I have included the links to specific areas I believe would be helpful for you, but please feel free to browse their website to learn more. https://www.nationaleatingdisorders.org/find-help-support https://www.nationaleatingdisorders.org/family-and-friends Thank you and I hope these resources will assist you in helping your wife. Sincerely, Laurie Dunham
  12. Erin July 27, 01:46
    I feel like some of the mom groups I am in on Fb - like there is some moms like this.......
  13. Bulimia Recovery Coach November 16, 01:06
    It's type of eating disorder that a lot of people misconceive as a healthy way of eating. The fact it's characterized as an eating disorder. It's wont make people healthy. It could cause negative effects to a person's emotional, social & physical well being.
  14. […] http://cincinnatichildrensblog.org/healthy-living/orthorexia-an-unhealthy-obsession-with-healthy-foo… […]