Studies have found that individuals with orthorexia nervosa often display symptoms of anxiety, perfectionism, and a strong need for control, which may stem from underlying self-esteem issues.

The societal emphasis on health and "clean eating" can exacerbate low self-esteem among those with orthorexic tendencies, as they may feel pressure to adhere to rigid dietary rules.

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Researchers suggest that the desire to achieve "purity" through strict dietary practices in orthorexia may be driven by a need to compensate for perceived flaws and boost one's self-image.

A 2019 meta-analysis revealed a negative correlation between self-esteem and eating disorder symptoms, including those associated with orthorexia nervosa.

Individuals with orthorexia may tie their self-worth to their ability to maintain a "perfect" diet, leading to feelings of guilt and inadequacy when they perceive they have deviated from their self-imposed rules.

The "Low Self-Mastery" cluster in a study on orthorexia was characterized by high levels of obsession, compulsion, and perfectionism, along with low self-esteem.

Orthorexia has been linked to higher levels of obsessive-compulsive tendencies, which may be a coping mechanism for individuals struggling with low self-esteem.

Research suggests that the cycle of poor self-image fueling rigid dietary practices, which in turn leads to a further decline in self-esteem, is a hallmark of orthorexia nervosa.

One study found that individuals with orthorexia displayed significantly lower self-esteem compared to those without the disorder, highlighting the strong connection between the two.

Orthorexia may be considered a separate eating disorder or part of the obsessive-compulsive disorder spectrum, both of which have been linked to low self-esteem.

The need for control and perfectionism associated with orthorexia can be a way for individuals to compensate for deeper feelings of insecurity and low self-worth.

Addressing the underlying self-esteem issues may be a crucial component in the treatment and recovery process for those suffering from orthorexia nervosa.