The “eating clean” movement started as a way to wean people off a glut of processed foods stuffed with fats, sugars, and salt. Twenty years ago when the movement began to take shape, it was heralded for its healthy focus—choosing whole, natural unprocessed foods and avoiding highly processed ones.
But the movement began to become even more restrictive, banning gluten and dairy, and promoting only eating organic and raw foods. It was widely promoted in the media as the next best healthy diet, and social media glorified clean eating with stories of glamorous celebrities adopting the eating plan and by nonstop publishing diet success stories.
Efforts to “eat clean” became equated with inner morality, causing some people to let the “eating clean” diet movement turn into obsession. Finding the “right” foods began to take over some people’s lives, causing them to eat so restrictively it affected their physical and mental health.
When “clean eating” becomes an obsession, the medical community call it orthorexia, a concept coined by Dr. Steven Bratman in the 1990s. After meeting with patients with overly restrictive ‘healthy’ eating patterns, Bratman created the name orthorexia, borrowing from the Greek word ortho meaning “right” and the –orexia meaning “appetite.” Bratman said he created this name because he saw links between restrictive “clean eating” and the disordered patterns of anorexia nervosa in which patients starved themselves to be thin.
“People would think they should cut out all dairy and they should cut out all lentils, all wheat … And it dawned on me gradually that many of these patients, their primary problem was that they were … far too strict with themselves,” he said to NPR.
Nutritionists applaud people’s efforts to eat healthfully, but when clean eating negatively affects the quality of your life, impacting your ability to socially engage with others and be spontaneous, than it starts to become an eating disorder.
Sondra Kronberg, founder and executive director of the Eating Disorder Treatment Collaborative outside New York City, said to NPR: “In the case of orthorexia, it centers around eating ‘cleanly’ and purely, where the other eating disorders center around size and weight and a drive for thinness.”
Occasionally these problems overlap; some people make such effort to eat “clean” that they miss critical nutrients from foods or eat too few calories. “It could become a health hazard and ultimately, it can be fatal,” Kronberg said to NPR.
However, there could be a danger with equating orthorexia with other recognized eating disorders like anorexia nervosa and bulimia nervosa. While orthorexia is in a handful of scientific journals, the term has no common definition, standard diagnostic criteria, or other ways to measure its psychological impact. Currently it is not yet in the DSM—the Diagnostic and Statistical Manual of Mental Disorders, the primary reference for psychologists and psychiatrists.
Dr. S.E. Specter, a psychiatrist and nutrition scientist based in Beverly Hills who specializes in eating disorders, said to NPR: “I just think orthorexia is maybe a little bit too hard to pin down, or it’s looked at as a piece of the other related disorders — the eating disorders, obsessive compulsive disorder, and general anxiety disorder as well.” As such, it could be difficult to treat effectively.