Healthy Eating Or Orthorexia? Take The Orthorexia Quiz

Do you spend much of your day obsessing over what you’re going to eat or thinking about whether your food is healthy or not? If so, this Orthorexia quiz post is for you. 

Finding the balance between healthy eating and obsessing over the foods we eat can be incredibly hard.

In this post, I’ll describe the difference between healthy eating and Orthorexia Nervosa (ON), a type of disordered eating marked by an obsession with healthy eating. You can take the Orthorexia quiz at the end to assess whether your own thoughts and eating habits might be putting your health at risk.

Let’s dive in.

What is Orthorexia?

Orthorexia is the obsessive pursuit of optimal, even “perfect,” healthy eating.

It is completely normal to think about the nutrition in the food you eat sometimes. However when you start to fixate on restricting certain foods or food groups in order to be “healthier,” this could be considered a warning sign of orthorexic thinking.

There is no “balanced diet” with Orthorexia. An individual with Orthorexia focuses heavily on the “health factor” of the foods they consume and may be hesitant to consume foods prepared by others. They will only eat a narrow range of foods they deem “safe” or “healthy.” 

When the pursuit of perfect eating (which does not exist) gets in the way of living a balanced life, Orthorexia may be at play.

How does Orthorexia start?

Often ON begins as a person slowly starts to restrict foods in their diet. They categorize foods as “healthy” or not – good or bad. It may seem harmless at first. For example, someone might choose to be a vegetarian, then eliminate more and more foods. They might choose to become a vegan, or eliminate gluten, or both.

As the person becomes more strict, they eliminate more foods from their diet and obsess about what is in the foods they do eat. They may become overly worried about the consequences of eating foods they deem “unhealthy.” Overall, a person’s life may start to revolve around food and health.

How does Orthorexia differ from healthy eating?

A person with Orthorexia might avoid parties, eating out, and other social events where they cannot control their meals. With this also comes food anxiety when or if they consume anything outside of their “safe” foods. Life becomes smaller, confined even.

Following their “health” habits can create feelings of satisfaction and purity for the person with Orthorexia. Although, breaking their food rules and highly restrictive diet will do the opposite, causing feelings of guilt. Self-esteem is oftentimes affected by this person’s daily food choices. 

Healthy eating, on the other hand, is unrestrictive. All foods can fit in a healthy eating pattern. 

A healthy eater might pay attention to getting nutritious foods in their meals often, but not obsessively so. They don’t worry that one meal (or even several) will have negative effects on their health. Their diet does not interfere with their social, mental, or emotional health.

What causes Orthorexia?

A combination of genetic factors, lifestyle habits, and exposure to diet culture can put someone at a higher risk for developing Orthorexia Nervosa. 

Some potential risks for developing Orthorexia include:

• having a history of having an eating disorder or a family member with an eating disorder
• following a vegan or vegetarian diet
• increased use of social media 
• mental health struggles, such as anxiety or obsessive compulsive disorder
• having poor body image and/or body dysmorphia
• being involved in athletics

Keep in mind that just because someone has one or more of these risk factors, it does NOT mean they have or will develop Orthorexia. 

Do I have Orthorexia? 

Orthorexia signs and symptoms include: 

• Consuming a lack of balanced foods due to rigid restriction of perceived “unhealthy” food groups
  • Ex: cutting out ANY foods that contain sugar, or gluten, or fat, or preservatives 
  • This could also include animal products or food preservatives 
• Spending excessive amounts of time reading about and/or prepping specific foods due to their quality/composition
• Feeling guilty after the consumption of things that are deemed “unhealthy”
• Being intolerant of other people’s food choices and/or beliefs 
• Avoiding going out to eat or eating food prepared by other people 
• Having inflexibility within your daily eating routines 

Orthorexia looks different in every person, so the symptoms may vary, appearing more or less serious than described above, depending on the individual. If you relate to any of the common warning signs or symptoms, it is best to reach out to a Registered Dietitian or therapist who specializes in treating disordered eating.

Does Orthorexia lead to Anorexia or other eating disorders?

Orthorexia on its own can have physical and mental consequences, such as difficulty with emotional regulation and nutritional deficiencies. It can also lead to the development of other eating disorders, such as Anorexia Nervosa. 

There is overlap among many of the behaviors we see in Anorexia and ON. If body image dissatisfaction develops in someone with Orthorexia, they may be at risk for developing Anorexia or Anorexia-like tendencies. 

The main difference between these two disorders is often the motivation for changing eating behaviors. In Anorexia, people alter their eating patterns to make their bodies smaller. Conversely, in Orthorexia, health and purity, rather than body size, are the main drivers.

Individuals with Orthorexia are typically proud of their eating habits while those with Anorexia may try to hide their eating behaviors. 

Although those with Orthorexia believe they are optimizing their physical health through this pattern of eating, these behaviors “may lead to nutritional deficiencies, medical complications, and poor quality of life” in the long term, according to researchers. 

How can we treat Orthorexia?

Recovering from Orthorexia is best approached with a combination of treatment methods, usually involving a therapist and a Registered Dietitian. If you experience any of the symptoms discussed within this post or just want more information, you can learn more about eating disorder treatment options in this post. 

Take the Orthorexia Quiz

For each question below, answer with the number that applies best to you:

1 = Always  

2 = Often  

3 = Sometimes 

4 = Never 

1. Do you spend more than 3 hours a day thinking about your diet?
2. Do you plan your meals several days ahead?  
3. Is the nutritional value of your meal more important than the pleasure of eating it? 
4. Has the quality of your life decreased as the quality of your diet has increased? 
5. Have you become stricter with yourself lately? 
6. Does your self-esteem get a boost from eating healthy? 
7. Have you given up foods you used to enjoy in order to eat the ‘right’ foods? 
8. Does your diet make it difficult for you to eat out, distancing you from family and friends? 
9. Do you feel guilty when you stray from your diet? 
10. Do you feel at peace with yourself and in total control when you eat healthy? 

Add up the numbers you indicated in your answers. Interpretation: A score below 40 indicates a risk for Orthorexia. This Orthorexia quiz is the Bratman Test for Orthorexia, created by Steven Bratman, MD.

If your Orthorexia quiz score is below 40 and you are wondering what to do next, read more about eating disorders here or contact me to begin working together. 

Final thoughts:

Dealing with food related issues can be confusing and scary, but you are not alone. So many people face their struggles and fears about eating, healthy and/or body image. As an eating disorders Registered Dietitian and Certified Intuitive Eating Counselor, I am here to help you overcome them, one meal at a time. 

This article was researched and written by University of Vermont dietetics student Jenny Nardello with oversight and review from Britt Richardson, RDN.