Steven Lippmann, M.D.

Could healthy eating habits be bad? Good nutrition and careful food selection sounds just great and indeed they are. We all applaud healthy eating. However, like any behavior, too much of it, can become counter-productive or even dangerous. Excessive adherence to an overly rigid diet can become physically unhealthy and hamper social function. Being compulsive in restricting oneself exclusively to the very “healthiest” of food choices can result in malnutrition and social dysfunction.

Orthorexia nervosa (ON) is a newly described condition characterized by an obsessive focus on compulsive eating habits and food selections; when carried to an extreme degree, health and interpersonal relations suffer. People with clinical degrees of ON become so concerned about food that it leads to poor nutrition. Preoccupation with a healthy diet is the hallmark of ON, even as somatic and personal life declines. Such eating habits impair participation in communal or family meals and going to a restaurant becomes uncomfortable for the person involved. 

This exaggerated version of normalcy has much in common with conventional eating disorders and certain other life-styles, just carried to an excess. Thus, orthorexia nervosa is simply an exaggerated variant of dieting. It has close association with other obsessive/compulsive conditions and could overlap with other psychiatric disorders.

Intervention follows a thorough evaluation. Management includes conventional psychotherapeutic, pharmacologic, and social therapies. Other medical or psychiatric illnesses should be treated. Dietary concerns, physical complications and inappropriate socialization must be addressed. Education about nutrition and adjusting food selections is provided. The aim is to establish better eating habits which are in fact healthy, while affording more normal emotional life and interpersonal relationships.