We all know someone like this or maybe you are this someone: Every time you’re around them, they just can’t stop talking about the raw, vegan, cacao super-fruit cookies they made and how they can feel the plant energy healing them every time they bite into one. Or maybe they’re paleo and they refuse to even touch anything that isn’t free-range, organic, and GMO free. Oh, and heaven forbid they eat a single speck of rice! You invite them out to dinner pretty regularly but they’ve never said yes, citing that, “I can’t risk exposing myself to all the toxins in that food! You know how sensitive I am!” It’s a real drag right? But, does their obsession with their diet indicate they have a problem?


nutrition, fear of food, healthy food, healthy relationship to food, orthorexiaDon’t get me wrong, I am a pretty darn healthy eater. I encourage people to take an active role in choosing healthy foods. It’s important to our fitness goals, as well as our vitality, happiness, and longevity. But there is a fine line between eating in a healthy way and what is now known as orthorexia.


Orthorexia, while not officially recognized by the DSM-IV as an eating disorder, is basically an unhealthy obsession with eating healthy food. The phrase orthorexia was coined by Dr. Steven Bratman in a Yoga Journal article back in 1997. Dr. Bratman worked as a chef and an organic farmer in a commune that attracted vegetarians, raw vegans, those who eat macrobiotic diets, and other specialized diets before he became a doctor. Based on what he observed there, his own issues with orthorexia, and his experience with his patients, he came to some conclusions. While eating healthy should certainly be encouraged, an unhealthy preoccupation can be socially and mentally debilitating and physically damaging, even deadly in some cases.


What exactly separates an orthorexic from your everyday paleo enthusiast or strict vegan? Dr. Bratman stated that when the obsession with food impairs other parts of the person’s life then it becomes pathologic. When the majority of a person’s time is spent planning, cooking, and thinking about food, when social engagements are avoided at all costs, when anxiety, fear, and guilt become the driving force to adhere to the “ideal diet,” whatever that may be, there is a problem. Dr. Bratman explained that orthorexia is much like bulimia or anorexia, but that instead of an obsession with thinness and quantity of food consumed, the obsession is with the quality of food. Bratman himself admitted he found himself so preoccupied with food and “righteous eating” that he had lost the “poetry” of his life. He said he was lonely and could not enjoy any of the social aspects of eating anymore.


Karin Kratina , PhD, RD, LD/Ns, also did a great job of describing orthorexia. She said:


“Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with ‘slip-ups.’ An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be ‘good,’ rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts, and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake… Eventually, the obsession with healthy eating can crowd out other activities and interests, impair relationships, and become physically dangerous.”


eating disorders, healthy eating disorder, paleo disorder, orthorexia, paleoAnd yes, there have been cases of death associated with orthorexia. Of course, eating junk food has a much higher death toll, I will not argue with anyone on that point. Far more of us are in danger of being overweight and unhealthy due to the massive amounts of processed, chemically-laden, trans-fat-containing food we have available to us. However, for the people who are affected by othorexia or who have loved ones who are, this is a significant issue. Most often death occurs as a result of starvation, or anorexic orthorexia. A person, so afraid of eating unhealthy or un-pure foods, loses weight and slowly starves to death. It’s important to note the obsession is not on being thin or losing weight. It is on the purity or righteousness of the food. It’s a scary thought and one we should be aware of when evaluating others or ourselves for orthorexia.


And how can we tell if we or someone else is orthorexic? Dr. Bratman developed a quiz that can help identify if someone may indeed have an obsession with healthy eating. I’m giving you the abbreviated version. The full version can be found in Dr. Bratman’s book, Health Food Junkies. If you answer “yes” to two or more questions you may have a bit of an issue. Over four “yes” answers means you probably are obsessing over your healthy diet too much. If you answer “yes” to all of the questions, you have an issue that is impacting your life in a negative way.


The Orthorexia Quiz


  1. Do you spend more than three hours each day thinking about food? (For four hours give yourself two points.) The time measurement includes cooking, shopping, reading about your diet, discussing (or evangelizing) it with friends, and joining Internet chat groups on the subject.
  2. Do you plan tomorrow's food today?
  3. Do you care more about the virtue of what you eat than the pleasure you receive from eating it? 

  4. Have you found that as the quality of your diet has increased, the quality of your life has correspondingly diminished? 

  5. Do you sacrifice experiences you once enjoyed to eat the food you believe is right? 

  6. Do you feel an increased sense of self-esteem when you are eating healthy food? Do you look down on others who don't? 

  7. Do you feel guilt or self-loathing when you stray from your diet?
  8. Does your diet socially isolate you? 

  9. When eating the way you are supposed to, do you feel a peaceful sense of total control?


Now, to wrap this up, I’m going to speak in my un-politically correct voice. If you answered yes to more than four of these, please, get some help or at least reevaluate how you think and approach your diet. Life is not meant to be lived like that. Enjoy your life, eat well, but live. Don’t forget our life is about collecting memories and experiences. If we aren’t out their soaking up the joy found in friendships, travel, and yes, eating, then what is all that healthy eating really doing for us? 



1. Bratman M.D., Steven. "What is orthorexia?." Orthorexia.com (blog), June 04, 2010. (accessed July 2, 2013).

2. Bratman M.D. , Steven, and David Knight. Health Food Junkies. New York City, New York: Random House, Inc., 2000.

3. Kratina PhD, RD, LD/N, Karin. "Orthorexia Nervosa." NEDA Feeding Hope, (accessed July 2, 2013).


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