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A lot of arguments in nutrition and health come down to definitions – differences in understanding of the meaning of certain words and terminology.

Take this website: it was borne out of the recognition that the term “Paleo” is often misinterpreted as either a desire to recreate caveman nutrition based on shoddy anthropological science and/or a diet consisting of low levels of carbs and vast quantities of meat.

Many of the articles on this site are written to address the misconceptions about what ancestrally-appropriate nutrition means because there sees to be so much will to misrepresent what “Paleo” means. This article is no different in that respect.

The difference is that we are not about to write an article on some misrepresentation of the makeup of the Paleo diet – meat, vegetables, macronutrients, micronutrients. Instead, we’re going to take on a word that often gets thrown as an accusation towards Paleo.


This is another word which has clear parameters and a definition but which often used colloquially without real comprehension of what it truly means. The word is “Orthorexia” – or, to discuss Paleo, “Orthorexic”.


Many people use this word to refer to an obsession with any dietary style, particularly one which involves eliminating certain foods or food groups (as opposed to a more conventional ‘diet’ which limits food quantity or calories). We lazily, sometimes even jokingly, use the term “Orthorexia” to refer to anyone obsessing about what used to be called ‘Clean Eating’ – or now, just anyone who is concerned about health and makes decisions based upon their desire to be healthy.

From a lighter definition, it is perhaps easy to see why those following a Paleo diet are accused of being Orthorexic. Founded on what some believe to be principles of ‘good health’ and focused on limiting things which don’t promote it, Paleo could be seen to be a synonym for Orthorexia.




Except that Orthorexia isn’t defined by the above loose parameters. Strictly speaking, Orthorexia is when any nutritional style is obsessively followed with the conviction that it will guarantee health – and that deviating from it will cause ill health.

The obsession in Orthorexia is about being ‘healthy’ at all costs – with an almost paralysing fear of anything that does not qualify under someone’s subjective definition of ‘healthy’.

The health obsession within Orthorexia may be due to physiological fears or fears of actual illnesses, or it may be more to do with associating being healthy with being ‘virtuous’ and ‘good’ (thereby indicating a more subtle psychological need to be approved of or deemed worthy). Whatever the roots of orthorexic tendencies are, it is always founded on the fear that all health variables must be controlled at all times.

To qualify as suffering from Orthorexia (not yet a diagnosable condition according to medical textbooks, but for our purposes we’ll describe the definitions used by scientific studies into this mental obsession), there must be a degree of life disruption which seriously affects the sufferer. Decisions (on what to do, where to go, how to live and how to eat) will entirely revolve around the limitations imposed by whatever health regimen the sufferer has become fixated upon. Deviations from the ‘healthy’ are met with profound resistance, panic and distress.

Basically, as with other, more well-established, eating disorders such as anorexia, in Orthorexia, food, eating and the human body all become deeply preoccupying and alter the personality, choices and behaviours of the sufferer. In anorexia the fixation is upon body size and weight and minimising intake in order to be smaller, whereas within Orthorexia the fear-motivated goal is ultimate health and limiting intake to only ‘good for you’ foods.


It is important to stress that Orthorexia is NOT primarily a fixation upon weight loss. However, the lines become murky because losing weight or being thinner/lighter/slimmer is often – somewhat erroneously – linked to being more ‘healthy’. Weight loss can become an obsession because it is generally believed that being thinner signifies being healthier… Whilst there are many false assumptions in this statement, to those with Orthorexia size often becomes part of the obsession because of the societal false assumption which conflates thinness with wellness.





The ‘healthy’ of Orthorexia is subjective – much like the aspired-to physique that stalks the mind of the anorexic. The ‘healthy diet’ the orthorexic chooses can be pretty much anything – providing they believe that it is providing health.

The irony is that the fixation on ‘health’ demands a fixation on what is ‘unhealthy’ such that this can be avoided at all costs. The complication is that for anyone who has orthorexic tendencies there is way too much information about what might be ‘unhealthy’.

Of course a diet like Paleo can be used as a tool by someone with Orthorexic tendencies. If the Paleo framework is what someone’s mind defines as ‘healthy’ and ‘optimal’ then actually it is very easy to take the Paleo nutritional template as a list of exclusion rules. Instead of focusing on the nutrients and foods that are ‘in’, Paleo can (and often is) seen as a long list of foods that should be ‘out’.

Moreover, Paleo is a small step from AIP. And, whilst it is untrue, AIP can be seen by someone obsessed with avoiding anything unhealthy as ‘a better Paleo’. Following an AIP (sometimes low-carb AIP) incorrectly or for too long, or indeed with too much obsession about the ‘dangers’ of certain foods, can result in semi-starvation and nutrient deficiencies. In this obsession with avoiding every shred of what is feared to be ‘unhealthy’, the pursuit of health down the Paleo and AIP paths can quickly turn to ill health.




However, the same is true of any nutritional approach which – in any way – marginalises or eliminates a food or food group, for whatever reason.

Veganism, often considered to be the height of dietary virtue due to its ethical overtones, can be taken to an extreme by those who are orthorexic – eliminating so many foods (even figs, things that may have involved the killing of animals – which basically means all grains and legumes) that the obsessive avoidance traits are just as strong as with Paleo.

Then there’s the ‘calorie-counting’ diets of old: Weight Watchers or Slimming World. Both of these attribute points values to foods, the latter even using “Syns” value (and I’m sorry Slimming World, but changing the spelling does not make this any less of a meritocratic system in which you demonise and pile emotional context into the arena of nutrition).

Using Syns, points and numerical tables against which you are measured does the same thing. Points add up… to hack the game you just must spend LESS points. Orthorexia sufferers can take the points game to interpret a virtue and a Syn level in foods – and then become obsessed with eating ONLY from the practically zero-points pile.

The fact that also this means practically zero-nutrition either is massively unhealthy – but when an authority places numerical values on foods and a low score is better, what else are we, as humans, supposed to think?!


Wherever virtue is attributed to foods or eating styles, humans will be psychologically manipulated. This is perhaps a strong statement – but it is the truth.


It is perfectly human to want to be ‘good’, to be seen as doing the ‘right thing’. As soon as external “authorities” (such as slimming club businesses or bloggers, gurus, fitness ‘experts’ or nutritionists) place values, Syns, points or any system of ‘ins’ and ‘outs’ on the nutrition that we eat it will alter our freedom of choice. This means that food carries a whole other associated price/cost/value. And this is true FOR EVERYONE.


The only real difference between one person’s desire to be healthy and another person’s Orthorexia is one of degree. And the problem with the modern world in which we live is that there is so much information – not all of it legitimate – and it makes being healthy seem complicated and difficult. When there are rule books, points books, whole websites that need to be created to share and discuss the merits and the science behind the recommendations… is it any wonder that all of this can fuel the fear of doing something ‘wrong’ that might harm your body.

This is why Paleo can be orthorexic – because it simply provides recommendations that, in the minds of those for whom health is an obsession, can be turned into mandatory and restrictive, suffocating rules.

We go to great lengths on this site to explain the breadth that is within the tramlines of true Paleo. This isn’t and should never be another burden or another thing that someone feels they have to do – for any reason, whether that’s to stay safe, to gain acceptance, to feel worthy, to feel ‘good’. Paleo shouldn’t be seen as a rulebook for health – it is a conglomeration of data based on studying scientific mechanism and epidemiological data which can help inform certain choices.


INCLUDED within the Paleo recommendations are fun, relaxation, socialisation, de-stressing and emotional fulfilment.


If we focus on Paleo as just a diet then, sure, it could be considered unnecessarily obsessed with healthy foods. However – and the main reason that we built our site – Paleo is about far more than this.

Paleo is actually built on the foundations of nourishing the WHOLE HUMAN. That means so much more than food. But it also means that whenever any element of a lifestyle or nutritional regimen that you are trying to maintain becomes overwhelmingly stressful, that’s the time to re-evaluate whether your ‘health’ goals are doing more harm than good.

If you are reading this and you have identified with the notion that the Paleo Diet you are following is leading you towards a place where anything non-Paleo is unsafe and threatening and must be avoided then do head over to our founder’s site this weekend.

She has shared an article which digs more deeply into the work she does one-on-one with clients: addressing Orthorexia and how it manifests. She discusses how Orthorexia is especially common in those with chronic health conditions for whom nutrition and health become priorities. When you do have an illness the pursuit of health through nutritional purity and optimisation can become a damaging and self-defeating obsession. This week, she discusses how she works through this dilemma with her clients.



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