When Healthy Eating Becomes Unhealthy – By Andrea Wachter, LMFT


It starts out healthy enough — or, seemingly so. Maybe you started by cutting out processed foods. Then desserts. Then sugar. Then meat. Maybe you switched to all organic and while you were at it, went gluten-free and wheat-free. In a culture that has gone health-food crazy, it’s easy to see how some people can take a “healthy” diet to an unhealthy extreme.

For some, it’s a short-lived stage that ricochets into a junk food rebellion. Others find their way back to the middle of the road. But for many, this so-called “healthy” way of eating can become a true obsession and, at its most extreme, an eating disorder known as orthorexia. Derived from the Greek words, orthos, meaning “correct,” and orexis, meaning “appetite,” people who suffer from orthorexia become obsessed with eating foods they deem healthy, safe or pure.

Whether someone has a full-blown disorder or a lesser-degree preoccupation, what is unhealthy about being too healthy is that it is extremely limiting, very time-consuming and can ironically lead to malnutrition. It can also become a replacement and a distraction for finding healthy ways of dealing with anxiety or grief.

In my opinion, the definition of a healthy eater is someone who eats healthy approximately 80 percent of the time and with the other 20 percent, has desserts, snacks or quick meals. I always say, moderation in all things (except murder!).

When recipe browsing, meal preparation, food shopping, and thinking about eating become an obsession and/or a part-time (unpaid!) job, it might be time to ask yourself if your healthy eating is really healthy. When a slice of pizza with friends or an occasional piece of birthday cake are unthinkable, it might be time to take a closer look at your patterns with food. When taking a day off from exercise feels terrifying or unacceptable, it might be time to examine your so-called “healthy lifestyle.” When the list of what feels safe to eat becomes smaller than the list of what is off-limits, it might be time to admit there is a problem.

So what do you do if you suspect that you have orthorexia? First, take a look at when it all started. What was going on for you at the time? Many of the people I have treated in my counseling practice have discovered that they started when something painful happened, perhaps a loss, trauma or difficult situation in their lives. Feeling out of control with their painful life situation, they turned to perfecting and purifying their eating. Throw in a crazy culture that glorifies sugar-free, wheat-free, gluten-free and meat-free diets, throw in a sensitive person who has difficulty tolerating and expressing emotions, and the recipe for orthorexia is created, featuring perfectionism, food-obsession and emotional avoidance.

Many people who feel out of control with life will latch onto food, exercise and weight control in an attempt to try to control something. It’s easy enough to do in a culture that promises us nirvana if we eat, exercise or look a certain way. Wouldn’t it be wonderful if it were true? If we could purify our eating, exercise rigorously, attain the perfect body and everything in our lives would magically be okay! It’s a great idea in theory, but the real power in life comes from learning how to manage and communicate difficult emotions, and learning how to face life’s challenges rather than avoid them with food preoccupation and body obsession.

One client in my counseling practice got teased about her looks when she was young. Rather than deal with her emotions and learn how to strengthen her sense of self, she embarked on a health-food diet she read about online. It started out innocently enough and she received a lot of praise for how “good” she was and how much weight she lost. But her healthy lifestyle took an unhealthy turn when it became more and more rigid and limiting. No longer willing to go out to eat with friends, she began to turn down more and more social invitations. No longer willing to eat what her family ate, she began to spend more and more time poring through recipe books and watching The Food Network. No longer casual about exercise, she stopped doing the walks and bike rides she had previously enjoyed with her family, replacing them with hardcore, rigidly timed runs.

Another client had a death in her family and turned to so-called healthy eating and “getting in shape” rather than dealing with her grief. It took a near-death experience from malnutrition to get her to turn inward and face the original grief she was literally and figuratively running from. Once she did, she learned it was necessary and healing to cry and that grieving (and eating some foods that were not on her “safe” list) was not going to kill her. It was a shock to her that her so-called “healthy” lifestyle is what almost killed her.

Imagine food, weight and exercise as the tip of an iceberg above the surface of the water. That’s all you can see and it’s what becomes easiest to focus on. But if you go deeper underneath the water and take a look at what you’re avoiding, you will find the real issues. For most people it’s good old human emotions that they’re afraid to face. Whenever an obsession is running the show, it’s easier to focus on the tip of the iceberg (in this case, food and eating) and ignore the emotions floating underneath the surface.

Oftentimes it’s only when the problems caused by food and body obsession get big enough or difficult enough in and of themselves that some people become willing to go deeper to feel and heal their pain.

The good news is you can heal your unresolved pain, make peace with difficult life situations and learn how to effectively cope with emotions. Obsessing on recipes, food, cooking, and exercise is a never-ending cul-de-sac since we still have difficult life situations occurring while we are cooking, baking and running! The only real solution is to gain emotional coping skills.

The next time you find yourself obsessing on food or exercise, try asking yourself what you might be thinking or how you might be feeling if you weren’t thinking about food or exercise.

If you have orthorexia, take a look at how isolated and limited your life has become. See if you would be willing to step out of your comfort zone just a little bit. Consider taking a class you have been interested in (one that has nothing to do with food or exercise). Try connecting with an old friend, reaching out to someone new or seeking professional help.

Consider challenging yourself to eat a food that is not on your “safe” list and see that nothing bad will happen if you do. (You might have some big feelings, but you will not get big from one food item!) You can learn to ride your emotions out until they pass, and you’ll become stronger and more equipped as a result.

You might start by adding one food item a week, continually testing the safety of the water. If you are having a free-range burger with organic aioli, try adding a few fries. The next time your friends are going out for pizza, try one slice with your salad instead of a salad only or staying home. Afterwards, you can try journaling out all your thoughts and feelings and reassure yourself that you are not unsafe, just emotionally full of feelings. The next time you are at a birthday party, consider having one piece of cake, even if it’s not organic.

See if you can begin to speak more kindly to yourself. Your unkind thoughts led you into these rigid patterns in the first place, they will not be what gets you out. Just like a child who is afraid to go to her first day of school, you will need a lot of kindness and compassion as you step out of your seemingly comforting rules. You can begin to find safety, value and worth in yourself that is unrelated to your exercise output or your food intake.

A question I love asking my clients is, “Ships are safe inside the harbor, but is that what ships are for?” It is safe to venture out. You don’t have to set sail for months. Simply taking one small step outside your safe, self-made comfort zone can help you develop new skills and prove to yourself that your safety does not lie in food control but in self-care and self-soothing.

Published with the permission of Andrea Wachter LMFT

Poem written by a client who is overcoming Orthorexia
The sense of control over food
Strongly affects my mood
From gluten-free eats
To vegan no meats
To strictly organic
Or I will panic
To sugar-free desserts
Oh how it hurtsEating clean
Becomes my mean
For purpose in life
and to boost self esteemAnxiety over ingredients
I wish to be lenientCounting each calorie
Obsessing on my salary
Is not the answer
To if I’ll get cancer
If I’ll stay thin
Or get a double chinMoney will not define
To what is the fine line
Between happy and sad
Teary and glad

We are who we are
Each a unique star
Not by our type of diet
I need to train my mind to be quiet

Andrea Wachter

About Andrea Wachter

Andrea Wachter is a Licensed Marriage and Family Therapist and the author of Getting Over Overeating for Teens. She is also co-author of Mirror, Mirror on the Wall: Breaking the “I Feel Fat” Spell and The Don’t Diet, Live-It Workbook. Andrea is an inspirational counselor, author and speaker who uses professional expertise, humor and personal recovery to help others.
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  2. I find it hard to believe the author asserts “healthy” can be defined in percentages. (80 healthy and 20 desserts and snacks?) This is very damaging. Where are you getting this number from? What sort of desserts do you promote? What snacks? Sure, anyone can obsess over anything. And yes, taking too much time to worry about eating “perfectly” can be more avoidance and control. And yes, under-eating is a gravely serious problem. This over-pathologizing also feels silly given the magnitude of serious eating disorders out there. And to say including desserts is healthy? I think not. There are so many studies out of recent showing the deleterious effects of sugar. I have cut out deserts and fast food and feel 100 percent better. Occasionally I succumb, but I would never promote it or assert eating snacks and desserts as meaning this therefore means you are a healthy, balanced person. Clients beware!

    • As a recovering bulimic and someone who has studied nutrition for years I believe that her article is well written in simple terms to make it highly accessible for the lay person. The 80/20 rule comes from nutrition and I have heard many teachers mention it as well as saying that things like desserts are a ‘sometimes’ food. For many years I labelled foods as ‘good’ or ‘bad’, but now I like to eat a balanced diet that is non-restrictive. I agree with the author that society is obsessed with healthy, to a point where cutting out so many foods leads to malnutrition and low levels of several vitamins, minerals and amino acids. When I think about eating for my health and well being, ‘sometimes’ foods in moderation are a part of a balanced diet for me. When I’m getting off track, it’s good to be reminded of what is included in a healthy, balanced diet so I make better choices when eating.

  3. I am surprised at the lack of awareness in this article. I have had an eating disorder in various forms for most of my life. Ranging from exercise bulimia to severe restricting to compulsive overeating. I joined the rooms of OA in a desperate state – I was experiencing food blackouts – literally ‘coming to’ in places with no clue how I got there – often with food I didn’t know how I had got.
    For me (and many others) I have alcoholic foods and quantities of foods that if I ingest ‘just a small slice of’ I literally lose all control of how much of it I consume & very quickly I am in a hellish world whereby suicide feels like the only way out. The disease of addiction has reared its head & I am back in a juggernaut with no brakes. Since I have been in recovery I have discovered allergies & intolerances – as medically/professionally indicated – these have been exactly as you describe; gluten/wheat/dairy and I was told I was on the brink of becoming diabetic so refined sugar was also removed. My diet is indeed pretty healthy…not through hysteria as you seem to suggest…but rather through sanity and my HP’s grace.
    Yes, it can be a challenge to eat out with friends/family however, my focus now is the quality of the time I spend with those people not on what’s on my plate!
    In my experience, the people who are most concerned about what either I am or am not eating are people who struggle with their own food issues.
    I am the healthiest I have ever been in my life…through the grace of working the 12 steps and developing a profound connection to my HP.
    I do concur that there is often a lot of unresolved emotional stuff that behaves as a driver – in much the same way as it does with any addiction be it to alcohol, drugs, gambling, shopping etc…
    However, for me freedom & sanity is a weighed & measured food plan, devoid of my alcoholic foods – yes I do eat out & I usually don’t weigh & measure when out, although if food becomes more than just sustenance I have been known to weigh & measure when out too.

  4. Not in agreement to this line of thinking – surely obsessing about diet (or recovery) can be sourced in control or arrogance or other negative concepts. Balance is of course the recommended template of living. But, to term a phrase and create a ‘condition’ of being overly involved in your healthy diet plan is a symptom itself of obssessive analysis of the human condition. Surely it is far better to be overly concerned about your health and diet – than to recklessly consume the processed crap, fast foods, caffeine, and GMO sugar (HFCS) etc that dominates the supermarket counters. Caffeine is a drug – it is that simple – effects the interaction of emotion, energy, and the brain. Excess sugar leading to predictions that by 2050 – nearly 50% of americans are going to be diabetic (or pre-diabetic). There is zero problem if someone takes very seriously their diet – there is no problem is someone is vegan – there is zero problem if someone avoids GMOs – and it is a super great thing to be around someone that integrates compassion and local-sourcing into their eating plan. So the point of this article is unclear – it seems to be jumping on the backs of those that choose to have nutritional sobriety – to make a point that obssession can be unhealthy. I grant that point – but to make that assertion by pointing to those that don’t eat pizza (vegans shun dairy since dairy cows lead a miserable life) or avoid birthday cake (full of GMO sugars and chemicals) – seems more to be a projection of the author’s struggles rather than solid advice. Obssession is bad – and this article seems obssessed to use nutritional choices to make that point. Surely society has a much greater and dangerous problem surrounding overeating, consumption of excess sugar, incessant caffeine ingestion, denial about impact of diet on environment, blind eye to cruelty imposed on our livestock – than a problem of those that take seriously their diet and the impact of that diet – and are not interested in ‘compromising’ to eat dairy pizza or sugar-stuffed cake.

  5. Loved this article Andrea! I absolutely agree with you! I have friends who are in Recovery and yet there is eating is so disordered. They may have overcome Addiciton and Bulimina but their severe restrictions in terms of what they ingest, often leaves me baffled. I too am someone who has struggled with food as a comfort since a young child, but feel that the other extreme is equally as dangerous.

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