Orthorexia: Can clean eating be bad for you?

Posted on 18 April 2019

If you have orthorexia it means you take ‘clean’ eating a little too far. Berna Harmse, a clinical dietician practicing at Mediclinic Panorama, explains further.

“Orthorexia is a pathological fixation with healthy food which some have described as a disease disguised as a virtue,” explains clinical dietician, Berna Harmse. The word literally means ‘proper appetite’ (the Greek ‘orthos’ refers to ‘proper’ or ‘correct’).

This condition generally develops when you slavishly follow a theory of healthy eating such as paleo, veganism, raw foods and elimination diets. While most of the more popular diets associated with orthorexia can be followed safely, others are simply dangerous.

There is an ongoing debate as to whether orthorexia is an eating disorder or a form of obsessive-compulsive disorder.


Most healthy people use coping mechanisms to manage the anxieties of daily life, but in orthorexia sufferers, control over food becomes the primary defence. Other symptoms include:

Drive for purity. Eating the right food creates a sense of virtue.

Social isolation. Non-food-related aspects of life begin to fall away.

Compulsive behaviour. Constantly checking ingredient lists and nutritional labels.

Food elimination. Cutting out an increasing number of food groups.

Judging others’ diets. Unusual interest in the health of what others are eating.

Panic. Becoming distressed when ‘safe’, ‘healthy’ or ‘pure’ foods aren’t available.

“On a biochemical level, your body always aims for homeostasis ( balance) and you need a little bit of everything to maintain that balance,” Harmse explains. Even when there is no desire to lose weight, cutting out whole food groups poses physical problems in the long term.


Are your gut bacteria making you sick?


Certain foods, such as refined carbohydrates and sugar, can safely be cut from your diet, but someone with orthorexia might define sugar differently and cut out all fruit.

Harmse makes the following examples of complications linked to eliminating ingredients:

A person following a vegan diet may fail to consume enough protein. This can lead to muscle atrophy (including the muscles of the heart) which can lead to death.

Vegans or vegetarians may need a vitamin B injection as they generally lack vitamin B12 . Deficiency of different types of vitamin B (and other vitamins) cause different syndromes, diseases and symptoms, including anaemia

As Harmse adds, some diets advocate cutting out fruit and vegetables for certain blood types. “This can lead to immune deficiencies, lowering your body’s ability to fight off disease,” she says.

There’s a blood disorder that limits your absorbsion of vitamin B [link to April content on blood disorders]

Cutting fibre (whole grains) carries the risk of developing blood sugar problems and digestive complications.

A lack of other nutrients may lead to anaemia, osteoporosis, hair loss, fatigue, low blood pressure, skin problems and many other health issues.


A clinical dietician can help create a balanced diet appropriate for you. Because of the emotional aspect of the condition, psychotherapy is advised to address the underlying psychological factors that drive orthorexia.


INFOGRAPHIC: What does a healthy meal look like on your plate?



Published in Healthy Life

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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