They Diagnosed It as Orthorexia, Now She Is Speaking Out

Loz Antonenko did not step into a gym to chase perfection. In 2016, her husband died suddenly, and life lost its grip. She said, “I buried my grief in productivity.” Exercise gave her a timetable, and the timetable reduced panic. Yet the same drive that built strength also tightened her eating. “Clean eating” looked responsible, so people praised it. Anxiety followed. Isolation arrived. Constant checking followed. Influencer Danielle Mitchell learned a similar lesson in the wellness world. Danielle spoke plainly about the mask. “What I labelled as clean eating and wellness was actually a cover for disordered eating,” she said. Both women later heard the same word from clinicians: orthorexia. This article uses their quotes, then adds clinical research. It explains warning signs, measurement debates, and treatment paths.

Grief, a gym routine, and the lure of control

Grief can push a person into motion because stillness can sting. Loz said she went straight into “doing” mode after her husband died. Walking became a coping tool, then she moved into late-night gym sessions. A volunteer suggested weight training, and she tried it. She joked about “sweaty, grunty blokes,” then she found support there. “The gym became my anchor,” she said. Training gave her a goal on days that had no shape. Body change arrived fast, and praise arrived with it. That praise can feel like proof that a routine works. She also met people who spoke about training as a long-term project. Those conversations gave her companionship during an isolating season. She said the men became an “unexpected support system.” Support can help, but it can also normalize extreme behavior.

Research helps explain why control can attach to food after stress. In their 2016 review, Thomas Dunn and Steven Bratman described restriction focused on food quality. They wrote that some people restrict “based not on quantity,” but on “its quality.” That framing can hide danger, because it sounds like self-care. Harvard Health notes that people may worry about preparation and sourcing. It also notes guilt after breaking rigid plans. Loz described that shift in her own words when her routine stopped bending. She said she panicked when anything deviated from her plan. Control can start as comfort, then it can become a cage. Orthorexia often blends with traits that look admirable in sport culture. Planning meals can look like a commitment, especially in fitness spaces. Yet the mind can start scanning food like it scans threats. Over time, the person may avoid restaurants to protect the rules.

When “clean eating” turns into panic

Loz’s strength gains came with a rush, and she chased the rush. She decided to enter a bikini bodybuilding competition on impulse. She said it felt brave, and it gave her pain a target. Soon, her days revolved around training blocks and food rules. She already managed autoimmune flare-ups, so restriction seemed logical. Then “clean eating” turned into a strict identity. “To me, it meant removing anything processed or unnatural,” she said. She packed meals for social events and avoided eating out. “I lived by the plan and panicked if anything deviated,” she said. Over time, panic can replace hunger cues because fear drives the schedule. She also chased online approval, because the transformation drew attention. She later described losing spontaneity and mental space.

Definitions of orthorexia focus on fixation, distress, and impairment. NEDA says orthorexia “means an obsession with proper or ‘healthful’ eating.” It adds that people can become “so fixated” that they “damage their own well-being.” That harm can include malnutrition or impaired social functioning. The Academy of Nutrition and Dietetics notes a common split from anorexia. It says the focus is often on quality “instead of the quantity” of food. Quality can become a moral test, where the person chases purity at all costs. When a rule breaks, shame can spike, and the person tightens the rule again. Clinicians also watch for rigid avoidance of foods labeled as unhealthy. Eatright.org links severe restriction to nutrient loss and malnutrition risks. In practice, the turning point often arrives when the body or mind collapses. Loz said she lost joy, and the cost finally became clear.

Danielle Mitchell and the cost of performing wellness

Danielle Mitchell’s story shows how wellness can become a stage. She said her early motivation centered on appearance. “It was all about aesthetics,” she said. She entered the health and fitness industry and tried to help others. At first, she believed the plan was healthy. Then the plan became a cover for deeper distress. “What I labelled as clean eating and wellness was actually a cover for disordered eating,” she said. To protect the plan, she skipped gatherings and kept food under strict control. She started scanning her body for flaws, then she got stuck in the scan. “I’d look at my reflection, overanalyse it for hours until I couldn’t look anymore,” she said. Eventually, she accepted that she needed professional help. Her schedule became the priority, and relationships came second. “The wellness industry can be life-changing, but it can also be deeply damaging,” she said. 

She wanted habits that could last without guilt. Social reward can hide risk, because orthorexia looks like dedication. Eatright.org notes that “food marketing claims and social media have continued to fuel the behavior.” The fuel matters because online content often frames restriction as expertise. NEDA lists obsessive tracking of “healthy lifestyle” content as a warning sign. Platforms amplify extreme meal rules because extreme content keeps attention. Loz described this reward loop too. “Likes, comments, and shares became addictive,” she said. Danielle described a different reason to change her direction. “Therapy helped, but my real turning point came when I decided I wanted to become a mum,” she said. Purpose beyond appearance can weaken the grip of food rules. However, recovery still needs support and time. Experts often describe orthorexia as socially sanctioned because people praise it. Praise can delay help-seeking, since the person thinks they are doing well.

What clinicians mean by orthorexia

Orthorexia often starts with a plan that sounds sensible. A person wants steadier digestion, better energy, or fewer flare-ups. Loz had autoimmune flare-ups, so restriction sounded protective. Later, she learned the label that fit her experience. “I’d never heard of it, but it described me perfectly,” she said. NEDA says orthorexia is not formally recognized in DSM-5-TR. “Although not formally recognized in the Diagnostic and Statistical Manual DSM-5 TR, awareness about orthorexia is on the rise,” NEDA notes that the term was coined in 1997. That timing matters because research still trails culture. Clinicians, therefore, focus on harm, not on labels. Loz said the harm lingered even after her last show in 2018. Food anxiety can persist even when competition ends. Some people call foods “good” and “bad,” then treat eating as a test. That framing can turn meals into constant self-judgment.

Harm shows up in behavior, thoughts, and relationships. Harvard Health says some people “hardly ever have dinner with friends.” It adds that they may prefer starvation to eating “impure” foods. Eatright.org describes a family meal that can seem like “a minefield.” Those phrases describe impairment, not a dietary preference. A person can choose a diet for faith or ethics and remain flexible. Orthorexia turns flexibility into danger, and it demands constant vigilance. Loz defined vigilance in blunt terms. “Orthorexia is disordered eating dressed up as health,” she said. Clinicians look for distress, physical consequences, or social withdrawal. They also watch for perfectionism tied to food purity. NEDA notes that many people with orthorexia also have obsessive-compulsive disorder. Overlap can complicate care, so clinicians tailor treatment to the person.

Why prevalence numbers vary so widely

People often ask how common orthorexia is, but research struggles to pin it down. NEDA notes that “without formal diagnostic criteria, it’s difficult to get an estimate.” Studies, therefore, rely on screening tools and cut-offs. A 2021 literature review describes how tools vary across countries and versions. One common tool is ORTO-15, designed in 2005 by Donini and colleagues. The review explains that ORTO-15 uses 15 items with Likert responses. Different teams translated it, shortened it, and changed cut-offs. That churn makes comparisons hard, because the same label can mean different scores. Loz also described confusion before diagnosis. She said, “I’d never heard of it,” even while her life revolved around food. Some studies report higher rates in groups with a strong diet focus.

The same review raises concerns about ORTO-15 validity and reliability. It reports, “the frequency of ON as measured by ORTO-15 is too high.” It also states, “The cut-off point of 40 does not reflect the real prevalence of ON.” These critiques do not deny suffering, but they show why numbers swing. People can get labeled as disordered when they are simply health-focused. At the same time, serious cases can hide in plain sight. A 2023 review in PubMed Central calls orthorexia “emerging and controversial.” It notes the debate about how to separate health interest from disorder. Other tools exist, including the Eating Habits Questionnaire and the Düsseldorf Orthorexia Scale. Researchers created the Eating Habits Questionnaire in 2013. The authors were D. H. Gleaves, E. C. Graham, and S. Ambwani. Good measurement guides care and public understanding. Poor tools can create false positives, and they can also miss severe cases.

Risk rises in certain cultures, careers, and sports

Orthorexia can affect many people, but some environments raise the risk. Competitive sport rewards control, and bodybuilding can reward rigid food rules. Loz moved from grief training into competition, and food became a constant metric. Dunn and Bratman warned that extreme diets “intended for health reasons” can still cause harm. They wrote that these diets can lead to “malnutrition” and “impairment of daily functioning.” Wellness culture also frames control as virtue, which can hide warning signs. Sarah Cox described the shifting standard in public messages. “The goal posts are always shifting,” she said. Shifting standards can push people to tighten rules again and again. Danielle said she missed major moments to stay “on track.” Loz said eating out was off the table during that period.

Risk also rises when perfectionism attaches to food ideals. NEDA lists “high levels of perfectionism” as a possible warning sign. Harvard Health describes guilt when someone breaks rigid plans. In 2023, Stine Marie Hafstad and colleagues reviewed orthorexia in people who exercise. They wrote, “The overall prevalence of ON in exercising populations was very high.” They also wrote, “The between-study disparity was large and was partly explained by the ON-instrument administered.” These findings suggest vulnerability in fitness spaces, even with uncertain measurement. That vulnerability can arise when social media rewards purity claims. People may start checking labels for safety, then checking becomes compulsive. Once food rules drive mood, daily functioning can slip. Their subgroup analysis showed far lower estimates with other instruments.

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Conclusion

Orthorexia can begin with a wish to eat well, yet it can narrow life fast. Loz Antonenko said, “Orthorexia is disordered eating dressed up as health.” When food rules become nonnegotiable, anxiety can steer each day. Praise for discipline can hide risk, especially inside fitness and wellness circles. Relationships suffer when meals become negotiations, and invitations become tests of control. Physical health can suffer when diets cut out major food groups for long periods. Help works best when it supports both body and mind. A clinician can assess medical risk and refer to trained eating disorder providers. Therapy can challenge rigid beliefs, while a dietitian rebuilds adequacy and flexibility.

Danielle Mitchell explained the time recovery can require when she said, “Recovery took years.” Sarah Cox warned that“the goal posts are always shifting,” so boundaries around online content can protect progress. Carly Dober said, “Early intervention is key.” Reaching out sooner can reduce harm and shorten recovery. Supportive friends can help by joining meals and keeping the conversation about food neutral. Clinicians often watch for guilt after slip-ups and rising avoidance. When exercise becomes punishment, stepping back can protect recovery long-term. With time, meals can support health without fear or judgment.

A.I. Disclaimer: This article was created with AI assistance and edited by a human for accuracy and clarity.

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