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Connections between 'clean eating' and orthorexia

On the surface, clean eating appears to be a positive health choice. However, it is one which harbours the potential to cause major long-term health concerns.

The clean eating approach has recently been accused of being one of the main drivers for the increase in cases of orthorexia. Is this a fair accusation or a poorly supported assumption?

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Clean eating vs. orthorexia

When comparing the definitions of both terms they do appear to be curiously similar. Clean eating generally means eating foods in their most natural form, avoiding processed or refined foods, eating healthily and cooking from scratch. Meanwhile orthorexia, which was first defined in 1997, is described as a 'pathological fixation on the consumption of appropriate and healthy food'.

Dr Max Pemberton, a psychiatrist who specialises in eating disorders, is in no doubt. "Clean eating is not an innocent trend that’s come along to counter unhealthy diets. It’s simply an eating disorder by another name and in the unit I work in, it’s an epidemic."

This is not to say that all people who claim to follow a clean eating diet are orthorexic or may become orthorexic.

The US National Eating Disorders Association states that the more of the questions listed below that you answer with a ‘yes’, the more likely it is that you would be determined to be orthorexic, rather than some who just eats clean.

  • Do you wish that occasionally you could just eat and not worry about food quality?

  • Do you ever wish you could spend less time on food and more time living and loving?

  • Does it seem beyond your ability to eat a meal prepared with love by someone else – one single meal – and not try to control what is served?

  • Are you constantly looking for ways foods are unhealthy for you?

  • Do love, joy, play and creativity take a back seat to following the perfect diet?

  • Do you feel guilt or self-loathing when you stray from your diet?

  • Do you feel in control when you stick to the “correct” diet?

  • Have you put yourself on a nutritional pedestal and wonder how others can possibly eat the foods they eat?

Specialists often find that people suffering with orthorexia have deficiencies in vital nutrients. This is because they have eliminated so many foods perceived as ‘unclean’ from their diet that they are unable to get the range of nutrients they need for healthy body function. If left unresolved this can lead to medical complications. For instance, the National Osteoporosis Society has highlighted the possible link between clean eating, orthorexia and osteoporosis in later life.

Studies have shown that orthorexia generally originates from what was originally a healthy motivation to eat well for better health. It is when this good intentioned behaviour change becomes an obsession, much like OCD, that there is the potential for a move away from healthy behaviours and into unhealthy obsessions.

A fast-acting illness

Annie saw her daughter go through this process at a horrifying rate.

“I noticed that she had started following some clean eaters on Facebook and before long was cutting out gluten and exercising more. After a short period of time she became incredibly particular about food labels and was instructing me to only buy certain brands of food. Her weight dropped dramatically and at the same rate her paranoia increased about food to the point that there was only a handful of foods that she would eat."

"After two hospital admissions due to worryingly low nutrient levels she finally started to turn a corner. She could see her friends and family were healthy and happy without following the strict regimes that she had been putting herself through."

"It was awful to see my daughter go through such torment and not know how to help her see another way. Fortunately however, three years on, I can now look to the future positively as she has recovered and is expecting her first child. The key to her recovery was realising that whether a food is clean or dirty is not black and white and that what is more important is eating in moderation."

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A modern phenomenon?

Records show disordered eating dates as far back as the 12th century. However, today the increase in this particular condition appears to be the ability to constantly compare ourselves to numerous others at the click of a button via social media. Air brushed images and unsubstantiated opinions are leading many to make dangerous changes to their lifestyles.

Dr Steven Bratman who overcame orthorexia wrote for "there have always been dual motivations for going to the gym and eating healthy food: to feel healthy and to look good. But I suspect that the appearance aspect of healthy diet has increased lately, due to celebrity endorsements and millions of Instagram photos. Currently, many people may be orthorexic at least in part for their looks rather than their health."

Moving forward

If you think you may be leaning on the side of orthorexia what can you do about it?

Limit social media

The idea that there is a relationship between social media (specifically Instagram) and the risk of orthorexia has been evidenced in a recent study.

So, although social media can have many positive impacts upon culture, business and lifestyle, it is important to be aware that it has the potential to have negative effects both mentally and physically when overused.

A positive change would be to review the people you are following on social media, delete those who you do not think have a healthy approach to eating and follow those who do.

Get back to basics and focus on the eat well plate

Each day make sure your meals have incorporated all the main required food groups. They are the building blocks for the body and will help to reduce the risk suffering deficiencies.

  • Fruit and vegetables

  • Carbohydrates

  • Dairy or dairy alternatives

  • Protein from meat, poultry, fish, pulses, beans, soy and eggs

  • Healthy fats from oily fish, avocados, nuts, seeds, oils and dairy

Speak to your doctor

They will be able to point you in the direction of support and also check whether you may be suffering from a deficiency.

Article history

The information on this page is peer reviewed by qualified clinicians.

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