Athletes and orthorexia is a pairing more common than many realize and it’s reshaping how we think about “healthy eating” in endurance sports. While athletes are often praised for discipline and clean eating, a growing number are quietly struggling with a fixation on food purity that harms both performance and well-being.
In endurance communities, this pattern often goes unrecognized. It’s not driven by a desire to lose weight, but by a quest for optimal health. That pursuit can become rigid and obsessive—avoiding sugar, banning processed foods, and feeling anxious about anything “unclean.” That’s orthorexia, and for athletes, it’s more than a buzzword. It’s a very real risk.
What Is Orthorexia and Why Does It Matter for Athletes?
Orthorexia, though not officially recognized as a clinical eating disorder, refers to an obsessive focus on eating foods considered “clean,” “pure,” or “healthy.” The term was first coined in 1997, combining “ortho” (right) and “orexia” (appetite). Unlike anorexia, which often centers on weight loss, orthorexia is about the perceived quality of food.
This matters because:
- Athletes often equate clean eating with better performance.
- The culture of sport reinforces rigidity around food choices.
- Misinformation and pseudoscience thrive in fitness spaces.
The problem? What starts as a desire to eat well can spiral into obsessive behaviors that compromise health, mental focus, and athletic outcomes.
How Athletes and Orthorexia Are Connected
Endurance athletes are uniquely vulnerable to orthorexic behaviors due to:
- High nutritional demands that make food a central focus
- Performance pressures that lead to extreme dietary “optimizations”
- Influencer marketing that promotes restriction over balance
- Cultural messages about body image disguised as wellness
A 2023 study in Journal of Eating Disorders found that 55% of people who exercise regularly demonstrated orthorexic tendencies. Another study showed higher symptom severity in endurance athletes, especially those in sports like distance running and triathlon.
These behaviors often hide behind phrases like:
- “I just want to be healthier.”
- “I need to clean up my diet.”
- “Processed foods make me feel off.”
While the intentions may seem harmless, the outcomes can be anything but.
What Does Orthorexia Look Like in Endurance Athletes?
Orthorexia can show up in subtle ways. You might not see calorie counting or weight loss goals—but you will see anxiety, rigidity, and a deep moral judgment of food.
Common signs include:
- Avoiding entire food groups (like dairy, gluten, or sugar) without medical reason
- Demonizing processed or packaged sports nutrition
- Agonizing over ingredients and food sourcing
- Anxiety in social situations involving food
- Declining performance due to underfueling or poor recovery
It’s not unusual for an athlete to show up with a history of stress fractures, amenorrhea, or persistent fatigue—only to realize that their “healthy” diet is the root cause.
The Problem with “Clean Eating” in Sport
“Clean eating” sounds like a good thing. But the term has no scientific definition, and it’s often used in ways that promote fear and judgment around food.
For athletes, this language creates major challenges:
- It encourages restriction over fueling.
- It prioritizes aesthetics over function.
- It links food to morality—labeling choices as good or bad.
Marketing messages from sports nutrition brands often reinforce this. When electrolyte powders claim to be “clean energy” (even though electrolytes provide no calories), it spreads misinformation. When companies compare their products to medications like Ozempic, it muddies the waters between performance and weight obsession.
Why Orthorexia Is Difficult to Recognize
Orthorexia lives in the gray area. Unlike other eating disorders, it doesn’t always result in weight loss or extreme behaviors. That makes it harder to spot—and easier to excuse.
What makes it tricky:
- It often looks like discipline or dedication.
- The pursuit of purity is socially rewarded.
- People may not realize they’re underfueling.
- Even coaches and healthcare providers can unknowingly reinforce it.
Many athletes believe they’re simply “doing the right thing” for their bodies—until they burn out, stop recovering, or stop menstruating.
How Orthorexia Harms Performance
Let’s be clear: underfueling and rigid food rules can have major consequences for performance, including:
- Slower recovery times
- Increased injury risk (especially stress fractures)
- Poor sleep and mood regulation
- Hormonal disruptions like RED-S
- Loss of focus, energy, and motivation
Athletes who fear sugar or carbs during workouts often fail to meet their energy needs—missing a critical opportunity to support both performance and adaptation.
Even worse? Many believe they’re doing everything “right.”
Sugar Isn’t the Enemy. Fueling Is Key!
The demonization of sugar is one of the most pervasive orthorexic tendencies in endurance sport. But when you’re moving for hours at a time, quick-digesting carbs are your best friend.
Carbs and sugars during activity:
- Provide fast energy for working muscles
- Help maintain blood glucose
- Prevent muscle breakdown
- Support cognitive performance (like decision-making during a race)
Skipping sugar during long workouts to avoid “inflammation” not only contradicts current sports nutrition science—it can actually increase stress hormone levels and impair recovery.
How Social Media and Wellness Culture Contribute
Social media is a massive driver of orthorexic behaviors. The constant barrage of smoothie bowls, “what I eat in a day” videos, and fear-based nutrition messaging can rewire how athletes view food.
Here’s what the research shows:
- Instagram users demonstrate significantly higher orthorexic tendencies
- TikTok algorithms push pro-eating disorder content within days
- Even nutrition students and healthcare providers are at risk
You might start out looking for recipes—and end up immersed in a culture that labels food as toxic, inflammatory, or addictive. The result? More fear, less fuel.
What Athletes Need to Hear Instead
Instead of restriction and perfection, athletes need messages that emphasize:
- Adequacy over purity
- Consistency over control
- Science over fear
- Pleasure and performance over rules
Being able to enjoy a burger or eat a donut without spiraling doesn’t make you undisciplined—it makes you resilient.
Red Flags to Watch For
If you or someone you coach starts to exhibit the following, it may be time to seek help:
- Refusal to use sports nutrition due to ingredients
- Guilt after eating processed foods
- Increased anxiety around meals or social eating
- Hyperfocus on “natural” or “clean” products
- Frequent injuries or poor recovery despite solid training
These behaviors aren’t signs of commitment—they’re signs that something deeper may be at play.
Coaches, Dietitians, and the Role of Authority
Authority figures matter. Unfortunately, doctors, coaches, and even dietitians sometimes unintentionally reinforce orthorexic ideas.
Examples include:
- Telling athletes to go keto for performance
- Suggesting weight loss without discussing energy needs
- Praising athletes for being “so clean” with food
- Recommending detoxes or elimination diets without context
Words matter. For high-achieving athletes already prone to control and perfectionism, these messages can tip the scales.
Healing from Orthorexic Behaviors
Recovery from orthorexia doesn’t mean giving up on health—it means redefining it in a way that includes mental health, social connection, and sustainable performance.
Steps toward recovery:
- Work with a registered dietitian who understands sports nutrition and disordered eating
- Reintroduce feared foods slowly and mindfully
- Journal about your food beliefs and where they came from
- Follow body-diverse accounts on social media
- Unfollow fear-based nutrition content
- Ask: What would change if I ate this without guilt?
You don’t have to do it alone—and healing is possible.
Final Thoughts on Athletes and Orthorexia
Athletes and orthorexia is increasingly common in a world that moralizes food, glorifies control, and rewards restriction. In the pursuit of performance, many endurance athletes are sold a version of “health” that leads to injury, burnout, and disconnection from the joy of movement and nourishment.
The goal isn’t to abandon nutrition. It’s to embrace it in a way that’s evidence-based, flexible, and empowering. True performance doesn’t come from eating perfectly. It comes from fueling adequately, recovering well, and trusting your body.
Want to go deeper on this topic?
This post was inspired by a full podcast episode I recorded with Zoe Rohm. If this resonated with you, I’d love for you to check it out.
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