Orthorexia nervosa is an eating disorder characterized by an obsessive focus on "healthy" eating, and inflexibility in diet, which leads to clinically significant medical or psychosocial impairment. This review describes the clinical features and management of orthorexia nervosa. Focusing on the endocrine aspects of the syndrome, it explores the multiple bidirectional links between endocrinopathy and orthorexia, as well as endocrine management and orthorexia.