Orthorexia nervosa is an eating disorder characterized by restrictive eating secondary to obsessive behaviors in pursuit of a healthy diet. Although this not considered an official eating disorder recognized by the DSM V, which is the authoritative guide to the diagnosis of mental disorders, this eating disorder is recognized by eating disorder therapists as it can have many negative mental health effects and is known to lead to anorexia nervosa if not professionally treated. Orthorexia nervosa, like all other eating disorders, is not a choice but rather an unconscious behavior that develops due to an unhealthy relationship with food. Many individuals are pressured to conform to a certain image portrayed in society, which leads to leading causes of orthorexia nervosa; strict dieting, and obsessions about healthy food which can further lead to feelings of anxiety, isolation, and depression.

There is no one specific cause that is known to lead to orthorexia nervosa and not enough research has been performed to correlate specific causes however similar to other eating disorders, there are risk factors that can lead to unhealthy relationships with food.

  • Past history of trauma
  • Unhealthy relationships
  • Unresolved personal conflicts
  • Low self-esteem
  • Perfectionist personality
  • A long history of dieting
  • Substance abuse
  • Obsession with exercise
  • Overwhelming society pressures
  • Unresolved childhood trauma
  • Depression
  • Anxiety
  • Bullying
  • Social media obsession
  • An intense need to “fit in”
  • Need for extreme control

Social and Psychological Causes of Orthorexia Nervosa

Ironically, a person who is obsessed with healthy eating congruent with orthorexia nervosa is actually more at risk for problematic health issues. Restricting or avoiding foods or entire food groups, like fats and carbohydrates can increase an individual’s risk for malnutrition and nutritional deficits. It is also possible to experience weight loss that can also contribute to medical complications.

The social and psychological implications of orthorexia nervosa are also significant and devastating. A person with orthorexia may withdraw from their social life and all meaningful relationships in their pursuit to eat “healthy” and “clean,” forsaking many of the things in their life that had been meaningful. Eating behaviors associated with orthorexia nervosa may even jeopardize a career or ability to thrive in a job or as part of a family unit. A person with this disorder may also experience extreme forms of guilt, depression, and anxiety when unable to follow their food rules, which can lead to more serious mental health issues.
Why me?

Orthorexia nervosa is a disorder and not a choice. Although some individuals have a higher risk than others, you did not wake up one morning and decide to have orthorexia nervosa, rather it develops over time due to a combination of negative behaviors. This eating disorder manifests as a result of negative underlying experiences and emotions that have not been dealt with in a healthy manner. Maybe you were abused as a child, had a horrific experience in a relationship, were bullied in school, constantly called “fat” by your cross-country coach or were raised by overly protective and strict parents. There are many causes that most likely have contributed to this behavior and therefore it is important to realize that this is not your fault nor it was your choice. Seeking treatment will help you uncover the underlying causes and triggers associated with your orthorexia nervosa so you can learn positive coping skills to deal with stressful experiences that may come your way in the future.