Eating clean, feeling broken: A qualitative meta-synthesis of the lived experience of orthorexia nervosa.

Orthorexia nervosa refers to a pathological obsession with healthy eating, yet its classification, causes, and clinical relevance remain contested. This qualitative meta-synthesis explores the lived experiences of individuals with orthorexic behaviors to better understand the psychological, social, and cultural dynamics that sustain this condition. Drawing on thematic synthesis of 16 peer-reviewed, qualitative studies, three major themes emerged: (1) Origins and Motivations for Orthorexic Behavior, highlighting the role of perfectionism, identity, and sociocultural ideals; (2) The Orthorexic Experience and Its Consequences, illustrating the emotional, physical, and social costs of rigid dietary practices; and (3) Individual's Perspectives on Orthorexia as a Disorder, revealing ambivalence toward diagnosis, conceptual confusion, and overlaps with other eating disorders. Findings suggest that orthorexia serves both as a personal coping strategy and a moralized performance of health shaped by contemporary wellness culture. The synthesis reveals how orthorexic behaviors are often normalized, socially reinforced, and deeply tied to individual identity-rendering recognition and recovery particularly challenging. Rather than advocating for diagnostic categorization, this study highlights how orthorexic practices are embedded in broader cultural narratives around health, control, and morality.