Orthorexia: An Unhealthy Obsession with Healthy Foods

Worried young girl with her head down


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. 

For more information about our Eating Disorders Program at Cincinnati Children’s, please call 513-636-9657.


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.

Write a comment


  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
  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 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… […]
  15. Elise M December 06, 18:28
    My mom has orthorexia and I don't know what to do. She controls everything I eat to a ridiculous point. I have a slight autoimmune disease called ITP, but my mom seems to think it's as bad as cancer. If it wasn't for blood labs, we wouldn't even know I had a disease; it hardly affects my lifestyle or overall health at all. She is obsessive about not eating too much salt, sugar, grains, etc. She acts like I have celiac disease when all the gluten sensitivity tests have come back negative. (Apparently, there's a slight chance that they can miss a certain kind of sensitivity.) I also have not shown any symptoms of being allergic to dairy either, but if I even get some yogurt on a sweater she'll make me change my clothes even after I've cleaned it off. When I ask why she starts saying something about "there's still a bit left" (not even visible), "you will touch the spot, then touch your food, and then you'll eat it." My diet sucks, and she obsesses over certain ingredients while ignoring overall lifestyle. She even used to do Eastern energy medicine, which is not even scientific. She also believe any research paper she finds or doctor she hears about on the internet. She had me doing a diet for two years which just a week ago she discovered was "a terrible way to treat autoimmune disease." And the worst part is that I am HOMESCHOOLED. So this obsession carries over to lots of other things in my life and unfortunately she has complete control over it all. What should I do??
    • Laurie Dunham, MS, RD, LD Author December 07, 20:12
      Hi Elise, Thank you for reaching out. There appear to be many factors that need to be taken into consideration to answer your question thoroughly. I would suggest you schedule an appointment with your doctor to have a medical professional assess your health and provide appropriate recommendations. Additionally, a mental health therapist might be able to help you (and your Mom) with handling anxiety and differing viewpoints in the home.