Opinion: Are Optimization Culture & Fatphobia the Reason for Orthorexia?
- Sara Geiger
- Aug 10
- 4 min read
Orthorexia does not emerge in a vacuum. While many factors play a role in the development of eating disorders, today's optimization culture, combined with pervasive fatphobia, are certainly not helping. We live in an environment where obsessive "healthy eating" is praised as “willpower,” making orthorexic behaviors difficult to recognize. In this post, we will explore the relationship between orthorexia and the optimization wellness culture we currently live in.
A health journey may begin with honest, well-meaning intentions, but how do we know when it has gone too far? In order to fully understand the opinions laid out in this post, let’s define some commonly-used terms:
Orthorexia: An unhealthy obsession with eating in a way perceived as pure, clean, or optimal. While not currently recognized as a formal diagnosis in the DSM-5, clinicians recognize orthorexic behaviors when they cause distress, impairment, rigidity, or nutritional deficiencies.
Fatphobia, aka ‘anti-fatness’: A system of beliefs, attitudes, and practices that stigmatize and discriminate against people in larger bodies. Fatphobia often equates thinness with health, self-control, and moral virtue while portraying larger bodies as unhealthy or irresponsible. Some people choose to use the term ‘anti-fatness’ as a phobia is a legitimate psychological condition, not a disdain or dislike for something/someone.
Diet culture: A system of beliefs that promotes weight loss, thinness, and body modification as pathways to health, success, and worthiness. Diet culture often moralizes food choices and places body size at the center of all health discussions.
Optimization culture: The belief that every aspect of life should be continuously improved and maximized. In health spaces, this can manifest as a relentless pursuit of better nutrition, fitness, sleep, productivity, longevity, and biomarkers. These pursuits can begin to compromise quality of life and become obsessive or compulsory.
Healthism: The belief that health is primarily an individual responsibility and a measure of personal virtue. Healthism often overlooks Social Determinants of Health (SDOH) and can encourage judgment of people based on perceived health behaviors or body size.
You may be wondering, “Well, Sara, how can healthy behaviors ever be bad?!”
The answer to that question requires a close look at how we, as a society, understand the word “healthy.”
Some will define this as tracking every bite, eliminating entire food groups, and turning meals into moral tests of willpower. This is where we begin to see the paradox. Behaviors that are framed as healthy can become rigid, anxiety-driven, and all-consuming.
These behaviors are often introduced under the banner of “health” and, in many settings, are not only normalized but actively praised. We hear from clients all the time that they have been praised for their eating disorder behaviors, which can make it even harder to recover. We are frequently told that discipline, control, and restriction around food are markers of wellness, motivation, and even self-worth. Social media reinforces this message daily by rewarding highly structured eating patterns and rigid “clean eating” with validation and admiration
While not formally recognized in all diagnostic systems (yet!), orthorexia describes a meaningful and clinically relevant pattern of distress and impairment related to food rules and a focus on health. Over time, the amount of foods allowed into the diet can become extremely restrictive and the rules no longer allow for flexibility, enjoyment, or attunement to the body. Oftentimes, nutritional abnormalities and malnutrition-related symptoms like weakness, irritability, fatigue, coldness, and dizziness are present with orthorexia nervosa. When “healthy eating” becomes defined by strict rules, moral judgment, and pardoxically, medical concerns, it is no longer healthy… PERIOD!
Orthorexia emerged in the late 20th century alongside increasing cultural emphasis on health, nutrition, and “clean eating.” Since then the rise of social media and online wellness and optimization culture has further shaped conversations around nutrition.
Optimization culture is everywhere. From people without diabetes wearing continuous glucose monitors to wellness influencers promoting longevity hacks, hormone balancing supplements, and "clean eating," we're constantly told there's a better version of ourselves we have yet to achieve.
Not all of this is inherently harmful. I enjoy checking my Oura Ring sleep score because it reminds me to prioritize rest days. The problem isn't the latest technology. The issues arise when we fixate on health as something we feel obligated to perfect.
As an eating disorder dietitian, I've noticed a sharp rise in orthorexic behaviors among teens. While correlation doesn't equal causation, it's hard to ignore that this increase has coincided with the explosion of wellness optimization on social media. Many adolescents no longer say they simply want to lose weight. While talk of weight is often still there, they also talk about reducing inflammation, improving gut health, balancing hormones, or eating ‘clean’. Wellness culture and diet culture are inextricably linked- a
fear of weight gain can disguise itself as an unwavering commitment to health, making orthorexia especially difficult to recognize.
“I get how healthism could be harmful, but what about personal responsibility and motivating people to be healthier?”
It's important to remember that our health choices don't happen in a vacuum. Healthy habits exist on a spectrum. They stop being ‘healthy’ when they're driven by fear, become increasingly rigid, or come at the expense of mental health, relationships, or quality of life. In addition, it's important to remember that the social determinants of health (SDOH) shape what health-related choices are actually available to us. True health isn't about constant optimization; it's about flexibility, nourishment, and living a FULL life in a way that works for you.
At New Paths Nutrition, we believe in flexible nutrition, movement without punishment, and a holistic view of health. Through a weight-inclusive, intuitive eating approach, we recognize that true well-being goes beyond trackers and numbers. It includes mental, social, and physical health and is specific to YOU.
To close, orthorexia doesn't develop in a vacuum. Optimization culture and fatphobia create an environment where food obsession is often praised as “healthy," which can make orthorexia more common. If a culture celebrates obsession as long as it looks like health, perhaps the problem isn't only the individual, but it's the culture itself.
Thanks for reading! If this is something you struggle with and want to unpack, we'd love to support you. Reach out here and let's chat.
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