The 'Clean Eating' Trend Could Lead to Disordered Eating

Eating “clean” has never been trendier. People of all ages are increasingly focused on consuming balanced meals, increasing their protein and fiber intake, and cutting back on ultra-processed foods as more research highlights the impact of diet on health and disease risk.

On social media, videos with “clean” recipes and tips for avoiding processed foods abound, as many — young people in particular — move away from “junk” food and instead fill their plates with ingredients like Greek yogurt, chia seeds, salmon, and a plethora of fruits and veggies.

This is objectively a good thing.

Recent research suggests that a diet high in ultra-processed foods can increase your risk for a number of chronic diseases, including some cancers, heart disease, diabetes, mental health issues, and more. In contrast, a diet made up primarily of whole foods can reduce your risk of adverse health outcomes.

However, a preference for healthy eating can quickly become all-consuming and even veer into eating disorder territory, turning a healthy practice into something that is actually quite damaging.

So how do you know when it’s gone too far?

“Clean eating has been trending more recently — it is blowing up with influencers on Instagram and Tiktok, especially as people search recipes and the demand for that content rises,” says Alyson Curtis, LMHC, a mental health counselor who specializes in eating disorder recovery. “However, some people take it too far. Sometimes we even catch this in an influencer's video when they do a ‘day of eating’ and viewers pick up on under-eating.”

Signs ‘clean eating’ has gone too far

The signs that “clean eating” has become too extreme may be subtle, Curtis says, but there are things to look out for in yourself or in loved ones.

In her work with eating disorder patients, she says she always tries to determine the degree of intensity by asking: What percent of your daily thoughts are focused on food/your body?

“Many of my ED clients report upwards of 80%,” she says. “This lets me know that their fixation on their food intake and body image has gone to an unhealthy level.”

Other signs that habits have become disordered, according to licensed therapist Megan McConnell, LCSW, include:

• Spending excessive time thinking about, planning, or preparing what you are going to eat.
• Missing out on life experiences, like going out to eat with friends, because you fear there won’t be food you feel “safe” to eat.
• Eliminating entire food groups when it is not medically necessary to do so.
• Your diet becomes very limited because you are fixated on only eating foods that are "pure" or "natural."
• Experiencing anxiety if you find yourself in a situation where you don’t have access to the foods you deem healthy.
• Going hungry rather than eating “unhealthy” foods.
• Judging others or feeling superior to other people who you view to be making "unhealthy" food choices.

In these cases, McConnell explains, a focus on “clean eating” may have become orthorexia nervosa.

What is orthorexia?

While not yet listed as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders alongside other eating disorders, orthorexia is an eating disorder that has been clinically recognized since 1997, McConnell says. It refers to an obsession with eating only healthy foods, so much so that it interferes with an individual’s mental health, physical health, and daily life.

An example of orthorexia, according to Curtis, is as follows: A group of friends may go out to dinner, and someone who values clean eating but hasn't veered into dangerous territory will simply select food that feels the most nourishing to them while remaining open to trying anything else on the table.

“There is a flexibility there and the enjoyment of food beyond the function of fuel remains intact,” she explains.

On the other hand, someone with orthorexia may engage in behaviors like obsessing over the menu beforehand and analyzing what food item is the absolute "cleanest." When at the restaurant, the individual may not partake in any communal food sharing when invited to. They may present rigidly with an undertone of "need" and fear rather than fulfillment and joy for their food selections, she explains.

“I would add that friends or family should be concerned when the individual seems to be notably protective around their behaviors or relationship with food,” Curtis says. “Folks with EDs often develop a protectiveness around their relationship with food.”

How to support loved ones or find balance for yourself

If you’re concerned about a loved one, Curtis advises simply to check in. There is no one-size-fits-all approach, but she says checking in is the best first step.

“You can find your own organic way to do this and sometimes rehearsing in your head what you might say can help, but you can try something along the lines of, ‘Hey, how's your clean eating kick been going? It seems you're really immersed in it and I just wanted to check in,’” she says. “From there, you can see how they respond.”

If you suspect that you yourself may be suffering from orthorexia, seeking out therapy with a practitioner who specializes in eating disorder treatment is your best next step, McConnell says.

“It’s beautiful to have the desire to care for your body by eating healthy foods,” McConnell says. “It is important, however, to not become perfectionistic about this pursuit.”

Instead, she says you should aim to eat a wide variety of foods and ensure that this at least occasionally includes foods you eat just for fun or pleasure, regardless of their nutritional value.

“Further, be mindful that if your overall goal is health, creating stress for yourself around trying to maintain a ‘perfect’ diet is counter to that goal as stress is also damaging to health,” McConnell notes. “Maintaining flexibility and not overthinking food choices will allow you to avoid the stress trap.