The truth about 'orthorexia' and the dark side of clean eating

In the '90s and early '2000s, diet culture manifested through the extremities of anorexia and bulimia, powered by a generation obsessed with being skinny. Today, the conversation has pivoted towards a cleaner, supposedly healthier path—one that is aspirational, guised as wellness, and egged on by algorithm-approved advice. Orthorexia blurs the line between mindful eating and restrictive dieting, leading to an obsession that is now classified as an eating disorder.

Unlike anorexia nervosa or bulimia nervosa, however, orthorexia isn't necessarily driven by weight loss or body image alone. Instead, it centres around eating clean and healthy, essentially focusing on the quality and purity of food. "Orthorexia develops when food choices become rigid, compulsive, and emotionally loaded to the point that they interfere with a person's physical health, mental well-being, relationships, and overall quality of life," explains Dr Morgan Francis, who is equipped with a doctorate in clinical psychology.

In today's wellness-obsessed world, orthorexia creeps in as ‘discipline’. Under the guise of self-care and self-optimisation, we have normalised restrictive habits and tend to celebrate detox culture, fear-driven nutrition advice, and elimination diets—making it difficult to identify when healthy habits cross into more harmful territory.

“We live in a diet culture,” says Dr Francis. “The kind that moralises food and equates health with virtue. Social media algorithms reward extreme behaviours because rigidity, transformation stories, and ‘what I eat in a day’ content generate engagement.” The result? An environment where cutting out food groups, fearing processed foods, or obsessively optimising meals is framed as aspirational rather than concerning.

Dietician and certified diabetes educator, Dr Archana Batra, adds that misinformation and oversimplified nutrition advice also play a pivotal role in encouraging this approach. Claims such as seed oils causing cancer, all processed foods being toxic, or carbohydrates being harmful are often presented without proper scientific context, encouraging people to fear food rather than understand it. “Healthy eating should be based on balance, variety, and evidence-based guidance rather than fear,” she says.

WHEN CLEAN BECOMES DIRTY

The line between eating healthy and orthorexia lies in the obsession. According to Dr Francis, the warning signs begin when flexibility disappears, and fear takes over. What often starts as nutritional awareness can spiral into guilt, anxiety, and an extremely consuming need for control.

“It becomes unhealthy when the food choices start to control a person’s thoughts, feelings, and daily life,” says clinical psychologist Mehezabin Dordi, Sir HN Reliance Foundation Hospital. “A good question to ask—is the person in control of their diet, or is the diet controlling the person?”

Orthorexia often develops gradually, which is what makes it extremely difficult to identify. Early warning signs include obsessively reading labels, eliminating entire food groups without medical necessity, spending excessive time researching nutrition, and avoiding social gatherings because ‘safe’ foods may not be available.

Unfortunately, orthorexia can be mistaken for virtue. “Friends and family may praise the behaviour before realising how emotionally consuming it has become,” says Dr Francis. Emotionally, people may experience obsessive thinking, heightened anxiety, and depression. Socially, the consequences can be equally isolating. Meals with friends become stressful, holidays feel unsafe, and spontaneous eating disappears entirely.

For many, restrictive eating patterns can lead to nutrient deficiencies, fatigue, hormonal imbalances, bone density loss, cardiovascular complications, weakened immunity, and digestive complications. “The impact, however, extends beyond nutritional deficiencies. Restrictive eating can also disrupt hormonal health,” Dr Batra warns. She notes that eliminating dietary fats, for example, can affect hormone production and regulation, as fats play an essential role in synthesis and overall hormonal function. In women, especially, this may contribute to menstrual irregularities and other reproductive health concerns. In men, deficiencies like low zinc intake can negatively impact testosterone levels and overall reproductive health, too.

PSYCHOLOGICAL OVERLAP

For some, rigid food rules create a temporary sense of safety, especially during periods of stress or emotional instability. A strong need for certainty or control, perfectionism, and other mental health conditions, such as anxiety, obsessive-compulsive traits, low self-worth, depression, exercise addiction, trauma-related disorders, and body-dysmorphic concerns, can also contribute towards orthorexia.

“There is often black-and-white thinking around food,” explains Dr Francis. Foods become morally categorised as superior or ‘bad’, and self-worth gets entangled with that very dietary perfection. In many cases, being healthy becomes less about nourishment and more about achieving a sense of purity, discipline, or worthiness.

Orthorexia can also coexist with conditions such as OCD, anxiety disorders, depression, anorexia nervosa, and body dysmorphia, making diagnosis and treatment more complex. According to Dordi, diagnosis of orthorexia isn’t just dependent on food choices, but also the patient’s motivations, emotional responses, and overall functioning with the disorder.

STRIKING A BALANCE

While orthorexia is not yet formally recognised as a standalone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, treatment is similar to that for eating disorders and compulsive behaviours. Cognitive behavioural therapy, nutritional counselling, and exposure therapy are commonly used to challenge rigid beliefs around food and rebuild flexibility.

This article originally appeared in Harper's Bazaar India's June-July 2026 print issue.

Lead image: Getty Images

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