In a large pot or Dutch oven, heat over medium-high heat and add the lean ground beef. Cook for 5–6 minutes until browned and juices are released.

Add the chopped medium onion to the pot and stir well with the beef. Cook for another 5 minutes until the onion softens and becomes translucent.

Stir in minced garlic, crushed red pepper flakes, and Italian seasoning, cooking for about 1 minute until fragrant. Then add the uncooked orzo.

Pour in the tomato sauce, beef broth, heavy cream, and Worcestershire sauce. Bring to a bubble over medium-high heat, then reduce to medium-low and simmer uncovered for about 10 minutes.

Once the orzo is tender and most liquid is absorbed, remove from heat. Stir in Parmesan cheese and fresh spinach until the cheese melts and the spinach wilts.

Taste and season with salt and pepper if needed. Serve immediately while hot.