Orthorexia has been widely studied, but recently, a new conceptualisation was proposed to distinguish its healthy characteristics from its pathological ones. The objective of this study was to differentiate healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) by exploring their sociodemographic, psychological, health and dietary characteristics using comparative and correlational statistical methods.

Cross-sectional analysis. Participants completed an online, self-administered questionnaire assessing their sociodemographic characteristics, orthorexia, exercise dependence, personality, health anxiety, food choice motives, emotional competences and eating disorders (ED).

Data were collected between May 2021 and September 2022.

1515 French females (meanage = 37·67). Responses from men were excluded.

While OrNe was mainly associated with weight control motives in food choices (r = 0·42), HeOr was more strongly correlated with natural content (r = 0·60) and health motives (r = 0·49). In relation to exercising, OrNe showed its highest association with weight control (r = 0·41). Health anxiety was more strongly associated with OrNe than with HeOr. Both OrNe and HeOr were related to diet adherence and regular exercise, but the association was stronger for the latter. Orthorexia scores, mainly OrNe, were higher in participants at the risk of ED. Participants who were afraid to gain weight showed higher OrNe scores.

HeOr seems to be part of a healthy lifestyle in general. In contrast, OrNe falls into the category of an ED and is associated with more problematic psychological functioning. Particular attention should be given to individuals who are beginning to control and reduce their food intake to prevent them from developing OrNe.