The concept of orthorexia nervosa emerged in 1997 to describe a pathological obsession with healthy eating. Before any consensus was reached by the medical community, orthorexia started to appear in the news. But how do news media cover a diagnosis with an uncertain and unofficial status? Based on a qualitative content analysis of 492 news articles published between 1998 and 2016 and interviews with reporters, this paper explores the growth and spread of news interest in orthorexia, and how reporters have addressed the uncertainty surrounding the proposed diagnosis. Findings suggest logics of news production have driven orthorexia coverage, which predominantly depicted the unofficial diagnosis as settled (58% of articles) and legitimate. When the uncertain status was acknowledged, it was usually managed rhetorically, addressed as a minor caveat, and in some cases justified; only rarely was it foregrounded. Interviews with reporters suggest they overwhelmingly perceived orthorexia as legitimate and did not consider its unsettled status an obstacle-for some it added appeal. Based on the findings, I argue for the need to consider news media not only relevant sites in the production of medical knowledge, but actors in and of themselves. I discuss implications for scholarship about medicalization and its intersection with journalism.