Eating disorders on college campuses are nothing new. The combination of stress and new surroundings can be extremely triggering, and scores of students across the country struggle with issues surrounding food, eating, anxiety and control. Disorders like anorexia and bulimia are well-known within mainstream culture, but the rise of food as a status symbol and class signifier has pushed a new type of eating disorder into the public eye: orthorexia.

The term itself was coined by Dr. Steven Bratman in 1997. The name is related to the word anorexia, which literally means “without appetite,” whereas the prefix “ortho” translates to “right” or “correct.” Therein lies the difference between these two disorders. While anorexia is an eating disorder that focuses primarily on weight, orthorexia speaks to a desire for health and purity.

Over the past few years, the idea of “clean eating” has become extremely popular. Online communities from bodybuilding forums to Pinterest boards provide a wealth of ­— not always accurate — information on the benefits and mechanics of nutrition. Admittedly this non-processed, fresher style of eating has steadily drawn attention and support and can help shape healthy diets. But orthorexia occurs when a desire to eat healthily becomes obsessive, extreme and eventually a detriment to overall health. Orthorexics tend to place drastic limits on what foods are acceptable to eat, often dismissing groups of foods in their entirety. Animal products, gluten, foods that have been processed and non-organic products might be eschewed. For many, orthorexia stems from the obsession of knowing where our food comes from. It can begin with a strict diet because of the atrocity of meat industries, a disavowal from GMOs or even wanting to avoid processed food. Though there is nothing inherently wrong with these stances, for some it can easily become a pathological and all-consuming lifestyle.

The line between adhering to a strict diet and suffering from a legitimate eating disorder can get cloudy; while some behaviors are healthy for some, they can be destructive for others. The distinction lies in the emotional root of the behavior and the level of internal distress it causes. A few diagnostic questions from the National Eating Disorder Association include: “Does it seem beyond your ability to eat a meal prepared with love by someone else — one single meal — and not try to control what is served? Are you constantly looking for ways that foods are unhealthy for you? … Do you feel guilt or self-loathing when you stray from your diet? … Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?”

These questions also bring up another dimension that differentiates orthorexia from other disorders. Because the ideal is health and purity, it has an aspirational and spiritual quality which allows it to get buried deeper into one’s personality and identity. Self-esteem becomes enveloped in remaining “clean,” “pure” and free of toxins, with emotional repercussions if the diet is not followed to a tee. Often, a hallmark of orthorexia is controlling food as a means of emotional fulfillment to the detriment of actual health or interpersonal relationships.

As of now, orthorexia is generally recognized but does not have a place in the Diagnostic and Statistical Manual of Mental Disorders, the standard criteria used by the healthcare industry to diagnose and treat psychiatric disorders. This status refers to the fact that orthorexia is not a clear-cut diagnosis. What is and is not considered “disordered” varies from case to case, and many people eat restrictively for any number of reasons without negative consequences. However, if someone becomes unable to eat food prepared by others, which in turn leads to them being unable to participate in their life fully, then they should likely seek help.

When discussing eating disorders, it should be clear that these disorders aren’t always about food or bodies, they are mental illnesses that happen to manifest themselves in that way, but there is usually comorbidity with depression, anxiety, obsessive-compulsive disorder and other illnesses. What is healthy eating for some people can become orthorexia for others with the right constellation of brain chemistry and vulnerabilities. Orthorexia should be kept as distinct as possible from simple health consciousness, as conflating them does a huge disservice to those who are suffering.