A preoccupation with food purity has not until recently, been viewed as posing any individual physiological or psychiatric risk. In the latter decades of the twentieth century this situation changed, when through the efforts of a handful of practitioners and researchers, excessive preoccupation with the consumption of healthy foods moved quite rapidly to the verges of mainstream psychiatry. This chapter uses a social construction approach to examine the emergence of a new eating disorder, orthorexia nervosa (ON)— a fixation with food purity and cleanliness leading to rigid dietary patterns and feelings of anxiety and guilt after eating foods perceived as unhealthy (Cheshire et al., 2020; Zickgraf, 2019)— in the light of on-going debates around such things as ‘right’ food consumption, critiques of ‘healthism’ the intricacies of health maintenance and the place of social and cultural context in illness prevention and health promotion (Kickbusch, 1986; Van den Broucke, 2014). Although yet to be formally recognised by the Diagnostic and Statistical Manual for Mental Disorders (DSM) and/or International Classification of Diseases (ICD), ON has been the subject of extensive news coverage (Cheshire et al., 2020; Ross Arguedas, 2020) and much academic research. It is also of interest to researchers such as us who are concerned with the wider cultural shifts linked to the political ideology of neoliberalism, including the marketisation of healthcare and its focus on individual psychic and mental processes at the expense of structural social change (Fixsen et al., 2020; Fixsen & Cheshire, 2022).