The Academy of Nutrition and Dietetics defines disordered eating as a spectrum of irregular eating behaviors that may or may not meet the criteria for a formal eating disorder diagnosis (Academy of Nutrition and Dietetics, 2021). Unlike eating disorders such as anorexia nervosa, disordered eating is not a recognized psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). It describes a broad range of eating-related behaviors that may adversely affect physical, psychological, or social functioning.
This distinction matters because not every deliberate effort to consume a highly nutritious diet represents pathology. In public discourse and on social media, highly structured approaches to eating are sometimes characterized as disordered or labeled as orthorexia nervosa, a term not recognized as a diagnosis in the DSM-5-TR (American Psychiatric Association, 2022). A person who carefully selects foods based on health goals, disease prevention, athletic performance, or medical necessity may simply be making intentional dietary choices rather than exhibiting a mental health disorder.
When Healthy Eating Becomes Unhealthy
The critical question is not whether someone eats predominantly healthy foods, but whether those behaviors produce significant distress, anxiety, social impairment, nutritional inadequacy, or a reduced quality of life. In clinical settings, eating behaviors are generally evaluated based on their consequences rather than solely on the nutritional composition of the diet.
Unfortunately, public discussions sometimes blur the line between disciplined and pathological eating, causing dietary restraint itself to be mistaken for evidence of disordered eating.
The Modern Diet and Chronic Disease
At the same time, the normalization of highly processed, hedonic foods deserves consideration. Humans evolved consuming diets composed of minimally processed foods, whereas many modern ultra-processed foods are relatively recent additions to the food supply. Although occasional consumption of these foods may not be harmful for many individuals, the term “occasional” is often left undefined.
Current public health statistics illustrate the magnitude of diet-related disease. As of 2021–2023, 72.4% of U.S. adults had overweight status or obesity with 40.3% meeting obesity criteria. By comparison, adult obesity prevalence was approximately 13.4% in 1980, a 325% increase in the obesity rate!
The CDC also estimates that 40.1 million Americans, or approximately 12.0% of the population, had diabetes in 2023 with 11.3% of U.S. adults having high total cholesterol during 2021–2023.
Hedonic Foods and Addiction-Like Responses
Highly processed foods can produce addiction-like behaviors in susceptible individuals. A scientific consensus statement published in the British Medical Journal, The BMJ, concluded that ultra-processed foods may trigger behavioral and neurobiological responses that resemble those observed in substance-use disorders.
Repeated exposure to highly rewarding foods may strengthen neural pathways associated with craving, reward seeking, and habitual intake, potentially making dietary change more difficult.
Summary and Conclusion
Dietary restraint alone does not establish an eating disorder. While obsessive, distressing, and impairing behaviors surrounding food deserve clinical attention, deliberate efforts to consume a highly nutritious diet are not necessarily disordered or pathological.
Given that nearly three-quarters of American adults are overweight or obese and that diet-related chronic diseases remain widespread, caution is warranted before dismissing highly health-oriented eating patterns. Ultimately, the goal should be to develop a relationship with food that is nutritionally sound, psychologically sustainable, and supportive of long-term health. A registered dietitian can help individuals achieve that balance while respecting personal values, health goals, and quality of life.
About the Author
Patrick Traynor, PhD, MPH, RD, CSOWM, CPT, is a registered dietitian and founder of MNT Scientific, LLC (MNTScientific.com), an insurance-based nutrition practice serving South Lake Tahoe, CA; Minden, NV; and Ashland, OR. He holds the Interdisciplinary Specialist Certification in Obesity and Weight Management (CSOWM) from the Commission on Dietetic Registration. Virtual appointments are available via telehealth. For inquiries or appointments, visit MNTScientific.com, dial (530)429-7363, or email patricktraynordietitian@nym.hush.com.
